Dear Long Term Care Facility Administrator: Heat Advisory

Date June 9, 2008
DAL DRS 08-06
Subject Heat Advisory

Dear Long Term Care Facility Administrator:

Summer is here and we can expect extended periods of high temperatures and humidity. Residents with a history of dehydration, cardiovascular and/or pulmonary disease are particularly susceptible to heat related illnesses and complications. By regulation, each operator must provide a program which promotes the social, physical, and mental well being of the residents. To assist you in meeting that goal, we are providing you with information and recommended procedures to prevent heat illness among your residents during the hot and humid weather.

  • Alert staff to the signs, symptoms and consequences of heat prostration, heat stroke and heat cramps.

Heat Prostration

Warning Signals

Gradual weakness, nausea, anxiety, excess sweating, syncope (fainting).

Appearance and Signs

Skin is pale, grayish and clammy.


For syncope: Place head down and administer cool, slightly salty fluids immediately.


May lead to loss of consciousness and/or circulatory failure.

Heat Stroke (Serious Emergency)

Warning Signals

Headache, weakness and sudden loss of consciousness.

Appearance and Signs

Hot, red, dry skin, little sweating, very high temperature and hard, rapid pulse.


Immediately cool skin by wrapping or immersing in cold water or ice. Call 911 or paramedics.

Heat Cramps

Warning Signals

Severe cramps and spasms in the arms, legs and/or abdomen.

Appearance and Signs

Skin may be hot and dry or cool and clammy depending on the humidity. The muscles feel like hard knots.


Provide cool fluids and foods containing sodium chloride (table salt).

  • Alert staff to monitor residents for the signs and symptoms of heat illness (listed above). Notify the physician of such observations and obtain medical services, if necessary.
  • Review resident medications and identify those that may cause residents to become more susceptible to heat and sunlight.
  • Assure that facility policies and procedures for heat emergency situations are current, complete, known to staff, and are carried out.
  • Use air circulating and air cooling equipment (window fans, floor fans, mechanical ventilation systems and air conditioners) to achieve and maintain air movement and air cooling within the facility, especially in resident rooms and resident use areas.
  • Monitor choice of resident's clothes that may be inappropriate in extreme temperatures such as too heavy or vapor-impermeable.
  • Protect against temperature elevations within the facility by closing window blinds and shades on sun exposed walls, opening windows on shaded walls and turning off heat generating devices, such as lights in the daytime.
  • Assure, through active encouragement and assistance when necessary, that residents maintain adequate fluid intake, e.g., water and fruit juices should be available. Alcohol should be avoided.
  • Adjust menus as needed, incorporating items such as cold plates, salads, etc. Consult with your dietician.
  • Encourage residents not to lie or sit in direct sunlight, e.g., if outside, encourage residents to sit in shaded areas.
  • Monitor residents engaging in physical activities. Discourage strenuous physical activity as appropriate.

Thank you in advance for taking precautions to assure the health and safety of your residents during the summer. If you have any questions, please call the Bureau of Quality Assurance and Surveillance for Nursing Homes at (518) 408-1282.


Mark Kissinger
Deputy Commissioner
Office of Long Term Care