Heatwave disasters in rural Australia : planning for an ageing population

Relevance: Heat-waves are increasing in frequency, intensity and duration due to global climate change, and account for more deaths in Australia than any other natural hazard. Research has identified the aged, and those living in residential aged care facilities (ACFs), at increased risk of heat-related morbidity and mortality. Rural Australia experiences high summer temperatures and is home to proportionally more elderly residents than urban settings. Rural ACF buildings are more likely to be older, or not 'purpose-built' compared to their urban counterparts. Aims: The study aims were to: 1) investigate current heat-wave planning policies and heat prevention strategies in urban and rural ACFs and 2) identify barriers to successful implementation of adequate heat-wave health care in rural and urban ACFs in three Australian states (NSW, Queensland and South Australia). Methods: Residential ACFs were identified across three states using Department of Health and Ageing databases, white pages and internet searching. Participating facilities were asked to provide informed consent and invited to nominate two staff members to participate in a 15 minute Computer Assisted Telephone Interview (CATI). Participants were asked to detail current plans and policies which addressed residents' heat-wave health, strategies used to keep residents well during periods of extreme heat and barriers to the implementation of heat-wave health care. Data was entered into a purpose-built database and analysed using Statistical Package for the Social Sciences (SPSS) Version 19. Results: One hundred and sixty eight rural ACFs participated in the study. Ninety per cent of facilities had a current ACF emergency plan, although only 30% included heat-wave emergency planning. Staff used a range of strategies to keep residents cool in extreme heat, although strategies were not consistent across all states or facilities. One third of rural ACFs in two states did not have air-conditioning, instead relying on other cooling methods such as fans and evaporative cooling. Barriers to heat-wave health included; poor building design, low staffing levels and poor cooling equipment. Conclusions: This study identifies the current policies and strategies rural ACFs use to keep residents well, and highlights the barriers to maintaining wellness in the residential aged during periods of extreme heat. As the Australian population ages, planning for the health effects of extreme heat in elderly rural residents is critical to ensure wellness in this population group is maintained.