Heat preparedness in health and social care institutions and care units

Who are the instructions for?

This guideline is intended for social and health care professionals working in units that provide around‑the‑clock care services (hospitals and primary health care inpatient wards, care homes, and assisted living facilities).

Heatwaves and overheating of facilities caused by hot weather pose a significant risk in social and health care institutions and care units, as older adults, people with chronic illnesses, and patients with severe acute conditions are particularly sensitive to the adverse effects of heat. This guideline explains how health care institutions and care units can prevent health and wellbeing problems caused by heatwaves through proactive planning and preparedness measures implemented during hot periods.

Preparing in advance

• Assess the health risks caused by heatwaves: Which wards and rooms are most prone to overheating? In which wards and rooms are the patients or residents who are most sensitive to the effects of heat located?
• Install thermometers in patient or resident rooms, procedure rooms, medication and care supply storage areas, as well as in common lounges and waiting areas to monitor temperature and, if needed, humidity.
• Ensure that windows can be opened when necessary (if the ventilation system permits) and shaded using light‑colored blinds or curtains. Heat gain can also be reduced with window‑mounted solar protection film, exterior awnings, or shading vegetation.
• If patient or resident rooms tend to heat up easily, establish dedicated cool spaces where the temperature consistently remains below 25°C. Make the necessary adjustments and procure equipment for keeping these spaces cool well in advance (e.g., solar window protection, portable cooling units).
• Plan preparedness measures for heatwaves, assign responsibilities, and provide staff with clear instructions. Ensure the guidelines cover monitoring room temperatures and, when necessary, humidity; measures for cooling down the rooms; establishing and using dedicated cool spaces; identifying heat‑vulnerable patients or residents and prioritizing protection measures for them if needed; regularly monitoring the condition of patients or residents; providing necessary care to patients or residents to prevent heat‑related harm; and ensuring wellbeing and safety of the staff. Also consider ways to quickly increase staffing levels if needed.
• Train and instruct staff on heat preparedness measures in advance and at the beginning of the warm season.
• Monitor weather forecasts and heat warnings during the summer and take action in good time.
  • Warnings (Finnish Meteorological Institute)
  • Warnings on hot and cold weather (Finnish Meteorological Institute)

Measures during heatwaves

• The Finnish Meteorological Institute issues a heat warning when the forecast predicts that the daily maximum temperature will reach 27°C and the mean temperature 20°C. However, protection from heat and sunlight should be considered already at lower temperatures. Preparedness measures should be taken whenever indoor temperatures rise above normal levels.
• Inform staff about the heat warning and remind them of practices and preparedness instructions related to hot weather.
• Ensure that fluids and other necessary supplies are sufficiently available.
• Monitor room temperatures in the morning, during the day, and late in the evening.
• Identify patients or residents who are particularly vulnerable to the adverse effects of heat and, if necessary, prioritise protection measures.
  Risk Groups
• Aim to prevent temperatures from rising in patient or resident rooms, treatment rooms, medicine and supply storage areas, as well as in common areas and waiting areas. Shade sun-facing windows with blinds or curtains, keep windows closed during the day when outdoor air is warmer than indoor air, switch off unnecessary lights and electrical devices, and ventilate the premises in the evening/night using cross‑ventilation or by boosting mechanical ventilation. If possible, use air conditioning.
• Fans can provide relief if the indoor temperature is below 35 °C. Since a fan does not cool the air, at higher temperatures it causes more harm than benefit. In excessive heat, a fan increases the body’s heat load. A fan also increases fluid evaporation from the skin, so it should not be placed right next to the patient or blowing directly on the skin. A suitable placement is one where the fan does not blow air directly from one person to another.
• If necessary, cool at least some patient or resident areas below 25°C. Move the most heat‑sensitive individuals to cool rooms for at least a few hours a day. Care facilities should also have common cool spaces where more independent patients or residents can go on their own.
• Regularly monitor patients’ or residents’ hydration and overall wellbeing. In addition to fluid balance and worsening of disease symptoms, monitor body temperature, heart rate, and blood pressure. Adjust medications that affect thermoregulation according to doctor’s instructions. Cool down the body if needed, for example with cool showers or cold packs.
  Heat Illnesses
• Ensure that patients or residents wear light, loose‑fitting clothing and bedding made of natural materials such as cotton.
• Avoid unnecessary physical exertion, as well as outdoor activities during the hottest part of the day. When outdoors, stay in the shade.
• Use special consideration when discharging a patient or resident if their condition may significantly worsen due to heat, if their home heats up easily, or if assistance is not available at home.
• Increase staffing if preparedness measures require it. If needed, consider postponing non‑urgent activities.
• The use of personal protective equipment may increase the risk of heat‑related health effects among health and social care workers. More information on working in hot conditions and related protective measures is available on the Finnish Institute of Occupational Health website.
  Working in Hot Conditions (Finnish Institute of Occupational Health, in Finnish)

Action limits for high indoor temperatures under the Housing Health Decree

Under the Housing Health Decree (545/2015), action limits have been set for indoor temperatures. Outside the heating season, the action limit for high indoor temperature in assisted living facilities, nursing homes and similar facilities is 30°C.

If the action limit is exceeded, the party responsible for the nuisance must take measures to evaluate the potential health hazard and, if necessary, remove or reduce it. In problem situations contact the property owner and, if needed, the municipal health protection authority.

It is important to note that the action limits set in the Housing Health Decree are not health-based values. Serious health effects may occur even at temperatures that are considered acceptable under the decree. Therefore, preparedness measures should be taken whenever indoor temperatures rise above typical room temperatures.

Housing Health Decree (Ministry of Social Affairs and Health Decree 545/2015)

Guidelines for the application of the Housing Health Decree (PDF, available for download on the Finnish Supervisory Agency’s website, in Finnish)