Workers in aged care face a raft of challenges in the provision of quality care, including understaffing, time pressures, and high turnover of staff. As COVID-19 made clear, care workers also perform essential work that places them at the frontline of public health crises. Rising temperatures as a result of climate change present an additional challenge for care workers responsible for people who are particularly vulnerable to the effects of high heat.
Based on preliminary analysis of our interview data, heat stress presents a growing challenge for workplace health and safety in care work. Workers reported that the physical nature of the work, time pressure to complete tasks and travel between clients, as well as long periods of time spent in their cars without air conditioning, all compounded the impacts of high heat. Caring for elderly people when it’s too hot to work places a large responsibility on workers that can put them at risk of heat stress.
Due to current funding arrangements, understaffing, and the nature of the work, home care work is both solitary and subject to significant time pressures. Workers frequently mentioned that they did not have enough time to complete tasks, including physically demanding labour, and travel to their next client in the time allocated. Strategies for dealing with this time squeeze included taking fewer or no breaks, drinking less water and rushing to and from clients homes. On very hot days the effects of physically demanding labour such as cleaning, hanging laundry outside, and showering people included dehydration, headaches and fatigue. Workers noted that some clients do have or prefer not to run air conditioning, likely due to the cost, which greatly increased the experience of heat stress. Some participants also noted that the demographics of home care workers include a high number of people experiencing the symptoms of menopause, which may make it even more difficult to perform work in the time allocated on very hot days. Another common issue was the provision of uniforms with fabric that does not breathe well, causing increased perspiration and discomfort on hot days. Some workers have been involved in a push for new uniforms with breathable fabric to deal with this issue.
For many of the people we interviewed, the car was the place they experienced the highest temperatures at work. Some workers were able to run air conditioning, but didn’t have time to let their car cool down adequately before they needed to rush to the next home. Others avoided using the air conditioning, even while waiting long periods in their car between shifts, because the cost was deemed ‘prohibitive’. Having no shared base or home office means home care workers spend a lot of time alone in their cars on very hot days, and this is a significant risk for heat stress. Despite these risks, safety notices from management were mostly related to manual handling, and when the potential risks of heat stress were discussed, the focus was on clients, rather than workers. Strategies for coping with heat included wearing a cool towel around their neck, parking in the shade and drinking extra water, but these were widely viewed as inadequate on very hot days. There were also concerns about a lack of planning for future bushfires or heat waves, with one participant noting:
If it gets to the point where workers can’t safely go out during the summer, how are we going to look after people in their homes if we can’t even leave our own homes because it’s too hot? So I don’t think anybody’s actually really thought that far ahead.
Home care workers attempting to provide quality care are potentially at risk of heat stress due to time pressures and the nature of the work involving physically demanding tasks and time spent in the car. Addressing these challenges requires changes to funding and staffing models for home care, taking into account the experiences of workers who are attempting to cope with high heat. It also involved ensuring those on low incomes can afford to cool their houses in hot weather, for the health and wellbeing of themselves and those that provide home care.