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QUESTIONNAIRE TO HELP YOU PREPARE FOR HEAT WAVES

Extremely hot weather can be dangerous. It can make medical conditions worse or cause serious heat-related illnesses. Staying hydrated, keeping cool, and having support can greatly lower everyone’s risk. When you’re well-prepared, you and those you care for can stay safe.

Please answer the following questions. When you’re finished, a personalized Spring To-Do List and a Heat Safety Plan will be created that will help you be prepared and protected during heat events.

Note: Information gathered in this questionnaire is used for educational purposes only. Any information entered in this form is strictly used to generate your personalized Heat Safety Plan for you to print and keep for your records. No private information is collected or stored.


Creating a Support Group of Check-in Companions


It’s very important to have a support network of nearby “Check-in Companions” – such as friends, family, or neighbours – that you can be in touch with and who can check in on you during extreme heat events (also known as heat waves) or other emergencies. 

Do you live alone?
Do you have nearby neighbours, friends or family you can call – or who can call you or check in on you – during a heat event or other emergency?

Think about who you can ask to be a “Check-in Companion” for you during heat events or other emergencies. Ideally this person or people should live or work nearby.
Don’t hesitate to say that your doctor asked you to set up a Check-in Companions group.

Do you know someone nearby who might be at risk during a heat event, that you could be a Check-in Companion for? In other words, someone who might benefit from staying in touch with you during a heat event?

Transportation

Do you have a car or access to other transportation?
Do you have someone that can drive you to a cool place or to the hospital during a heat wave?

It is recommended to call 211 or your municipality to find out what local transportation options are available during a heat wave. You may also want to discuss transportation options with a family member.

Medication

Are you on any medications that could increase your risk during a heat wave?

Check with your pharmacist about medications that could increase your risk during a heat wave and follow their advice about how to manage that risk.

Check with your pharmacist whether you are on any medications that could increase your risk during a heat wave and follow their advice about how to manage that risk.

For example: 

  • Beta blockers
  • Antiplatelet medications
  • Diuretics
  • Anticholinergics (some allergy medications, sleep aids, muscle relaxants, incontinence medications, gastrointestinal medications, respiratory medications, opioids)
  • Cholinesterase inhibitors for dementia
  • Antipsychotic/neuroleptic medications 
  • Stimulant medications used for ADHD
  • Antidepressants (particularly tricyclic antidepressants and SSRIs)
  • Antiepileptic and antiseizure medications
  • Antiparkinsonian medications
  • Thyroid medications
  • ACE inhibitors and ACE receptor blockers
  • Vasodilators 
  • Non-steroidal anti-inflammatory medications (NSAIDs)
  • Certain antibiotics 

Mobility Concerns

Do you have mobility concerns? For example, difficulties with getting to a cooler area of your home by yourself, or with taking a shower/bath?

Air Conditioning/Fans

Do you have an Air Conditioner (AC)?

Check to make sure your AC is in working condition.

Consider buying an AC, or if you can’t afford one, reach out to a local agency that may be able to help you with the cost of getting a portable AC. (A link to a list of agencies is available in your Spring To-Do List at the end of this questionnaire.)

If you don’t have AC, or if your AC stops working, it’s important to have a plan to go to a place with AC to cool down during a heat wave. Which of the following are available and accessible to you?

If you don’t know where you can go to cool down during an extreme heat event, you can call 211 for help and information. 211 is a 24-hour helpline that can connect you to local social services, programs and community supports.

Do you have one or more fans?

Make sure your fans are easily accessible so you can pull them out when needed.

Consider buying a fan, or if can't afford one, reach out to a local agency that may be able to help you with the cost of getting a fan. (A link to a list of agencies is available in your Spring To-Do List at the end of this questionnaire.)

Window Coverings

Do you have blinds, curtains or shutters to cover your windows during extreme heat?

Arrange to buy, make, or get window coverings to block sunlight and keep your home cooler during extreme heat. A low-cost option is covering windows with cardboard or blankets.

Indoor Thermometer

Do you have an indoor thermometer so you can monitor your indoor temperature?

Arrange to buy or get an indoor thermometer (available at most hardware stores).

Flashlight or Battery Operated Lamp

Do you have a flashlight or battery operated lamp for power outages?

Get a flashlight and/or battery powered lamp and keep it in an easily accessible place in your home.

Personal Supplies

Do you have an oral or ear thermometer so you can monitor your body temperature?

Get an oral or ear thermometer.

Do you have light, loose-fitting clothing that you can wear when there is a heat wave?

Arrange to get some light, loose-fitting clothing at a store or thrift shop.

Do you have a spray bottle?

Consider getting an inexpensive spray bottle, so that you can mist yourself with water when you’re hot.

Do you have a water bottle?

Get a water bottle that you can take with you if you have to go outdoors during a heat wave.

Fasting

During the summer, do you fast as a religious practice?

Ask your religious leader if accommodations can be made to stay hydrated on days when there is a heat event.

Do you fast as a dietary practice?

If you fast, make sure you stay hydrated. It is not safe to restrict your water intake during a heat wave.

Drinking Water

Do you rely on bottled water instead of tap water?

Make sure you are always well stocked with bottled water.

Power Outages

Power outages sometimes occur during heat waves. Do you have an emergency plan if there is a power outage?
If you have a cell phone, do you have a portable power bank or solar charger that you can use to keep it charged during a power outage?

Consider getting a portable power bank or solar charger for your cell phone.

Thank you for completing the heat safety questionnaire. After providing your email, please click SUBMIT. Your personalized Spring To-Do List and Heat Safety Plan will be created after submitting.

Your name and email will only be used to retrieve this form if you need to modify the questionnaire and to receive a new personalized Spring To-Do List and Heat Safety Plan.

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