If you are reading this with someone in front of you who is unwell in the heat, here is the short version. Heat exhaustion means someone is very hot, sweating heavily, dizzy or feeling sick; it usually settles within about 30 minutes once you cool them down, and it does not normally need a hospital. Heatstroke is different and far more serious: hot skin that has stopped sweating, a very high temperature, confusion, a fit, or not responding are all signs of heatstroke, and per NHS guidance that means calling 999 straight away.

I know that most people reading this are not doing so out of curiosity. You are worried, you are looking at your mum or your dad, and you need to know what to do in the next five minutes rather than the next five paragraphs. So we have written this the way we would want it written for our own family: the answer first, the detail after. Read on when you have a moment, because knowing the difference is something our carers keep an eye on every hot day across Kent, and it can genuinely change what happens next.

Heat Exhaustion: The Signs, and Why It Usually Settles at Home

NHS guidance describes heat exhaustion as the body's response to losing too much water and salt, usually through sweating in the heat. The signs to look for are tiredness, dizziness, a headache, feeling sick or being sick, heavy sweating with skin that turns pale and clammy, cramps in the arms, legs or stomach, a fast pulse or fast breathing, and a temperature of 38C or above. Someone with heat exhaustion is usually still sweating, still responsive, and able to tell you how they feel, even if they feel wretched.

The reassuring part of NHS guidance is that heat exhaustion, treated promptly, usually gets better within about 30 minutes. It is not yet an emergency. It is a clear signal to act quickly and calmly, and in nearly every case, cooling someone down properly is all that is needed.

The Four Steps NHS Guidance Recommends

If you think someone has heat exhaustion, NHS guidance sets out what to do, in this order:

• Move them somewhere cool, and get them lying down with their legs raised and supported.
• Get them to drink plenty of water. A sports or rehydration drink is fine too.
• Cool their skin: sponge or spray them with cool water and fan them if you can. Cold packs around the armpits or neck can help.
• Loosen any tight clothing.

Stay with them. NHS guidance is clear that if they are not feeling better within 30 minutes, you should call 999, because heat exhaustion can turn into heatstroke if it is not treated.

Heatstroke: The Red Flags That Mean 999

Heatstroke is what happens when the body can no longer cool itself down. NHS guidance lists the signs to treat as an emergency: a very high temperature, 40C or above; hot skin that is not sweating even though the person feels unbearably hot; a fast heartbeat; fast breathing or shortness of breath; confusion and a lack of coordination; a fit or seizure; and loss of consciousness or not responding.

If you see any of these, call 999 immediately. Do not wait to see whether things improve. Tell the call handler clearly that you think it might be heatstroke; it helps them get the right response to you quickly.

Why Older People Tip From One to the Other Faster

UKHSA guidance is clear that older people are at greater risk in hot weather, and the reasons make sense once you know them. The body's ability to sweat and regulate its own temperature reduces with age. Thirst signals become less reliable, so someone can already be short of fluid before they feel thirsty at all. Many common medications, for conditions like heart disease, high blood pressure or dementia, can affect how the body copes with heat and fluid, which is exactly why a GP or pharmacist, not us, is the right person to ask about any medication and hot weather. On top of that, reduced mobility can mean someone cannot easily move to a cooler room or reach a drink on their own.

Put those together and you can see why an older person can go from feeling a bit under the weather to genuinely poorly far faster than a younger, fitter person would, and why watching early rather than waiting matters so much.

What to Do While You Wait for the Ambulance

Once you have called 999, keep going with the cooling steps above. Move the person to shade or a cool room if you have not already. Keep sponging or fanning their skin. If they are conscious, alert, and able to swallow safely, keep offering small sips of cool water. Do not leave them alone, and keep talking to them so you can tell the ambulance crew if anything changes before help arrives.

If They Are Not Fully Conscious

Do not try to give a confused, drowsy or unresponsive person anything to drink or eat. If they are not responding but are still breathing normally, put them in the recovery position and stay close until the ambulance arrives.

If someone's heat exhaustion is not improving but they do not have any of the heatstroke signs above, you can call 111 or get help from 111 online for advice. If in any doubt at all, 999 is always the safer call.

This Is What Our Team Watches For, Every Hot Day

Most of our care visits are not about doing things for people. A big part of good care is stepping back and encouraging someone to manage as much as they safely can for themselves; that promotes independence, not the other way round. But hot weather is one of the times we watch a little closer rather than a little less, because the early signs of heat exhaustion are easy for a busy family to miss and easier for us to catch, simply because we are there, in the room, day after day.

We are not clinicians and we never try to be. What we can do, as a home care and live-in care provider working across Kent, is notice when someone seems more tired than usual on a warm afternoon, make sure a drink is actually within reach and not just left on the side, and know exactly when a phone call to a family member or a GP is the sensible next step. If your family is working out how to keep a relative safe through a Kent summer, whether that is a few domiciliary care visits a day, live-in care, or support through a supported living setting, we are happy to talk it through with you.

In Short

Heat exhaustion: hot, sweaty, dizzy, usually better within 30 minutes of cooling down. Heatstroke: hot skin that has stopped sweating, confusion, a fit, or not responding, and it means 999, now. If you are ever unsure whether someone's heat exhaustion is improving, call 111 or get help from 111 online; if you see any sign of heatstroke, do not wait, call 999.

For you, with you: that is as true on a hot July afternoon as it is on any other day. If you would like to talk to us about care for a relative in Kent, get in touch with our Gravesend team.