The continuing risk of domestic hot water scalds to the elderly

Elderly people are particularly at risk of accidents in the home and with an ageing population, they constitute a large proportion of scald victims. We have seen several elderly patients every year in our own unit who had sustained domestic hot water burns. We decided to ascertain the temperature of water in the private homes of elderly people and in residential care homes in our community. Twenty-five private homes and 14 residential care homes were visited and peak water temperatures were measured in the kitchens and bathrooms. Only one private home and one residential home had water below 45°C. It is recommended that water should be delivered at less than 43°C. We conclude that water is dangerously hot. However, if water is stored at a temperature of less than 60°C there is a risk of infection with Legionella pneumophila. Existing regulations governing the use of ‘fail safe’ thermostatic mixing devices must be enforced and extended to cover domestic hot water systems.