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More and longer heatwaves can be expected in Germany as aconsequence of climate change. Older persons are predominantly threatened with the associated health-related problems and premature death. So far, heat action plans have failed to prevent excess mortality. Therefore, new approaches of prevention must be found.General practitioner, ambulant care, hospital, and nursing home settings were investigated in aproject funded by the German ministry of health. Workshops were conducted and the results are presented here.Sufficient knowledge and continuous care are available in hospitals and nursing homes. The basic challenge for general practitioners and ambulatory caregivers is to provide appropriate care for older persons living alone and in need of help. Proactive care during extremely hot days cannot be provided due to staff shortages. Experience from other countries indicates that anew course of action must be found. The main tasks of general practitioners should be the identification and consultation of persons at risk. Experience from previous years have demonstrated that formal structures of nursing and medical care alone failed to prevent the recurrence of acatastrophe caused by aheatwave and that human loss is substantial.Apossible approach could be volunteer-based disaster protection, which is well-developed in Germany. After proclamation of amajor (heat) disaster in the community, close cooperation with general practitioners would be essential. Aregistry of persons at health risk from heat waves would also be essential. The feasibility and effectiveness of the suggested approach should be tested and ultimately regulated at apolitical level.