The frequency, intensity and duration of heat waves affecting the UK (and other parts of the world) is set to increase as the climate changes with potentially serious implications for future heat-related mortality. Epidemiological research has shown that in England and Wales older people in nursing and residential homes are among those most vulnerable to the impacts of hot weather. It is argued that there is a real need to deepen the understanding of the everyday settings in which people experience heat wave conditions and the ways in which various social, cultural, institutional, and infrastructural considerations may contribute to creating vulnerability and limiting the possibilities of short- or long-term adaptation. Epidemiological evidence is reviewed to establish who is vulnerable in hot weather. This is followed by an examination of how an ethnographic and qualitative approach can be used to provide a deeper insight into how those vulnerabilities are constructed. The provisional findings of a small pilot study are presented, along with a number of the problems encountered, in order to demonstrate the type of data that can be accessed through a qualitative methodology, and how the routines and practices of everyday life may be implicated in the reproduction of vulnerability. This is a first step in understanding and developing processes of adaptation that can provide alternatives to dependency on technical cooling solutions.