Advice for older people on staying safe in hot weather

Risk of heat-related health problems increases with age

Summer weather can pose special health risks to older adults and people with chronic medical conditions. It is critically important that adults particularly susceptible to hyperthermia and other heat-related illnesses know how to safeguard against problems. The National Institute on Aging (NIA), part of the National Institutes of Health, has some tips to help avoid the hazards of hot weather.

Hyperthermia is caused by a failure of the heat-regulating mechanisms of the body. Heat fatigue, heat syncope (sudden dizziness after prolonged exposure to the heat), heat cramps, heat exhaustion and heatstroke are forms of hyperthermia. Older adults are at risk for these conditions, and this risk can increase with the combination of higher temperature, individual lifestyle and general health.

Lifestyle factors can include not drinking enough fluids, living in housing without air conditioning, lack of mobility and access to transportation, overdressing, visiting overcrowded places and not understanding how to respond to hot weather conditions. Older people, particularly those with chronic medical conditions, should stay indoors in cooler spaces on hot and humid days, especially when an air pollution alert is in effect. People without air conditioners should go to places that do have air conditioning, such as senior centers, shopping malls, movie theaters and libraries. Cooling centers, which may be set up by local public health agencies, religious groups and social service organizations in many communities, are another option.

Factors that increase the risk of hyperthermia may include:

• Dehydration.
• High blood pressure or other health conditions that require changes in diet. For example, people on salt-restricted diets may be at increased risk. However, salt pills should not be used without first consulting a doctor.
• Heart, lung and kidney diseases, as well as any illness that causes general weakness or fever.
• Use of multiple medications. It is important, however, to continue to take prescribed medication and discuss possible problems with a physician.
• Reduced sweating, caused by medications such as diuretics, sedatives, tranquilizers and certain heart and blood pressure drugs.
• Age-related changes to the skin such as poor blood circulation and inefficient sweat glands.
• Being substantially overweight or underweight.
• Alcohol use.

Heat stroke is a life-threatening form of hyperthermia. It occurs when the body is overwhelmed by heat and unable to control its temperature. Signs and symptoms of heat stroke include a significant increase in body temperature (generally above 104 degrees Fahrenheit), changes in mental status (like confusion or combativeness), strong rapid pulse, lack of sweating, dry flushed skin, feeling faint, staggering or coma. Seek immediate emergency medical attention for a person with heat stroke symptoms, especially an older adult.

If you suspect that someone is suffering from a heat-related illness:

• Get the person out of the heat and into a shady, air-conditioned or other cool place. Urge them to lie down.
• If you suspect heat stroke, call 911.
• Encourage the individual to shower, bathe or sponge off with cool water if it is safe to do so.
• Apply a cold, wet cloth to the wrists, neck, armpits, and/or groin. These are places where blood passes close to the surface of the skin, and the cold cloths can help cool the blood.
• If the person can swallow safely, offer fluids such as water, fruit and vegetable juices. Avoid alcohol and caffeine.

The Low Income Home Energy Assistance Program (LIHEAP) within the Administration for Children and Families in the U.S. Department of Health and Human Services helps eligible households pay for home cooling and heating costs. People interested in applying for assistance should contact their local or state LIHEAP agency or go to http://www.acf.hhs.gov/programs/ocs/liheap .

Hyperthermia Danger

During the summer, it is important for everyone, especially older adults and people with chronic medical conditions, to be aware of the dangers of hyperthermia. The National Institute on Aging (NIA), part of the NIH, has some tips to help mitigate some of the dangers.

Hyperthermia is an abnormally high body temperature caused by a failure of the heat-regulating mechanisms in the body to deal with the heat coming from the environment. Heat stroke, heat syncope (sudden dizziness after prolonged exposure to the heat), heat cramps, heat exhaustion and heat fatigue are common forms of hyperthermia. People can be at increased risk for these conditions, depending on the combination of outside temperature, their general health and individual lifestyle.

Older people, particularly those with chronic medical conditions, should stay indoors, preferably with air conditioning or at least a fan and air circulation, on hot and humid days, especially when an air pollution alert is in effect. Living in housing without air conditioning, not drinking enough fluids, not understanding how to respond to the weather conditions, lack of mobility and access to transportation, overdressing and visiting overcrowded places are all lifestyle factors that can increase the risk for hyperthermia.

People without air conditioners should go to places that do have air conditioning, such as senior centers, shopping malls, movie theaters and libraries. Cooling centers, which may be set up by local public health agencies, religious groups and social service organizations in many communities, are another option.

The risk for hyperthermia may increase from:

• Age-related changes to the skin such as poor blood circulation and inefficient sweat glands

• Alcohol use
• Being substantially overweight or underweight
• Dehydration
• Heart, lung and kidney diseases, as well as any illness that causes general weakness or fever
• High blood pressure or other health conditions that require changes in diet. For example, people on salt-restricted diets may be at increased risk. However, salt pills should not be used without first consulting a physician.
• Reduced perspiration,caused by medications such as diuretics, sedatives, tranquilizers and certain heart and blood pressure drugs
• Use of multiple medications. It is important, however, to continue to take prescribed medication and discuss possible problems with a physician.

Heat stroke is a life-threatening form of hyperthermia. It occurs when the body is overwhelmed by heat and is unable to control its temperature. Heat stroke occurs when someone’s body temperature increases significantly (above 104 degrees Fahrenheit) and shows symptoms of the following: strong rapid pulse, lack of sweating, dry flushed skin, mental status changes (like combativeness or confusion), staggering, faintness or coma. Seek immediate emergency medical attention for a person with any of these symptoms, especially an older adult.

If you suspect someone is suffering from a heat-related illness:

• Get the person out of the heat and into a shady, air-conditioned or other cool place. Urge the person to lie down.
• If you suspect heat stroke, call 911.
• Apply a cold, wet cloth to the wrists, neck, armpits and/or groin. These are places where blood passes close to the surface of the skin, and the cold cloths can help cool the blood.
• Help the individual to bathe or sponge off with cool water.
• If the person can swallow safely, offer fluids such as water or fruit and vegetable juices, but avoid alcohol and caffeine.

The Low Income Home Energy Assistance Program (LIHEAP) within the Administration for Children and Families in the U.S. Department of Health and Human Services helps eligible households pay for home cooling and heating costs. People interested in applying for assistance should contact their local or state LIHEAP agency or go to http://www.acf.hhs.gov/programs/ocs/liheap .