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Posted: July 31, 2008

How Our Elderly Can Beat the Heat

Preventing Dehydration and Other Heat-Related Illnesses

Nearly everyone loves summer, and the Wisemans are no exception. Betty and Frank Wiseman of Shelby, Ohio, look forward to summer every year so they can get out in their garden. Last summer they had a scare, though. Betty, age 72, had been picking strawberries all afternoon in the sun when she began feeling poorly. She felt weak, as if she was going to faint. She barely made it back into the house.

Frank was alarmed at his wife’s condition and drove her to the local hospital emergency room. There, the doctor said Betty was suffering from heat exhaustion and mild dehydration. He gave her some IV fluids and sent her home with a warning: no more working in the sun all day. She needed to take breaks inside where it was cool, and make sure to drink more water.

Heat-related illnesses are serious business. Five years ago, in August of 2003, 14,802 people died during a heave wave in France. Several of the worst heat waves of the 20th Century occurred in the US, however. In 1955, 946 people died during eight blistering days in Los Angeles. In 1972, nearly 900 people died during a two-week heat wave in New York City. In 1995, an extreme heat wave in Chicago killed more than 700 people in a just a few days.

And with all of these crises, there was a common thread: the elderly were most often the most vulnerable victims of the heat’s grip.

In fact, overall the elderly and the ill are particularly vulnerable to summer’s heat. Under normal circumstances, our body temperature is 98.6 degrees. When exposed to extreme heat, our body tries to regulate our temperature by changing our circulation and by perspiring. In many elderly, circulation is not great to begin with. This may be especially true in people with conditions such as diabetes and heart problems. People with heart problems and other health conditions also may not sweat normally. These problems are made worse in high humidity.

There are a number of heat-related conditions to watch out for this summer while you and your loved ones are enjoying the sunny summer weather. You should note, though, that these illnesses don’t only occur from being out in the sun; they can occur from being inside an overly-warm home as well.

Dehydration

Dehydration is a common problem that occurs during extreme heat. It happens when a person loses more water than they take in. In hot weather, this water is generally lost through sweating.

One sign of dehydration is if someone stops sweating altogether. (It can also be a sign of heat stroke. We’ll talk about that in a minute). A person can still be sweating somewhat and be dehydrated, however. Thirst, dry mouth, weakness, and fatigue are other signs of dehydration.

As a caregiver, you can also check for dehydration by doing the “pinch test.rdquo; Gently pinch the skin on the arm of your loved one. If the pinched skin stays in place and doesn’t go back to normal right away, that is a sign of dehydration.

If your loved one shows signs of dehydration, they should get medical attention. While there are things you can do to try and prevent dehydration, once it occurs, home remedies are usually not enough. Intravenous fluids are often required to re-hydrate a dehydrated person.

Heat Exhaustion

Heat exhaustion is another common problem that can occur in hot summer weather. It occurs when someone’s body temperature begins to get too high. Heat exhaustion occurs when their internal temperature is usually over 100 degrees, but less than 105.

Signs of heat exhaustion include profuse sweating, muscle cramps, weakness, dizziness, nausea, and thirst. A person may also feel as if they are going to faint.

Heat exhaustion can usually be treated at home. If your loved one shows signs of heat exhaustion, get them into a cool place and give them something cool to drink. Avoid drinks with caffeine. Try applying cool compresses to the skin. If symptoms don’t improve with home treatment, you’ll need to seek medical care.

Heat Stroke

Heat stroke is another thing altogether. It occurs when someone’s body temperature gets dangerously high, 105 degrees or higher. It can be deadly.

Signs of heat stroke include unconsciousness or a very confused mental state (possibly including hallucinations) and hot, dry skin. The skin becomes dry because the person stops sweating.

Heat stroke cannot be treated at home. If your loved one shows signs of heat stroke, you need to call 911 right away. While you are waiting for help to arrive, you should get your loved one into a cool place and apply cool compresses to the skin.

Staying Safe

Remember what Betty’s doctor said -- if you’re going to be out in the sun, take breaks and cool off indoors. And make sure to drink plenty of water. Try to drink a glass of water every hour while outdoors in the sun.

If your loved ones don’t have air conditioning, make sure they have fans. On particularly hot and humid days, help them find cool places to go. Shopping malls, public libraries, and movie theatres are all places I used to hang out when I lived in an apartment without air conditioning.

Don’t exercise outdoors – even long walks -- in hot weather. This raises your body temperature too high and puts you at risk for heat exhaustion and heat stroke. Exercise indoors where it is cool, or exercise outdoors early in the morning or in the evening when it is not so hot.

Beware of swimming pools. You feel cool because the water’s cool, and you probably won’t get heat exhaustion or heat stroke because the cool water will keep your body temperature down. But you’ll still need to drink plenty of water to prevent dehydration.

While we’re speaking of exercising outdoors, that applies to working outdoors as well, even household chores. If possible, do outdoor work in the morning or evening when it’s cooler. Betty could pick her strawberries in the morning instead of in the afternoon to reduce her risk of heat-related illness.

Finally, check on your elderly loved ones frequently during especially hot, humid weather. Also educate them about heat-related illness and how to stay safe. Don’t hesitate to seek medical attention if in doubt. It’s better to be safe than sorry.

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Kelly Morris is a former social worker and home health and hospice worker whose writing has appeared in a number of health-related journals. She lives in Mansfield, Ohio, and can be reached at multihearts@hotmail.com.

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