Hot Weather is Coming!

When temperatures rise, will you know how to recognize the signs and symptoms of heat-related illness in elderly loved ones?

If you’re caring for elderly loved ones, it’s important to know the facts about heat-related illnesses.
People age 65 and older are more prone to heat stress than younger people, according to Lisa Krzyzewski, an elder care coordinator at McNamara Law Firm, PC, a Life Care Planning Law Firm in Valencia, California. “Older people don’t adjust as well to sudden changes in temperature,” said Lisa, a nurse who has worked in skilled nursing, hospital, home health, and hospice settings. “They are more likely to have a chronic medical condition that changes normal body responses to heat and they are more likely to take prescription medicines that impair the body's ability to regulate its temperature or that inhibit perspiration.”

What are heat-related illnesses? Heat stroke, the most serious, occurs when the body’s internal thermostat fails. The person’s temperature rises rapidly, the body loses its ability to sweat, and it is unable to cool down. Skin is red, hot, and dry. The pulse is rapid and strong. A throbbing headache, dizziness, and nausea are also common. Body temperatures can rise to 106°F or higher within 10 to 15 minutes, causing death or permanent disability if emergency treatment is not provided.

More common among elders is heat exhaustion, a milder form of heat-related illness that can develop after several days of exposure to high temperatures and inadequate replacement of fluids. Symptoms include heavy sweating, muscle cramps, fatigue, weakness, dizziness, headache, nausea, and fainting. Skin may be cool and moist, the pulse may be fast and weak, and breathing may be fast and shallow. 
Dementia affects the body’s ability to regulate its temperature, which can heighten the impact of heat-related illnesses. Caregivers will often overdress a loved one, making things worse. “If patients are wearing three layers of clothes in the summer, I ask their caregivers to remove a layer,” said Lisa. “It’s best to dress dementia patients as you normally would for the season.”

If you are an elderly loved one’s first line of defense from heat-related stress, what should you do?

Visit at least twice a day, watching for signs of heat exhaustion or heat stroke, especially if your loved one has mild cognitive impairment (MCI) or is in the early stages of dementia. If you have cause for concern, check to see if their cooling system is functioning, keeping in mind that some older adults confuse the heat and cooling settings. If their living space is too warm or their system isn’t working, arrange for them to go to a cooled space.

Make sure they are drinking enough water. Many older adults don’t, especially those with dementia. “Shoot for a sip or two every few minutes,” counseled Lisa, who noted that many dementia patients can’t tolerate water in larger doses. “Some demented patients forget they need water. Others can’t remember how to lift a glass and drink. They are totally dependent on their caregivers to stay hydrated.”

If your elderly loved one refuses to drink, adding a packet of flavoring may make the water more palatable. Gatorade is another option that works well. “Just be careful not to put your love one into fluid overload,” said Lisa, adding that the elder’s physician will be key in helping you strike the balance. 

Heat-related illnesses in older adults often result in a trip to the emergency room or a hospital stay. Both can lead to hospital trauma which can accelerate behavior changes in a geriatric or dementia patient who would otherwise be cognitively stable at home. “It can take weeks to come out of this fog,” added Lisa. “Prevention is always the best medicine.”