2003-09-19 / Community

Elderly Affected By Heat-Related Illnesses

Elderly Affected By Heat-Related Illnesses

Though the recent blackout may have been an inconvenience, the temporary loss of power did serve to highlight the dangers of prolonged heat exposure. Cases of heat-related illnesses soar with summer’s high temperatures and thick, humid air.

In fact, the National Institute of Aging estimates that 200 people die each year because of heat-related illnesses (grouped under the term "hyperthermia"). Those most at risk are the elderly – especially those who live alone – who suffer from the heat in disproportionately large numbers.

The most severe form of hyperthermia is heat stroke, which can cause permanent disability through brain damage and become life threatening if not treated promptly. Heat stroke occurs when the body becomes unable to control its own temperature, which may rise rapidly to 106 degrees.

As people get older, they lose some of the mechanisms of compensation to protect against the heat," said Jesse Roth, M.D., FACP, geriatrician-in-chief at the North Shore-Long Island Jewish Health System. "They don’t get thirsty as easily, so they tend not to drink enough. Their bodies have more difficulty regulating temperature, and sometimes they have a lower level of awareness of their own needs."

Obesity, mental illness, poor circulation, sunburn, prescription drugs, high blood pressure, heart or lung disease, fever, dehydration and alcoholic beverages can further increase the risk. And as we all learned recently, power outages contribute to the problem by taking away the relief of air conditioning, fans, and other cooling methods. Losing power also disrupts the regular social support system many elderly people rely on.

Dr. Roth urges people to use a "buddy system" to check up on an elderly relative, friend or neighbor who lives alone. He said it is critical to make sure there is always someone who will call or visit the person at risk – once or twice a day, every day, during very hot weather. If one visitor goes on vacation or is otherwise unavailable, there should be a designated backup.

How can you tell if a person is coming down with heat stroke or heat exhaustion? Among the warning signs of heat stroke are red, hot, dry skin and inappropriately diminished sweating; a body temperature of 101 degrees or higher; confusion; a rapid, strong pulse; throbbing headache; dizziness, nausea and unconsciousness. Encourage the sufferer to sip cool water if he or she is conscious. In the meantime, the victim should be moved to a shady or air-conditioned area, immersed in a cool bath or shower, sprayed with a garden hose or covered in wet towels or a sheet if humidity is low. Avoid alcoholic beverages.

Heat exhaustion is a milder illness that can develop over a number of days. Symptoms may be subtle and include cool, moist skin; a fast, weak pulse; fast and shallow breathing; excessive sweating, dizziness, headache or nausea; paleness, weakness, tiredness, fainting and muscle cramps. The victim should be given non-alcoholic beverages (e.g. water, Gatorade, consommé), brought to a shady or air-conditioned area, put in a shower or dressed in light clothing.

Don’t wait until someone you love reaches this stage – protect him or her against heat-related illnesses. Dr. Roth said the most important method of prevention is having a "buddy," but there are a number of other steps to take. Urge people at risk to:

1. Drink plenty of fluids – the traditional target of eight or more glasses may be a suitable target on very hot days, though this may be too much for some people. Avoid alcohol, sugar, and caffeine because they contribute to dehydration.

2. Wear lightweight, light-colored, loose fitting clothing that permit evaporation of perspiration.

3. If there is air conditioning, turn it on; if not, try to spend at least two hours a day somewhere that does (try public facilities such as a library or shopping mall). Electric fans are often less effective once the temperature hits the 90’s.

4. When outdoors, wear sunscreen and a wide-brimmed hat.

5. Avoid crowded places.

6. Reduce use of oven and other heat-generating equipment such as lights and television, if need be. Cover windows in a direct sunlight, and draw blinds or curtains during the sunny part of a day.

7. Create cross-ventilation at night by opening windows on opposite sides of a building. But make sure the windows have screens to keep mosquitoes and other disease-carrying insects out.

8. Restrict outdoor activity to the coolest parts of the day, but beware of insects that carry diseases such as West Nile virus. Encourage your "buddy" to limit exposure by staying inside during the twilight hours.

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