I believe it is fairly common knowledge that extra precautions are required for everyone during the hot summer months, but precautions are especially important for folks age 65 and older, who are at a higher risk of heat-related illnesses than younger adults. As we enter the height of the summer season, here are some reminders about the risk factors, prevention, symptoms, and treatment of heat-related illnesses.
Older adults are more susceptible to heat related illnesses for several reasons. First, their bodies do not adjust as well as younger adults to sudden changes in temperature. Older adults are also more likely to have chronic medical conditions, such as thyroid disorders, heart disease, and diabetes, which can affect the body’s normal responses to heat. Lastly, certain medications have side effects that can change the body’s ability to regulate its temperature or the ability to cool itself through perspiration. Antipsychotic medications such as Abilify, Seroquel, and Zyprexa can reduce perspiration. Antidepressants such as Effexor, Cymbalta, and Prozac may place an individual at higher risk for low sodium levels, which when combined with the salt loss that occurs with heavy sweating, may result in muscle cramps and heat exhaustion. Talk with your doctor to determine if your medical conditions or medications could increase your risk of a heat-related illness.
There are two main types of heat-related illness. Both types have similar symptoms of dizziness, headache, and nausea. Heat exhaustion is the milder type, during which fatigue and weakness are also present; heavy sweating and muscle cramps occur; the skin is pale, cool and moist; breathing is fast and shallow; and the pulse is fast and weak. When heat exhaustion progresses to heat stroke, the body becomes unable to control its temperature and the skin becomes red, hot, and dry (due to the loss of the ability to sweat); the pulse is rapid and strong; and the body temperature rises above 103 degrees. Prompt treatment is advised for both conditions, and heat stroke can result in death or permanent disability without emergency care. Attempts to cool a person with heat stress should be undertaken after 911 is called. When outside, providing shade and either immersion, spraying, or sponging with cool water are the first important actions to take. Loosening restrictive clothing is also helpful.
Ideally during hot weather, steps should be taken to help prevent heat-related complications before they occur.
- Drink more fluids than you usually do, even if you don’t increase your activity level or feel thirsty. If you take diuretics (“water pills”), check with your physician as to the amount of fluids you should be drinking. Alcoholic and high sugar beverages should be avoided as they will cause more fluid loss, and very cold drinks may cause stomach cramps.
- Replace salts and minerals lost through heavy sweating with fruit juices or sports drinks. Avoid salt tablets unless your physician has recommended them.
- Wear appropriate clothing, such as lightweight and light colored fabrics and loose-fitting styles. A wide brimmed hat can provide shade and help keep your head cool.
- Apply sunscreen 30 minutes before going outside, and reapply according to package directions. Sunburn causes the body to lose additional fluids and impairs its ability to cool itself.
- Schedule outdoor activities early or later in the day, and pace yourself carefully. Be aware that when the humidity is high, the body takes longer to cool itself because sweat doesn’t evaporate as quickly.
High temperatures can place even those folks with sedentary lifestyles at risk. When temperatures reach the high 90’s, electric fans by themselves will not prevent a heat-related illness. For those who do not have air conditioning, attempts to visit a public place with air conditioning (such as a library or shopping mall), for even a few hours a day, will make a difference. Routine checks on older folks who are at high risk are extra important during hot spells, and smart choices during a heat wave are imperative to prevent a crisis. Have a safe summer!
Karen Kaslow, RN