"As we get older, we gradually lose the ability to regulate our body temperature through perspiration," says Mary Brintnall-Peterson, University of Wisconsin-Extension program specialist in aging.
"Older adults may tend to overdress because they don't feel heat the same way anymore," Brintnall-Peterson says. "As we age, our heart rates do not speed up as fast during exercise, or return to normal afterward. Our skin also thins and offers less protection from the sun. Poor circulation, heart, lung and kidney diseases, and high blood pressure increase the risk for heat-related illness. Being overweight or underweight also increases risk."
"Medications can also interfere with a person's ability to manage hot weather," Brintnall-Peterson says. These include antipsychotic drugs commonly given to Alzheimer's patients, anticholinergic drugs, tranquilizers, sedatives (including over-the-counter sleeping pills), amphetamines, diuretics and drugs to control blood pressure, antihistamines and some antidepressants. People with cognitive impairment may not be able to communicate their distress. In some cases, they may not feel discomfort because of changes in the brain's abilities to process sensory information or regulate the body's responses to heat.
Caregivers can prevent a heat-related emergency by keeping a loved one cool, watching for signs of heat stress and following these tips from the Family Caregiver Alliance.
- Wear cool clothing that is light-weight, light-colored, loose-fitting and of natural fabrics like cotton. Use hats and umbrellas outside. If air conditioning bothers the person, offer layers, a sweater over the shoulders, or a light cloth over the ankles.
- Keep air conditioning on below 80 degrees F. If you don't have air conditioning, invest in a room air conditioner or use room fans to circulate inside air. If possible, take the person to an air-conditioned place where they can sit, such as a library, mall, restaurant or theater, avoiding overcrowded places and rush hours.
- During the day, pull the curtains on windows that are in direct sunlight. Open windows at night and use fans or cross-ventilation to circulate cooler air.
- Avoid direct sun and stay indoors between 11 a.m. and 4 p.m. Drive to the door of destinations if possible, but don't leave the person in the car. Go outside only during cooler hours and remain in the shade, on a covered porch, or under an umbrella. Check the news for temperatures, humidity levels and air pollution alerts.
- If the person's physician approves light exercise such as walking and movement exercises, limit them to short periods during cool hours. Eliminate exercise entirely on very hot days.
- Give the person plenty of water and fruit or vegetable juice even if they say they're not thirsty. Avoid alcohol, coffee or tea. Seek medical help if you suspect dehydration.
- Serve light meals. Avoid hot, heavy meals and don't use the oven.
- Find out if the person's medications increase the risk of heat stress. Ask a physician about all medications being taken, including off-the-shelf items.
- Help the person take a cooling shower or bath. Lay a cool, moistened towel over the forehead or back of the neck and replace often.
- If the person lives alone, check in daily or ask a neighbor to look in several times a day. If the person lacks transportation, make sure someone takes him or her to and from appointments and to the grocery store, etc.
- If the person is in a nursing home or other facility, make sure the facility has a plan for dealing with rising temperatures and is following the tips mentioned above. Visit as often as possible.
- Be alert: Remember that a cognitively-impaired person may not be able to tell you when he or she is feeling hot or ill. http://www.uwex.edu/news/read.cfm?id=619
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