Ways to Keep Older Adults Safe in Hot Weather

Older adults must take necessary precautions as temperatures soar across the United States. Summer brings sunshine, warmth, and heat waves that can be particularly challenging for seniors, especially those with health or aging issues.

Staying hydrated is the number one way to ensure anyone can stay healthy during hot weather. Christopher Bazzoli, MD, emergency medicine physician for Cleveland Clinic, says dehydration is a significant concern during a heatwave. 

Dehydration means loss of sufficient body fluid levels and you can think of body water content as, kind of, the motor oil of the body. You need enough of it to make everything function just as it should.

Dr. Bazzoli noted that signs of dehydration can include headaches, fatigue, dizziness, dry mouth, dark-colored urine, flushed skin, and muscle cramps. In severe cases, dehydration can lead to heatstroke, kidney failure, or even death. While anyone can become dehydrated, children and older people are particularly vulnerable. 

The increased stress of hot weather poses a significant concern for older individuals, but with some practical advice, you can help ensure their well-being and enjoy peace of mind, whether you're a caregiver or a concerned family member. 

Dr. Corey Slovis, head of emergency medicine at Vanderbilt University Medical Center in Nashville, told ABC News that as we age, our tolerance and perception of heat changes. 

As we age, and especially as we get into our 70s or 80s, we don't tolerate heat or perceive the dangers as well as when we were younger. 

The National Institute on Aging (NIA), part of the National Institutes of Health, says as temperatures rise, it is crucial to understand the health risks that excessive heat can bring and know the signs of heat-related illnesses. 

Older adults and people with chronic medical conditions are particularly susceptible to hyperthermia and other heat-related illnesses. Hot weather can be a big concern for older people, says Calvin Hirsch, a geriatrics specialist with UC Davis Health System.

No one is comfortable when the temperature soars," said Hirsch, who is a professor of internal medicine, "but seniors account for a disproportionate number of heat-related hospitalizations and deaths.

Medications and High Temperatures 

Patrick McHugh, MD, an emergency medicine physician at Cleveland Clinic, says you may be more at risk if you take certain medications because they could be impacting your body's natural response to hot weather.

The body responds to heat with an increased heart rate, increased blood flow to the skin as well as sweating, however, people can be on medications that blunt or stop their body's natural response to heat, which puts them more at risk for developing heat exhaustion or heatstroke.

Dr. McHugh said some medications could affect your body's response to rising temperatures. He noted beta blockers can actually mute the increase of heart rate and blood flow that's needed when your body gets overly hot. Meanwhile, anticholinergics, including certain allergy medications, can impact the body's natural ability to sweat.

Dr. McHugh said those who take diuretics could also have an increased risk of heat exhaustion. Other medications could also affect your body's response to the heat, and it's crucial to talk to your doctor. 

If you're on any medications, it's very important for you to have a discussion with your doctor to see if there is any increased risk of dehydration or heat exhaustion. Your doctor will work with you to come up with a plan.

Along with checking in with your physician, Dr. McHugh said staying hydrated is key to avoiding heat exhaustion and seeking shade or remaining indoors during the hottest points of the day. Be sure that older family members pay attention to these suggestions.

Signs of Dehydration or Heat Exhaustion

As our bodies age, skin and fat tissue, the body's insulators, tend to thin. Because of that change, seniors regulate temperature less efficiently, putting them at greater risk than others from heat-related health problems. Signs of dehydration or heat exhaustion are less pronounced in seniors, who:

• Tend to sweat less than younger people—so their bodies don't shed heat as easily as they once did.
• May lose some of their sense of thirst and not feel thirsty until severe dehydration has set in.
• May take high blood pressure and heart disease medications that remove salt and fluids from the body. These medications, coupled with heat, can cause a senior to become dehydrated—leading to confusion, organ damage, and even death.
• Heat stress, heat fatigue, heat syncope (sudden dizziness after exercising in the heat), heat cramps, and heat exhaustion are all forms of hyperthermia. Hyperthermia is caused by a failure of the body's heat-regulating mechanisms. The risk of hyperthermia can increase with the combination of higher temperatures, underlying general health, and individual lifestyle.

Certain lifestyle factors can increase the vulnerability of older adults to heat-related health issues. These include inadequate fluid intake, lack of air conditioning in their living environment, limited mobility and transportation options, wearing excessive clothing, visiting crowded places, and lacking awareness of how to respond to hot weather conditions.

On days characterized by high heat and humidity, especially when air pollution alerts are in effect, it is advisable for older adults, particularly those with chronic medical conditions, to remain indoors in cooler environments. 

If available, those without air conditioning or fans should consider seeking refuge in air-conditioned places such as senior centers, shopping malls, movie theaters, and libraries. Additionally, many communities offer cooling centers established by local public health agencies, religious groups, and social service organizations as an alternative option to beat the heat.

Remember, older adults may not feel thirsty. They get dehydrated more quickly, which increases the risk of falls. Falls are one of the biggest reasons older people require long-term health care. So, experts remind us to make sure our older family members drink enough water even if they don't feel "hot."

Extreme Heat is Deadly

The Centers for Disease Control and Prevention (CDC) note that "around 618 people in the United States are killed by extreme heat every year," even though heat-related deaths and illnesses are preventable.

Heat stroke is a life-threatening form of hyperthermia. It happens when the body is overwhelmed by heat and unable to control its temperature. Signs and symptoms of heat stroke include:

• A significant increase in body temperature (generally above 104 degrees Fahrenheit).
• Changes in mental status (like confusion or combativeness).
• Strong rapid pulse.
• Lack of sweating.
• Dry flushed skin.
• Feeling faint, staggering, or coma.

Emergency medical attention is critical for a person with heat stroke symptoms, especially in an older adult.

Many factors can increase the risk for hyperthermia, including:

• Dehydration
• Alcohol use
• Reduced sweating caused by medications such as diuretics, sedatives, tranquilizers, and certain heart and blood pressure drugs
• High blood pressure or other health conditions that require changes in diet. People on salt-restricted diets may be at increased risk; however, salt pills should not be used without first consulting a doctor.
• Use of multiple medications. However, it is important to continue to take prescribed medication and discuss possible problems with a physician.
• Age-related changes to the skin, such as poor blood circulation and inefficient sweat production
• Heart, lung, and kidney diseases, as well as any illness that causes general weakness or fever
• Being substantially overweight or underweight

The CDC makes these recommendations:

• Wear appropriate clothing: Choose lightweight, light-colored, loose-fitting clothing.
• Stay cool indoors: Stay in an air-conditioned place as much as possible. If your home does not have air conditioning, go to the shopping mall or public library—even a few hours spent in air conditioning can help your body stay cooler when you go back into the heat. Call your local health department to see if there are any heat-relief shelters in your area.
• Keep in mind: Electric fans may provide comfort, but they will not prevent heat-related illness when the temperature is in the high 90s. Taking a cool shower or bath or moving to an air-conditioned place is a much better way to cool off. Use your stove and oven less to maintain a cooler temperature in your home.
• Schedule outdoor activities carefully: Try to limit your outdoor activity to when it's cooler, like morning and evening hours. Rest often in shady areas so that your body has a chance to recover.
• Pace yourself: Cut down on exercise during the heat. If you're not accustomed to working or exercising in a hot environment, start slowly and pick up the pace gradually. If exertion in the heat makes your heart pound and leaves you gasping for breath, STOP all activity. Get into a cool area or into the shade, and rest, especially if you become lightheaded, confused, weak, or faint.
• Wear sunscreen: Sunburn affects your body's ability to cool down and can make you dehydrated. If you must go outdoors, protect yourself from the sun by wearing a wide-brimmed hat, sunglasses and by putting on sunscreen of SPF 15 or higher 30 minutes before going out. Continue to reapply it according to the package directions.
• Tip: Look for sunscreens that say "broad spectrum" or "UVA/UVB protection" on their labels- these products work best.
• Avoid hot and heavy meals: They add heat to your body!

Lifestyle Factors and Cooling Options: Reducing the Risk of Heat-Related Illness in Older Adults

Certain lifestyle factors can increase the vulnerability of older adults to heat-related health issues. These include inadequate fluid intake, lack of air conditioning in their living environment, limited mobility and transportation options, wearing excessive clothing, visiting crowded places, and lacking awareness of how to respond to hot weather conditions.

On days characterized by high heat and humidity, especially when air pollution alerts are in effect, it is advisable for older adults, particularly those with chronic medical conditions, to remain indoors in cooler environments. 

Individuals without air conditioning or fans should consider seeking refuge in air-conditioned places such as senior centers, shopping malls, movie theaters, and libraries. Additionally, many communities offer cooling centers established by local public health agencies, religious groups, and social service organizations as an alternative option to beat the heat.

Stay Informed

Stay updated on extreme heat alerts and safety tips by tuning in to your local radio or TV news. These sources provide valuable information to help you stay safe during periods of intense heat. Smartphones and computers can also provide this information, including apps that alert you to high temperatures. 

Additionally, check for any cooling shelters available in your area through these channels. If you are concerned about the well-being of a loved one who lives far away, various websites can provide relevant information on cooling shelters and resources to ensure their safety.

Know the Signs

Learn the signs and symptoms of heat-related illnesses and how to treat them. If your loved one is 65 years of age or older, be sure to check on them twice a day during a heatwave.

Monitor Those at High Risk

Although anyone at any time can suffer from heat-related illness, some people are at greater risk than others:

• Infants and young children
• People 65 years of age or older
• People who are overweight
• People who overexert during work or exercise
• People who are physically ill, especially with heart disease or high blood pressure, or who take certain medications, such as for depression, insomnia, or poor circulation

Visit adults at risk at least twice a day and closely watch them for signs of heat exhaustion or heat stroke. Infants and young children, of course, need much more frequent watching.

Careful With Sudden Temperature Changes

The CDC says that older adults do not adjust as well as younger people due to sudden temperature changes.

• Older people are more likely to have a chronic medical condition that changes normal body responses to heat.
• Older people are more likely to take prescription medicines that affect the body's ability to regulate temperature or sweat.

Most seniors like to keep their thermostats at 78. You don't want it too warm; however, seniors often feel cooler than younger adults. Warm summer temps are one thing, but when heatwaves hit, keep cool and hydrated - good advice for everyone, regardless of age.