Elderly at Risk

As the summer heat continues, it is advisable to be aware of the symptoms and risks associated with over-heating. Continuing our series of heat related health problems, we first outlined dehydration. Last week, we discussed heat exhaustion. Today we outline the most serious, and possibly fatal form of heat injury, which is heat stroke.

Heat stroke is a medical emergency — an abnormally elevated body temperature with accompanying physical symptoms including changes in the nervous system function. Heat stroke is often fatal if not promptly and properly treated. The body has overheated (severe hyperthermia) with temperatures above 104 degrees Fahrenheit. It is important — especially during heat waves — to pay attention to the reported heat index (which is a measurement of the combination of humidity and air temperature.) For example, a relative humidity of 60% or more hampers the ability to evaporate sweat, which adversely effects bodily cooling. Heat-related illness and associated risks will dramatically increase when the heat index climbs to 90 degrees or above.

If you suspect that someone has heat stroke — also known as sunstroke — you should call 911 immediately and render first aid until paramedics arrive.

Heat stroke can kill or cause permanent damage to the brain and other internal organs. Although heat stroke mainly affects people over age 50, it also takes a toll on healthy young athletes. (Heat stroke is not the same as a “stroke”, which is a general term used to describe decreased oxygen flow to an area of the brain.) The body’s cooling system (dissipation of heat through the skin or by sweating) is not functioning properly, or has been overwhelmed by the physical exertion, heat and humidity present.

The elderly, in general, are a population most at risk for heat stroke. In many cases, there are pre-existing conditions which adversely effect their ability to deal with heat. Often, seniors with lung disease, heart disease, or kidney disease are compromised. Also, certain medications may make seniors vulnerable to heat exhaustion and heat stroke. Some symptoms may include nausea, throbbing headache, confusion, hallucinations, difficulty breathing, and an absence of sweating. Other high-risk groups may include people of any age who don’t drink enough water, have chronic diseases, or who drink excessive amounts of alcohol.

Homecare staff should be aware of cooling strategies for the elderly and/or the environment. Heat stroke is most likely to affect older people who live in apartments or homes lacking air-conditioning or good airflow. If you or elderly parents live in an urban area, there are increased risks for developing heat stroke during a prolonged heat wave, particularly if there are stagnant atmospheric conditions and poor air quality. In what is known as the “heat island effect,” asphalt and concrete store heat during the day and only gradually release it at night, resulting in higher nighttime temperatures.

Caregivers should also closely monitor any seniors who are taking medications such as tranquilizers, stimulants, heart & blood pressure meds, sedatives, diet pills, and antidepressants. Seniors with diabetes may also be at increased risk.

Action Steps:

Limit exposure to full sunshine. It may be possible to wet the senior with a sponge or a garden hose. Or move to a cool, shaded, air-conditioned room. Ice packs, or immersion in a tub of cool water, may assist the body’s cooling mechanisms.  Drink water, and avoid fluids containing caffeine or alcohol.