Senior Summer Safety: Precautions and Preventions

Senior Summer Safety: Precautions and Preventions

By Brenda Eggert Brader

Aging is difficult enough without the added environmental challenges. Living in Florida’s extreme heat can take its toll on everyone, but especially the elderly.

Sip a lemonade to stay cool during a hot summer day in Florida. Staying hydrated is some of the best advice offered by physicians who are in-the-know about seniors weathering the high temperatures of summer in the Sunshine State.

“The elderly deserve to enjoy the summer season, to enjoy parks, gardens and beaches, go driving, do gardening or take pets out and go golfing,” says Dr. Manuel Jain, who practices geriatric medicine for WellMed Medical Clinic in Haines City. “At the same time, it puts them at risk because of what they are. Age is not an illness, but sometimes it is an impediment to what they want to do and a lot of restrictions are put on them. They should do what they want to do, but should note the risks involved. They deserve that privilege.”

Seniors and/or their caretakers should be aware of their exposure to temperatures.

“The brain can’t adjust like a young person,” Dr. Jain says. “When cold, (the elderly) are already too cold, or there is a delay in feeling that cold. So, they take a sweater to a party outside when it is 90 degrees. There is a delay for them to feel it. The body can be too hot to sweat to cool down. So, they don’t perspire that much.”

The summer heat could be dangerous to seniors and the elderly primarily because it could lead to heat stroke, a condition that can be fatal, says Dr. Theophilus Sai, who practices internal medicine in Tampa. Dr. Sai is the medical director for Central Florida Medicare at Humana, and works with the Senior Connection Center, which covers several counties, including Polk.

“Heat stroke is a medical emergency that needs to be treated quickly,” Dr. Sai says. “It is a medical condition that occurs when a person’s body gets too hot. This typically occurs when a person exercises in very hot weather and humidity without drinking enough water or other hydrating fluids. However, heat stroke can affect people who are not exercising, especially the elderly or anyone with health problems.”

“Heat cramps and heat exhaustion are other conditions that occur when a person is exposed to excessive heat,” Dr. Sai continues. “But they are not as dangerous as heat stroke. Other dangers, specifically for outside sun exposure, include sunburn and development of skin lesions and skin cancer.”

In heat stroke, the body temperature gets so high and the skin is not able to cool down. Meanwhile, the mouth is dry, however, thirst isn’t necessarily felt, according to Dr. Jain.

“Elderly hyperthermia can occur when they are not doing anything but sitting, and (they) get a 104-degree temperature and become dehydrated,” Dr. Jain says. “Heat stroke becomes a stroke because that is what it is. The skin is dry, not perspiring. There is no sweat, they are dehydrated, hot and dry. They get sleepy and die.”

Elderly are more susceptible to heat as they age because they have a “reduced ability to deliver heat to the skin,” Dr. Sai says. “Blood vessels under skin tend to lose some of the ability to dilate in response to heat; chronic diseases like high blood pressure, diabetes, and small strokes affect the body’s ability to control temperature. Severe arthritis and Alzheimer’s disease can physically limit an individual’s ability to remove themselves from an area of excessive temperature or to getting fluids, and certain medications affect it as water pills (diuretics). Beta blockers slow the heat down and could affect a response. Some medications can affect the ability of the sweat glands to produce sweat in response to heat as in antihistamines, some antidepressants, and sleeping pills.”

Signs of heat stroke include the following:

— Body temperature of 104 degrees Fahrenheit or higher (40 degrees Celsius or higher).

— Brain/mental symptoms of confusion or inability think clearly, headaches, decreased alertness, hallucinations, sleepiness or drowsiness, passing out or fainting.

— Cardiac symptoms of fast heartbeat and skipped heartbeat.

— Fast or labored breathing.

— Vomiting or diarrhea, skin redness and warmth and cramping or weakness of muscles.

Precautions / Preventions

“It is dangerous in the elderly to drink eight glasses (of water) a day,” Dr. Jain says. “They develop water intoxication. ‘Ballplayers need electrolytes’ is the advice we give elderly to not drink much water. If outside and sweating, drink something with electrolytes – Powerade, Gatorade and lemonade. There is no medical reason (for the elderly) to drink eight glasses of water a day. It should be eight glasses of liquid with electrolytes. The elderly need to be careful of hydration and dehydration.”

The U.S. Department of Health and Human Services, Centers for Disease Control advises protecting oneself by avoiding heavy exertion, extreme heat, sun exposure, and high humidity when possible. When these cannot be avoided, take the following preventative steps:

— Wear light-colored, loose-fitting, breathable clothing such as cotton.  Avoid non-breathable synthetic clothing.

— Try to plan activities that require going outside during non-peak hours when it might be a little cooler.

— Move exercise indoors. Consider exercising at a gym, walking on a treadmill, or “mall walking” instead of outdoor walks or activities. Swimming and water aerobics are good options as well.

— Drink plenty of fluids (non-alcoholic, caffeine-free as these ingredients have a diuretic effect). Talk with your doctor if you take medications that affect fluid intake, such as Lasix.

— Additionally, it may be important to consume food and drink with sodium and potassium to restore electrolyte balance when losing fluids and drinking a lot of water: Broths or soups (contain sodium); fruit juice, soft fruits, vegetables (containing potassium); sports drinks that contain electrolytes.

— Stay indoors in cooled spaces as much as possible.  Check your air conditioning system, do a maintenance review. If electricity goes out or a loved one does not have air conditioning, consider alternative arrangements when heat is at dangerous levels.

— Schedule work during the coolest parts of the day.

— Take more breaks when doing heavier work, and in high heat and humidity.  Take breaks in the shade or a cool area.

“Avoid excessive physical activity when it is hot both inside and outside,” Dr. Sai says. “Take breaks during exercise, ideally in the shade. Drink enough fluids to not feel thirsty and don’t force yourself to drink large amounts of water in a short period of time.”

The elderly should be careful exercising in the heat.

“Summer is not the time to climb ladders,” Dr. Sai says. “(The elderly) were handy when they were young, but don’t realize that they have limitations and are not as young anymore. Everything in the elderly is delayed. If taking medicines stay away from the direct sun and take electrolytes.”

Dr. Jain warns that what temperature may be comfortable for young adults may be dangerous for the elderly. Nursing home temperatures generally feel hot to youth but are just right to the elderly.

“Listen to them rather than try to make them comfortable,” Dr. Jain says. “If they are cold, get a jacket.”

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