Elder Law FAX -- July 31, 2006

Keeping Cool in Hot Weather: Advice for Older People
After more than two consecutive weeks of triple-digit temperatures across much of the state of California, a break in the punishing heat wave finally arrived last week. The heat took a grisly toll: at least 126 persons died of heat-related causes. Most of the dead are elderly. The National Institute on Aging issued a warning to older people to stay out of the heat.

Older people are at high risk for developing heated-related illness because the ability to respond to summer heat can become less efficient with advancing years, the NIA says. Heat stress, heat fatigue, heat syncope (sudden dizziness after exercising in the heat, heat cramps and heat exhaustion are all forms of "hyperthermia," the general name given to a variety of heat-related illnesses. Symptoms may include headache, nausea, muscle spasms and fatigue after exposure to heat. If you suspect someone is suffering from a heat-related illness:

* Get the victim out of the sun and into a cool place, preferably one that is air-conditioned.
* Offer fluids but avoid alcohol and caffeine. Water, fruit and vegetable juices are best.
* Encourage the individual to shower, bathe or sponge off with cool water.
* Urge the person to lie down and rest, preferably in a cool place.

Heat stroke is especially dangerous for older people and requires emergency medical attention. A person with heat stroke has a body temperature above 104 and may have symptoms such as confusion, combativeness, bizarre behavior, faintness, staggering, strong rapid pulse, dry flushed skin, lack of sweating, possible delirium or coma.

Health factors which may increase risk include:
* Age-related changes to the skin such as poor blood circulation and inefficient sweat glands.
* Heart, lung and kidney diseases, as well as any illness that causes general weakness or fever.
* High blood pressure or other conditions that require changes in diet. For example, people on salt restricted diets may increase their risk. However, salt pills should not be used without first asking a consulting doctor.
* The inability to perspire caused by medications including diuretics, sedatives, tranquilizers and certain heart and blood pressure drugs.
* Taking several drugs for various conditions. It is important, however, to continue to take prescribed medication and discuss possible problems with a physician.
* Being substantially overweight or underweight.
* Drinking alcoholic beverages.

Lifestyle factors also can increase risk, including extremely hot living quarters, lack of transportation, overdressing, visiting overcrowded places and not understanding weather conditions.

The American Red Cross offers these tips to seniors and their caregivers:
* Keep cool. Stay in the air conditioning, keep out of the sun, and wear loose, light clothes.
* Review your medications. Painkillers, for example, can reduce awareness of the heat. Talk to your doctor about your medications if temperatures are climbing, especially if you don't have air conditioning. Older people are also more likely than younger folks to be taking medications that cause fluid loss (and therefore dehydration), including some laxatives, furosemide to counteract water retention, and other diuretics for blood pressure control. Caregivers should make sure that medications are placed in a cool, dry place.
* Check up on a friend or neighbor. People who live alone may be more at risk for heat-related illness and death.
* Stay hydrated. Thirst declines with age, and older sweat glands don't produce as much sweat as they used to. The sweat they do produce tends to contain more salt, and lack of salt in the body can lead to sudden drops in blood pressure. Caregivers should remain hydrated as well, taking frequent breaks for a quick glass of water to keep refreshed and revived.
* Listen to your body. Muscle cramps, fatigue, weakness, loss of concentration, confusion, lightheadedness, nausea, labored breathing, chest discomfort, and a rapid or erratic pulse can all be signs of trouble. If you feel ill--even just a little--get to a cool place, drink plenty of cool water, and seek medical help if you don't improve promptly.

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