By Chris Woolston, M.S.
Why is hypothermia dangerous for seniors?
In most parts of the country, a 60-degree day would hardly count as a cold snap. And yet if a senior citizen lives in a poorly insulated house and keeps the heater off to save money, such a day might be chilly enough to cause a hazardous drop in body temperature. As people get older, their bodies become a little less efficient at regulating heat. And if the body temperature dips below 94 degrees, hypothermia sets in: The person becomes confused, speech is slow and slurred, the pulse weakens, movements become clumsy, and the body often shivers uncontrollably (although some people don't shiver at all). In the worst cases, the heart beats wildly and suddenly stops. And all this can happen on a day when most people don't even bother to wear a coat.
Many common diseases can make it even harder for seniors to stay warm, including hypothyroidism, heart disease, stroke, arthritis, Parkinson's disease, and diabetes. Antidepressants, nausea medications, alcohol, and some over-the-counter cold remedies can also make them more vulnerable to cold temperatures. Because seniors are often low-income, many live in houses with little insulation or try to save money by cranking down the thermostat.
How is hypothermia treated?
If you suspect someone is suffering from hypothermia, take his temperature immediately. If the thermometer shows a reading below 96 degrees, or if the temperature doesn't even register, the person needs immediate care. Bundle him up and get him to a doctor, preferably at a well-equipped hospital. There, doctors can provide active warming such as intravenous fluids that warm the body from the inside. If the victim has not gone without aid for several days and if his temperature has not dropped below 90 degrees at any point, he has an excellent chance for total recovery.
If you can't get the victim to a doctor, move him to a warm location and wrap him in a blanket. You can also share your body heat by lying close to the victim. Don't rub his arms and legs, however; this might cause further damage.
How can I prevent hypothermia?
Staying warm begins at home. Keep your house well-insulated and leave the thermostat above 65 -- particularly if you have conditions that put you at risk or are taking medications such as phenotiazines. (Talk with your doctor if you're unsure whether any conditions or medicines you're taking put you at a higher risk for hypothermia.) If you can't afford to insulate your home properly or pay your heating bills, ask your local energy company about programs that assist low-income households.
When outdoors, protect your body from cold, moisture, and wind with multiple layers of clothes. And since large amounts of body heat can escape through the head, be sure to wear a hat and scarf. While exercise can help keep you warm, don't overdo it. The American Heart Association warns that exertion in cold weather can cause a heart attack, especially if you have heart disease. If that sidewalk needs shoveling, take it slow -- in fact, consider paying the kid next door to do it.
From the Centers for Disease Control and Prevention. Hypothermia-related deaths--Suffolk County, New York, January 1999-March 2000, and United States, 1979-1998. JAMA. 2001 Feb 28;285(8):1009-10.
Forgey, William. Basic Essentials : Hypothermia (Basic Essentials Series). Globe Pequot Pr: 1996, 99 pp.
Wilkerson, James. Hypothermia, Frostbite, and Other Cold Injuries : Prevention, Recognition and Pre-Hospital Treatment. Mountaineers Books: 1986, 105 pp.