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Preparing for and Dealing With the Summer Heat
Posted By Horizon NJ Health on August 07, 2013
Tags: summer, heat, elderly, symptoms
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Howard Lu, M.D., Senior Medical Director, Horizon NJ Health

Q. There are a lot of good things about summer, and I look forward to it every year.  But I don’t like the days, usually in July and August, when the temperature soars into the 90s and sometimes even higher. It gets very uncomfortable, almost impossible to move and to breathe. It also seems like it gets hotter and hotter every summer. What can people do to better tolerate the hot summer days?

A.  It’s very important to be able to keep cool during a time of year when it seems so hard to stay indoors, even if you have good air conditioning. The heat of summer’s dog days can be dangerous to everyone, but especially those who are older. In my highly informed scientific opinion as a medical doctor, I can tell you that it does seem as if summers have gotten hotter lately. I cannot tell you whether or not global warming is a factor, but I’m certainly not going to discount it!

In any event, we all suffer in hot weather. However, for elderly and disabled people and those with chronic health conditions such as vascular disease or diabetes, the level of discomfort – and the possible consequences – increases accordingly.

One of the most scary and dangerous consequences of heat is heat stroke, a life-threatening condition that can occur after the weather hits 100 degrees. However, it doesn’t have to get that hot for problems to surface.

As we age, we gradually lose the ability to sweat and regulate our body temperature. As a result, older people tend to overdress because they don't feel heat the same way anymore. Heart rates do not speed up - or return to normal - as fast during exercise. Older skin also thins and offers less protection from the sun. Poor circulation, heart, lung and kidney diseases, and high blood pressure increase the risk for heat-related illness. Being overweight or underweight also increases risk.

So it is very important that we take care of ourselves during the hot summer days; it is doubly important to make sure that any elderly or disabled people we live with, take care of, or just care about are comfortable as well.

Here are some signs that suggest an older person might not be reacting well to the heat. Call a doctor or, if you think the problems are more serious, call 911 immediately:

  • Headache, feeling like you might vomit or feeling tired are signs of at least some heat stress.
  • Heat fatigue: cool, moist skin, a weakened pulse, feeling faint.
  • Heat cramps: muscle spasms in the abdomen, arms or legs after exercise. (Note that these may be caused by lack of salt but do not give salt or salt tablets unless you talk to a doctor.)
  • Heat exhaustion: this is a warning that the body is getting too hot. Watch for thirst, giddiness, weakness, lack of coordination, and lots of sweating. The skin may be cold and clammy. The person may urinate less and may vomit.
  • Heat stroke: this is life-threatening. Immediate medical attention is required. Death can occur quickly when heat stroke occurs. Body temperature rises above 100 degrees F (some sources say 104 degrees F), and the person may become confused, combative, behave bizarrely, feel faint, stagger. Pulse is rapid. Skin is dry, flushed and may feel hot. Lack of sweating. Breathing may be fast and shallow. Pupils may widen or dilate. Delirium, seizures or convulsions, and coma are possible.

To make the person more comfortable while he or she is waiting for medical help:

  • Have the person lie down in a cool place.
  • Elevate the feet.
  • Apply cool, wet cloths or water to the skin, especially the head, groin and armpits which cool quickly.
  • Fan by hand or with an electric fan.
  • If possible, give small sips of cool water (no salt without a doctor's approval). Do not use rubbing alcohol.
  • Remember - if you suspect heat stroke, call 911 or summon medical personnel immediately.

And here are some general tips for everyone to help stay cool and comfortable during the summer:

  • Use air conditioning: Keep the air conditioning on below 80 degrees F. If you don't have air conditioning, invest in a room air conditioner or use room fans to circulate inside air. If possible, drive the person a short distance to an air-conditioned place where they can sit, such as a library, mall, restaurant or theater. But avoid overcrowded places and rush hours.
  • Cover windows: During the day, pull the curtains on all windows that are in direct sunlight. Open windows at night and use fans or cross-ventilation to circulate cooler air. (An open, uncovered window during the day will simply make the inside temperature the same as outside.)
  • Monitor medications: Find out if the person's medications increase his or her risk for heat stress. Be sure to ask a physician about all the medications being taken, including off-the-shelf items.

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