The natural ability of the human body to regulate itself and maintain a stable body temperature or thermoregulation changes with age. As a result, older adults are vulnerable to injury when exposed to extreme hot or cold conditions.

During the summer months, excessive heat is dangerous and poses safety and health risks to older people due to the body’s compromised ability to adjust to the climate. According to the Federal Emergency Management Administration (FEMA), excessive heat is defined as periods when “temperatures reach 10 degrees Fahrenheit or more above the average high temperature for a region.” Normally, our bodies keep themselves cool by letting heat escape through the skin and by the evaporation of sweat (perspiration). When the body does not cool properly or does not cool enough, a person can suffer a heat-related illness, or even die when heat pushes the body beyond its limits.

Anyone can be susceptible although those who are very young, very old, sick or overweight are at greater risk. If unattended, heat-related illnesses can become serious—or even deadly.In urban areas stagnant atmospheric conditions often trap pollutants, mixing unhealthy air with excessively hot temperatures. Asphalt and concrete may store heat longer, as well, gradually releasing it at night. These higher temperatures create a potent blend of heat and chemicals call the urban heat island effect. Health risks are increased, especially for those with respiratory difficulties.

Risk Factors

Did you know that as a result of body weight, inactivity, reduced muscle mass and changes to the skin, many older adults are more sensitive to air temperature and are less insulated from the cold and less resilient to the heat?

Age-related risk factors include:

Disease – including cardiovascular and endocrine

  • Medications and alcohol
  • Mental disorders
  • Obesity
  • Self-care deficits

Age-related thermoregulation risks:

  • Decreases in subcutaneous fat
  • Ability to adjust to heat
  • Decreased sweating
  • Decreased peripheral circulation
  • Ineffective vasoconstriction

Preventing Heat-Related Illness

  • Never leave children or pets alone in closed vehicles. Temperatures inside a closed vehicle can reach 140 degrees Fahrenheit (F) within minutes. Exposure to such high temperatures can kill in minutes.
  • Drink plenty of water. Carry water or juice with you and drink continuously even if you don’t feel thirsty. Injury and death can occur from dehydration, which can happen quickly and unnoticed. Symptoms of dehydration are often confused with other causes. Your body needs water to keep cool. Water is the safest liquid to drink during heat emergencies.
  • Avoid drinks with alcohol or caffeine. They can make you feel good briefly, but make the heat’s effects on your body worse. This is especially true about beer, which actually dehydrates the body. People who are on fluid-restrictive diets or who have a problem with fluid retention should consult their doctor before increasing liquid intake.
  • Air conditioning provides the safest escape from extreme heat, and there are ways to maximize how it can work for you:
    • Install window air conditioners snugly.
    • Check air conditioning ducts for proper insulation.
    • Vacuum air conditioner filters weekly during periods of high use to provide more cool air.
  • Go elsewhere to get relief during the hottest part of the day if you have no air conditioning.
    • Stay indoors as much as possible, on the lowest floor out of the sun.
    • Keep heat outside and cool air inside, closing any doors or windows that may allow heat in.
    • Consider keeping storm windows installed throughout the year to keep the heat out of a house.
    • Plan to check on family, friends, and neighbors -especially the elderly – who do not have air conditioning or who spend much of their time alone.
  • Wear loose, lightweight, light-colored clothing. Light colors reflect heat and sunlight and help you maintain a normal body temperature. Cover as much skin as possible to avoid sunburn and over-warming effects of sunlight on your body. Keep direct sunlight off your face by wearing a wide-brimmed hat. Sunlight can burn and warm and inner core of your body. Also use umbrellas and sunglasses to shield against the sun’s rays.
  • Change into dry clothing if your clothes become saturated with sweat.
  • Use sunscreen with an SPF (sun protection factor) of 15 or more—even on cloudy days.
    • Apply a liberal amount of sunscreen at least 30 minutes before going outside
    • Reapply sunscreen every two hours, or after swimming or sweating.
  • Eat small meals of carbohydrates, salads and fruit, and eat more often. Avoid foods that are high in protein, because they increase metabolic heat.
  • Avoid using salt tablets unless directed to do so by a physician.
  • Slow down. Reduce, eliminate or reschedule strenuous activity. If you must engage in strenuous activity, do so during the coolest part of the day, which is usually in the morning between 4:00 a.m. and 7:00 a.m.
  • Stay in the shade when possible, and avoid prolonged sun exposure during the hottest part of the day, between 10:00 a.m. and 4:00 p.m.
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Take frequent breaks when working outdoors or engaging in physical activity on warm days. Take time out to find a cool place. If you recognize that you or someone else is showing signs of a heat-related illness, stop activity and find a cool place. Remember, have fun, but stay cool!

Know the Meaning of Heat-Related Terms

  • Heat Wave: More than 48 hours of excessive heat (90oF or higher) and high humidity (80 percent relative humidity or higher).
  • Heat Index: A number in degrees Fahrenheit (F) that tells how hot it really feels when relative humidity is added to the actual air temperature. Exposure to full sunshine can increase the heat index by 15o F.


Know the Stages of Heat-Related Illness

Get training and be alert to heat related illness symptoms. Take an American Red Cross First Aid course to learn how to treat heat and other emergencies. Everyone should know how to respond, because the effects of heat can happen very quickly.  Watch for these health signals:

  • Heat cramps: Muscular pains and spasms due to heavy exertion that usually involve the abdominal muscles or the legs. These cramps can be very painful. It is thought that the loss of water and salt from heavy sweating causes the cramps. Heat cramps are an early signal that the body is having trouble with the heat.
  • Heat Exhaustion. A less dangerous condition than heat stroke, heat exhaustion typically occurs when people exercise heavily or work in a warm, humid place where body fluids are lost through heavy sweating. Fluid loss causes blood flow to the skin to increase, and blood flow to vital organs to decrease, resulting in a form of mild shock. Sweat does not evaporate as it should, possibly because of high humidity or too many layers of clothing. As a result, the body is not cooled properly. If not treated, a person with heat exhaustion may suffer heat stroke.The signals of heat exhaustion include:
    –Cool, moist, pale, flushed or red skin (the skin may be red right after physical activity)
    –Heavy sweating
    –Dizziness and weakness or exhaustion
    –The skin may or may not feel hot
    –Body temperature will be near normal
  • Heat Stroke: Also known as sunstroke, heat stroke is life-threatening. The victim’s temperature control system, which produces sweating to cool the body, stops working. The body temperature can rise so high that brain damage and death may result if the body is not cooled quickly.The signals of heat stroke include:
    –Decreased alertness level or complete loss of consciousness
    –High body temperature (sometimes as high as 105 degrees F)
    –Skin may still be moist or the person may stop sweating and the skin may be red, hot and dry
    –Rapid, weak pulse
    –Rapid, shallow breathing
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This late stage of heat-related illness is life threatening. Call 9-1-1 or your local emergency number.

General Care for Heat Emergencies

  1. Cool the Body
  2. Give Fluids
  3. Minimize Shock

For heat cramps or heat exhaustion:

  • Get the person to a cooler place and have him or her rest in a comfortable position.
  • If the person is fully awake and alert, give a half glass of cool water every 15 minutes. Do not let him or her drink too quickly.
  • Do not give liquids with alcohol or caffeine in them, as they can make conditions worse.
  • Remove or loosen tight clothing and apply cool, wet cloths such as towels or wet sheets.
  • Call 9-1-1 or the local emergency number if the person refuses water, vomits or loses consciousness.

For heat stroke: Heat stroke is a life-threatening situation! Help is needed fast.

  • Call 9-1-1 or your local EMS number.
  • Move the person to a cooler place.
  • Quickly cool the body. Wrap wet sheets around the body and fan it. If you have ice packs or cold packs, wrap them in a cloth and place them on each of the victim’s wrists and ankles, in the armpits and on the neck to cool the large blood vessels. (Do not use rubbing alcohol because it closes the skin’s pores and prevents heat loss.)
  • Watch for signals of breathing problems and make sure the airway is clear.
  • Keep the person lying down

Precautionary Measures

To reduce the chance of heat related injury, older adults exposed to excessive heat or living in a warm climate should be encouraged to take precautionary measures including:

  • Stay at home, if air conditioned, or go to an air conditioned environment (e.g. shopping center, movie theatre, designated cooling center).
  • Use fans to keep the air circulating (According to the EPA, fans do not prevent heat related injury when the temperature reaches 90 degrees.)
  • Drink lots of fluids – avoid caffeine, alcohol and beverages with excess sugar.
  • Take a cool shower or bath and/or put a cold compress on your forehead and wrists.
  • Wear loose fitting light-weight and light colored clothing.