Body Heat Regulation in the Elderly

July and August bring on what are known as the “dog days of summer” – hot, muggy, sunny days that can cause lethargy and exhaustion. Extreme temperatures that make the rest of us seek out the nearest beach or pool can have much more dire consequences for the elderly due to their increasing trouble with thermoregulation. It takes an elderly person nearly twice the time it takes a younger person to return to normal core body temperature after exposure to temperature extremes.

While normal body temperature doesn’t change much with aging, it does become harder for your body to control its temperature as you get older – noticeably so after age 70. Aging decreases the body’s ability to sweat due to increasingly ineffective sweat glands. Increased blood flow to the skin through vessel dilation (which allows warm blood to flow to the surface away from the body’s core) is also compromised during the aging process. Both factors put seniors at a much greater risk of potentially life-threatening disturbances of temperature regulation due to hypothalamus and thermal receptor issues. This is why the elderly are so vulnerable to overheating (hyperthermia) or suffering from heat stroke. To make matters worse, they also have a harder time noticing when they are becoming too hot.

Climate change has produced a greater variability in weather patterns, resulting in increasingly extreme weather events such as sustained heat waves. At the same time, the elderly are being bombarded with the message that they need to stay active to remain healthy, so many feel the pressure to get in as much exercise as possible during the summer season. It’s critical for both seniors and their caregivers to heed the following precautions, especially during heat waves:

1. If at all possible, install an air conditioning unit or central air in the home or residence of a senior citizen. (Some stores will even let you rent a unit to get you through a heat wave.) If that is not possible, bring the individual to an air-conditioned public place like a senior center, mall, library, or coffee shop during the warmest part of the day.
2. On very hot days, the elderly should remain indoors. If it’s necessary to venture outdoors for some reason, pick a cooler time of the day, such as early morning or evening.
3. Keep the house as cool as possible by keeping the shades closed during the hottest part of the day, or even using inexpensive mylar solar curtains.
4. Dehydration can have serious consequences. Make sure the older individual is drinking plenty of fluids throughout the day and not just waiting until s/he feels thirsty. Ideally, each day we should try to drink between half an ounce and an ounce of water for each pound we weigh. For example, an individual who weigh 150 pounds should drink between 75-150 ounces of water a day. It is best to avoid caffeine and alcohol on hot days.
5. If an elderly person begins to feel overheated (or you notice they are hot to the touch), have them sit with their feet in a pan of cool (but not too cold) water. You can also place a cool washcloth on the back of their neck and periodically refresh it, or have them take a cooling shower or bath. If the person is still too warm, cover them with a flexible ice blanket, making sure to protect their fragile older skin from direct contact by using a towel.
6. Monitor what older individuals eat on particularly hot days. Stay away from heavier meals or hot dishes. Instead, opt for light meats like chicken, or colder meals like pasta salad. Eat cooling snacks like popsicles or slightly frozen grapes.
7. Encourage seniors to wear layers of lightweight clothing in light-colored cotton so they can easily adjust their temperature throughout the day by removing or adding layers.
8. Those with existing medical conditions, such as Parkinson’s disease, hypertension, or diabetes, should be aware that they are particularly susceptible to heat-related injuries and should be extra cautious. Also, they should realize that prescription medications can impair the body’s ability to regulate temperature and can actually prevent sweating.

Being aware of thermoregulation issues and following these recommended guidelines will go a long way towards keeping your loved one safe and comfortable this summer!