Health Column: Hyperthermia — risk for the elderly

Hyperthermia is the medical term used to describe overheating. It’s a serious risk for the elderly as the barometer rises and the temperature soars.

Generally as we age, our natural thermo-regulation system slows down; all our organs that work to regulate body temperature — skin, muscle, glands and lungs — gradually decrease in efficient function. Healthy core body temperature is approximately 98.6 degrees Fahrenheit.

You may have wondered why when you are sitting in the hot sun your temperature doesn’t go up? The reason is your internal thermo-regulation system, directed from the hypothalamus region of the brain, makes the necessary accommodations to keep your temperature at the 98.6 degree set-point. But certain circumstances can interfere with efficient temperature regulation. Age is one. For example, 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 fluctuations.
The ability to thermo-regulate, decreases after approximately 70 years of age, and diminishes with each decade of life. Changes to levels of thirst, blood vessel dilation or restriction, lung capacity and reduction in sweat gland function — the mechanisms that help individuals regulate body temperature during extremes of cold or heat, are significant factors contributing to the risk of hyperthermia in the elderly.

The health problems that result from hyperthermia can vary from mild to life-threatening. Heat cramps, which can be brought on by a combination of physical exertion and excessively high heat, are muscles spasms which may occur in the arms, legs or even stomach, when the body is dehydrated. Athletes and those who work in high temperature areas are most susceptible.

Drinking plenty of fluids to keep the body hydrated can help combat heat cramps. Heat exhaustion can result when the body temperature rises to more than 100 degrees Fahrenheit. This is usually accompanied by dizziness, headache, nausea and weakness.

Heat exhaustion can quickly turn into heat stroke, which can happen when the body is so dehydrated (lacking fluid) that the core body temperature can reach as high as 104 degrees Fahrenheit. The dangers of heat stroke are brain damage, heart failure and sudden death. When the symptoms of hyperthermia are observed, action should be taken immediately to get out of the heat and into a cool environment. Drink plenty of fluids, strip off heavy clothing and apply cold packs or cool spray to the skin.

While these warnings are directed at the elderly, they should also be heeded for small children, obese persons, people with ill health and those who are taking photo-sensitive medications. Many antibiotics have a warning relating to excessive heat exposure enclosed in the packaging.

The health risks of hyperthermia are best addressed through preventive measures. At San Simeon, prevention is the task of the whole team of caregivers and facility staff. When the hot season approaches, environmental department workers, aware of the seriousness of the risk that weather extremes pose, always keep the facility and the residents’ quarters at a healthy temperature. Weather forecasts are carefully observed and “red alerts” are acted on promptly. Announcements are made over the public address system about the need for residents to dress appropriately. That includes using head-coverings and sun-screen and assuring that residents are hydrated, especially if they do venture outdoors. In addition, there is ample shade in the courtyard and gardens to keep residents cool, should they be outside on hot days. There have been no serious incidents of hyperthermia at San Simeon because these precautions are taken and staff members are all aware of the risks. So don’t forget to wear a sun hat and stay cool this summer.

Jean Rose Castiglione is a registered nurse and assistant director of nursing at San Simeon by the Sound Cener for Nursing and Rehabilitation in Greenport

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