The Cold Can Be Trouble for Older People
Institute on Aging
Cold weather can be risky for anyone,
but especially for older people. Almost everyone is familiar with winter
hazards such as broken bones from falls on ice or breathing difficulties
triggered by cold air. But the winter chill can also lead to a temperature
drop inside the body that can be deadly if not found quickly and treated
What is hypothermia?
Hypothermia is marked by unusually
low body temperatures, below 96° F (35.5° C) - well below the body’s
normal temperature of 98.6° F (37° C). What may seem like a mere couple
of degrees can have a devastating effect. Severe hypothermia can cause an
irregular heartbeat leading to heart failure and death.
Body temperature is a balance between how much heat is produced and how
much is lost. The brain acts as a thermostat, sending and receiving
signals to and from parts of the body that affect temperature: the spinal
cord, muscles, blood vessels, endocrine system, and skin. The body has
many different reactions to cold. Shivering by the muscles, for instance,
is one way the body produces heat. Muscles shiver in response to messages
sent by the nerves; shivering increases muscle cell activity, which in
turn produces heat.
What to look for
How can you tell if someone has
hypothermia? If a person says he or she is unusually cold, check their
temperature with a thermometer. Older people may be reluctant to complain,
or are unaware of how serious the cold can be. Look for these signs of
Confusion or sleepiness
Slowed, slurred speech, or shallow
Weak pulse; low blood pressure
A change in behavior during cold
weather or a change in the way a person looks
Excess shivering or no shivering;
stiffness in the arms or legs
Chilly rooms or other signs that the
person has been in a cold place
Poor control over body movements or
To figure out whether someone is
suffering from hypothermia, take his or her temperature with a
thermometer. First shake the thermometer to below its lowest point. Then,
if the temperature appears to be below 96° F (35.5° C) or it can’t be
read on an oral thermometer, take the person’s temperature again using a
rectal thermometer for a more exact reading. If the thermometer still does
not show the temperature or is below 96 degrees F, call for emergency
help. The only way to tell accurately if a person has hypothermia is to
use a special thermometer that can read temperatures below 94° F (34°
C). Most hospitals have these thermometers.
Treatment and recovery from
The most important step in treating
hypothermia is to make a person warm and dry. He or she must be seen by a
doctor, preferably one who knows about the condition and who is located in
a well-equipped hospital emergency room. There, the doctors will warm the
body from inside out. For example, they may give the person warm fluids
If you suspect that a person has hypothermia and emergency help is not
available right away, move the person to a warmer location, if possible,
and wrap him or her in a warm blanket to stop further heat loss. You can
also use your own body heat to keep the person warm. Lie close to the
victim, but be gentle and do not handle the person roughly. Rubbing the
person’s arms and legs, as many rescuers are tempted to do, can make the
Chances for recovery depend on how long a person was exposed to the cold
and his or her general health. If body temperature has not dropped below
90° F (32.2° C), chances for a total recovery are usually good. If body
temperature has fallen to between 80° F (26.6° C) and 90° F (32.2° C),
most people will recover, but some lasting damage is likely. If the
temperature goes under 80° F (26.6° C), most victims will not survive.\
Some Safety Tips!
Guarding against hypothermia
Living conditions, illness, and some
medicines (those affecting the body’s ability to respond to cold)
increase the risk for hypothermia.
People who live in poorly heated homes risk getting accidental hypothermia
when the weather is cold. Even mildly cool temperatures of 60° F (15.5°
C) to 65° F (18.3° C) can trigger the condition. Homes can have
inadequate insulation, or people with low incomes and little savings may
keep temperatures in the dangerous range as they try to keep heating bills
Some help is available. To improve insulation, some states fund programs
to help low income families “weatherize” their homes. You can contact
your state or local energy agency or the local power or gas company for
more information. Weatherizing your home, or heating only one or two of
the in-use rooms of a house, will keep the heating bills down.
In addition, some low-income families may qualify for help in paying their
heating bills. State and local energy agencies, or gas and electric
companies, have special programs. You can contact them for details. Also,
if a person cannot pay a utility bill, many states and cities now have
laws that stop landlords from cutting off gas or electricity in cold
weather, at least until other plans are made. Do not wait for winter to
find out about these programs.
Check with your local government about the laws that may apply, then pass
this information along to a relative or an older person’s legal
Older people may be vulnerable to hypothermia even when they live in
nursing homes or group facilities. These institutions have to be careful
when lowering temperatures, because patients who are already sick may have
special difficulty keeping warm.
Being knowledgeable about the weather can help reduce risks too. For
example, brisk winds cause more rapid heat loss than calmer weather.
Weather forecasters call this the wind-chill factor. They often suggest,
even when the temperature itself is not very low, that the wind-chill
factor is low enough for people to stay indoors.
Some illnesses and medications place a person at risk because they affect
the way the body handles cold temperatures. Illnesses that may blunt the
response to cold include:
Slow thyroid (hypothyroidism) or
other disorders of the body’s hormone system.
Stroke or other disorders that cause
paralysis and reduce awareness.
Severe arthritis, Parkinson’s
disease, or other illnesses that limit activity.
Any condition that curbs the normal
flow of blood.
Certain medicines also increase the
risk of accidental hypothermia. They include drugs used to treat anxiety,
depression, or nausea, and some over-the-counter cold remedies. Ask your
doctor how your medicines affect body heat. In addition to some
medication, alcoholic drinks lower the body’s ability to retain heat.
Stopping accidental hypothermia
Increased awareness is the most
effective way to prevent and treat accidental hypothermia. Older people,
their families, and friends should keep alert for hypothermia risks and
try to reduce them. Keep older people warm and dry during cool weather.
Doctors, nurses, and health professionals - including those working in
emergency rooms - must remember to check for hypothermia.
Remember these important facts
Accidental hypothermia is a drop in
body temperature to below 96° F (35.5° C).
Older people are at risk of
hypothermia not only in cold weather, but in mildly cool temperatures as
Hypothermia affects older people more
often than younger people.
Alcoholic drinks, certain illnesses,
and some medications can affect the body’s ability to regulate
A person suffering from hypothermia
is often confused, sleepy, or can have slurred speech.
Hypothermia is dangerous and requires immediate medical care.
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