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Practical Caregiving

The Cold Facts About Hypothermia in Our Elderly

By Jean Donahue

When I was taking care of my parents, I always wondered what I would do if the electricity went off. How would I keep Dad warm? He always had to have the temperature at about 78 degrees and he still wore long sleeved shirts.

If the temperature was any lower, he put on a jacket or coat. At night he used an electric blanket, even when the temperature was warm and he had on flannel pajamas. I decided that he must not be producing enough heat to keep himself warm, but I didn't understand it.

We didn't lose power for any worrisome period of time while I was taking care of my parents, but elderly people can border on hypothermia, and their caregivers may not realize it. With these elderly, when the electricity goes off or the weather gets cooler, they show mild signs of hypothermia. Now I know that Dad was almost there a few times -- and it wasn't very cold.

Exactly what is hypothermia? What I knew was that people shivered a lot with it and other things happened to the body, but I didn't delve into all the characteristics of hypothermia until now.

I have seen several definitions of hypothermia, but they all seem to say the same thing -- it occurs when the body temperature drops too low. Our normal temperature is around 98.6 degrees F. When that temperature drops to 95 degrees F, you should become concerned about hypothermia and get medical help immediately.

I didn't realize the problems that could be associated with Dad's temperature, but his temperature always ran low somewhere between 97-98 degrees. When he was really feeling cold, it would even get down to 96 degrees. I should have been more aware of hypothermia at that time, but I was so busy taking care of Mom and Dad and didn't have time to research much of anything. I hope this column gives you the information you need to monitor your loved one's condition when they get cold.

Any of several situations can make the body temperature drop, but the elderly are more susceptible because their bodies are getting old and tired. Things just don't work as well as they used to work. Their temperature can drop too low when it's cold outside and they aren't dressed warmly enough, even though you would be very hot if you dressed the way they needed to be. Exposure to cold water, sweating when the air temperature around you is cold, submersion in cold water, some medical conditions, physical problems, medications and malnutrition can all contribute to hypothermia. A person with dementia may know they are cold, but they don't have the mental capacity to understand how or when to get warm.

The symptoms of hypothermia usually develop slowly, making the elderly person with the symptoms unaware of them. If you suspect someone may be cold enough for hypothermia, the first step is to take their temperature. If it is 95 degrees or below, RUSH them to the hospital.

If they have several of the signs below and their temperature doesn't rise above 96 degrees, RUSH them to the hospital. Even a temperature of 96 can cause an irregular heartbeat leading to heart problems and possibly death. Don't procrastinate. Get help for them FAST. I should have understood these things when Dad's temperature was 96, but I didn't. I was just lucky that something didn't happen.

Of course, if the person has some of the signs below, and their temperature is normal, the problems are probably from some other source. A doctor should diagnose the problem even though it isn't hypothermia. The signs of hypothermia to look for are:

  • shivering (or not shivering when cold)
  • abnormally slow breathing
  • cold, pale skin
  • loss of coordination
  • fumbling hands
  • slurred speech
  • lethargy
  • fatigue
  • exhaustion
  • confusion
  • memory loss
  • drowsiness

What if you are in a blizzard and can't get to a doctor or hospital? There are ways to warm the person, but also some things you should not do. First of all, if you have a working telephone, call 911 for instructions. They will connect you with someone who can talk you through what you need to do. If you can't call anyone and are stranded, or need to do something until the ambulance arrives, the following are guidelines to warm someone with signs of hypothermia.

  • Raise the temperature in the room.
  • If the person is in wet clothing, take them off and put them in dry ones.
  • Warm the center of the body first (chest, neck, head and groin).
  • Use an electric blanket if possible or skin-to-skin contact under loose, dry layers of blankets, clothes, towels, sheets -- any cloth material.
  • DO NOT use hot water, a heating pad or heating lamp directly on the person. This causes too much concentrated heat and may actually harm them.
  • Warm beverages may help increase the body temperature, but do NOT give any alcoholic beverages.
  • Don't try to get someone to drink if they can't swallow on their own.
  • Do not rub or massage a person with hypothermia. It doesn't seem to help and sometimes causes more problems.

If you live in a cold-winter climate, be prepared for the times when the electricity might go off. If you need to go somewhere in the car with your loved one, make sure they are dressed warmly, their hands and head are covered, and they have a scarf around their nose and mouth. Heat the car before putting them in it, and have the necessities in the car if you get stranded.

Overall, do whatever you can to keep your loved one from getting too cold. It can cause all sorts of health problems, including death. A little prevention may save their life.