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Help elderly beat the summer heat! Watch for signs of dehydration (8/12/98)

Several weeks of 100-plus weather provide ample cause for concern for our elderly population. Our older family members, neighbors and friends need our attention to prevent dangerous heat-related medical consequences.

"Many seniors have multiple chronic conditions such as high blood pressure or diabetes and are taking one or more medications to control those conditions," said geriatric specialist Toni Miles, MD, PhD, professor of family practice at The University of Texas Health Science Center at San Antonio. "They may be taking diuretics, which are given for high blood pressure, or else the common allergy medications. These medicines amplify the effect of high heat and dehydrate the taker, causing dry mouth and inhibiting ability to sweat. This makes our seniors much more vulnerable to heat.

"Many of the elderly are generally frail and have compromised heat-regulating mechanisms--like those of babies. People of advanced age, 85 and older, may be relatively insensitive to their own bodies. Their kidneys may not be working well and they may not be sweating at all. During our hottest months we must keep a watchful eye on the extremely aged and frail."

According to the Census Bureau, there are 13,067 persons aged 85 years and older in Bexar County. Some 2,000 are centenarians (100 years and older).

Extreme heat can make anyone sick. Each year thousands of people nationwide are treated for heatstroke, which most frequently is caused by extreme dehydration. Symptoms include dry flushed skin, inability to sweat, high body temperature, rapid heartbeat, confusion and in some cases, loss of consciousness. Heatstroke can be fatal, so it is imperative to get the person out of the sun or hot area, apply a cold wrap if possible, give water and call 911.

Other persons suffer heat exhaustion, which is milder than heatstroke and may precede it. Symptoms include dizziness, fatigue, faintness, headache, clammy skin, rapid pulse, fast breathing, muscle cramps and thirst.

A third heat illness, chronic dehydration, is most common in the elderly. "Many seniors don't get full-blown heatstroke or heat exhaustion because they do not stress themselves in ways such as mowing the lawn or jogging," Dr. Miles said. "Yet, they may live in homes without air conditioning or where the a.c. is set above 80 to save money. They may be using fans to keep cool. Air blowing like that can be very drying. And they may not know that they need fluids. Something happens to our ability to perceive thirst as we age."

Caregivers must pay close attention to symptoms of chronic dehydration. If you see any of the following, attend to the individual or seek help from a health care professional:

  • Changes in cognitive function, such as delirium, confusion or forgetfulness.

  • Complaints of dizziness, especially on first waking.

  • Complaints of lack of appetite and constipation.
  • "Offer water all the time," Dr. Miles said. "Keep in mind that those of advanced age may not like ice water because it is a shock to their systems. In that case, offer water at room temperature. Some of the sports drinks are good as well."

    Coffee, tea, soda and alcohol may quench thirst but actually are dehydrating, she noted. During extreme heat spells, these drinks are best avoided or consumed in moderation by the elderly and people with chronic illnesses.

    Caregivers must act promptly if a senior shows signs of chronic dehydration. "Work with the doctor taking care of the geriatric patient," Dr. Miles said. "It may require adjustment of medicines, such as cutting back on diuretics (do only on a doctor's recommendation). If the dehydration gets severe enough, some people will have to be hospitalized and given fluids intravenously.

    "If you know a caregiver or elderly person who cannot read, please pass on this information orally."

    Contact: Will Sansom