Beating the heat responsibly: Practical measures to safeguard older adults | Alexander Attard

Alexander Attard is Commissioner for the Elderly

A week ago, I wrote about the increased risks faced by our older population in very hot weather, although truth be said, younger persons should also educate themselves regarding these risks and how to mitigate against them. Hence, I would like to highlight measures that should be taken to avoid complications related to the heat waves we are experiencing on a regular basis.

Core essential measures may seem obvious but are worth repeating.

Maintaining hydration is essential. Water should be drunk frequently throughout the day even in the absence of thirst. We should aim to drink 2-3 litres a day. Liquids such as alcohol, coffee and sugary drinks accelerate fluid loss and should be avoided. If sweating profusely, electrolyte replacement with diluted sports drinks or rehydration solutions should be considered.

It is clearly logical to stay indoors during peak hot hours (10:00am-4:00pm) but it is astonishing how many ignore this advice.

Practical measures to cool the house include using curtains/blinds to block sunlight. When outdoor temperatures exceed indoor temperatures, windows should be closed and kitchen/bathroom extractor fans switched on. Air conditioners should be set at 26°C. If unavailable, a number of low-tech cooling measures may be applied such as cool damp cloths applied to the body, frequent cool showers/baths and spending more time in the coolest rooms of the home such as basements or north facing rooms. Electric fans should not be used when temperatures are above 35°C since only hot air will be blown. If being outside can’t be helped, wear a hat, sunglasses, light coloured cotton/linen clothes and apply sun screen (SP 30+).

Certain commonly used medications may increase sensitivity to heat. These include diuretics (water tablets), blood pressure medicines and anti-depressants. Furthermore, certain drugs may deteriorate in high temperatures and lose their effectiveness. Check on storage requirements and consult your family doctor if in doubt. Apart from older persons, people with pre-existing medical conditions such as diabetes, obesity and heart, lung, or kidney disease, should be conscious of their increased vulnerability to heat.

Early intervention in heat related medical issues is essential and so it is important to recognise and monitor relevant symptoms on a daily basis. Dizziness, headaches, nausea and a rapid pulse are symptoms and signs of heat exhaustion. In this case, the individual should be moved to a cool place and cooled down with cold water or ice packs. Cold water or electrolyte drinks should be pushed and the situation monitored. If there is no improvement after an hour hospital admission may be required. Confusion, slurred speech, hot/dry skin, seizure and a body temperature over 40° C indicate a heat stroke and is a medical emergency requiring hospitalisation.

Heat waves require an aggressive multi-layered approach if the older population is to be protected. Maintaining adequate hydration, staying in cool environments, addressing health factors and modifying activities are crucial. However, family and the community also have an obligation to minimise risks by regularly checking in on the elderly especially during extreme temperatures.

Prompt intervention by recognising symptoms and signs of heat exposure will prevent minor issues from becoming life threatening medical emergencies. Be on the lookout for weather alerts so that adequate preparations can be put in place. As I said in my previous article: A single death from heat exposure is one too many.