As summer and year-round temperatures reach record highs, older adults face a significantly higher risk of heat-related illness, often without realizing they’re in danger.
For adult children worrying about how to keep their aging parents safe in extreme heat, there are several ways you can keep seniors cool at home, even if you’re a remote caregiver.
[READ: Signs of Heat Stroke and Hot Weather Safety Tips]
Why Extreme Heat Is Uniquely Dangerous for Older Adults
There are a few reasons why extreme heat can be especially harmful for older adults:
— Temperature regulation: As we age, our bodies have a harder time adjusting to heat. “If you’re exposed to very high temperatures, the internal temperature of the body starts increasing. As that internal temperature increases, tissues and organs can’t function properly,” says Dr. Kathy Mueller, a family medicine physician and a member of the American Academy of Family Physicians’ board of directors and system director for integrative medicine and cancer survivorship for the Nuvance health system in Connecticut and New York.
— Sweat volume: Our ability to sweat decreases with age, and sweat assists the body in coping with heat.
— Thirst awareness: Older adults may have less awareness of when they are thirsty. Hydration is always important, yet seniors may not always be aware of when they need to drink to help their bodies manage extreme heat.
— Cognitive impairment: Dementia and related conditions can negatively impact a person’s ability to recognize when they feel too hot. “That can decrease an older adult’s likelihood of making smart choices regarding hydration and seeking cooling,” says Dr. Mark Cascione, a neurologist with the MS & Neuromuscular Center of Excellence in Lutz, Florida.
— Coexisting health conditions: Certain health conditions can worsen in the heat, including heart conditions, multiple sclerosis, asthma and kidney disease. Dr. Cascione treats multiple sclerosis and says symptoms like weakness, vision loss and balance troubles get heightened during hot weather.
— Mobility issues: Being less able to move around may affect an older adult’s ability to find relief from extreme heat. For instance, they may choose to drink fewer liquids so they don’t have to get up and use the bathroom as often. Or, they may stay seated or lying down in an area of the house that’s not as cool as that’s more comfortable than moving around a lot.
— Living environment: Some older adults live in places that are naturally hotter, even if they’re mostly indoors. “Living on upper floors of buildings in urban areas markedly increases heat risk,” Cascione says.
— Medication usage: Certain medications can make you more heat-sensitive no matter your age, and older adults are more likely to be taking multiple medications.
— Social isolation: Seniors who are living alone don’t have friends or family who can be aware if they’re having difficulty with the heat.
Prescription Risks: Medications That Increase Heat Sensitivity
Medications can play a big role in how well aging parents are able to manage extreme heat. Common medications have heat-related health impacts, including increased heat sensitivity, dehydration and even higher internal body temperature.
| Category / Effect | Common Medications |
| Increased Heat Sensitivity |
— Diuretics (“water pills”), which prevent kidneys from retaining water and increase urination — Older antihistamines (diphenhydramine, hydroxyzine), which are commonly used for allergies and reduce sweat production — Beta blockers, which limit heart rate response to dehydration or heat |
| Increased Dehydration | — ACE inhibitors, diuretics and laxatives blunt the body’s ability to adapt to heat and cause rapid fluid loss |
| Increased Internal Heat | — Nasal decongestants, certain thyroid medications and certain weight loss medications increase heat production in the body, making people feel warmer |
Older adults are more likely to be on multiple medications compared with those who are younger, which means they are more likely to use a medication (or multiple) that makes them more heat sensitive.
Don’t change your parents’ medications on your own because of potential heat risks.
Instead, if you’re concerned about heat risk from certain medicines, check in with your parent’s healthcare provider for guidance. They may be able to make a seasonal adjustment, Cascione says.
[READ: Dehydration in Older Adults: Risks, Signs and Prevention]
Identifying Heat-Related Illnesses: Exhaustion vs. Stroke
It’s important to watch out for signs of heat illness in extreme heat and know when to seek help.
Heat exhaustion is the body’s response to losing a lot of water and salt. Heat stroke is more severe than heat exhaustion. It’s what happens when the body can’t cool down, and it can lead to permanent disability or death if left untreated.
Here are some of the key differences between heat stroke and heat exhaustion:
| Symptom/Feature | Heat Exhaustion | Heat Stroke |
| Body Temperature | Slightly elevated or normal | Very high (103°F or higher) |
| Skin Condition | Heavy sweating, pale, cool/clammy | Dry or damp, hot, flushed skin |
| Mental Status | Dizziness, fatigue, irritability, headaches | Confusion, slurred speech, unconsciousness, seizures |
| Primary Action | Move to cool area, sip water, rest | Call 911 immediately and cool person fast |
If you suspect an aging parent or anyone you know has heat stroke, call 911 for help.
If you’re not sure if it’s heat exhaustion or heat stroke, still seek emergency medical help. Move the person to a shaded area. Use cold wet clothes on the skin. Give them only small sips of water unless a healthcare provider tells you to provide more.
“Heat illness in an older adult may not always look obvious,” Cascione says. “Families should watch for any sudden change from the person’s normal behavior.”
Sleepiness, confusion or something as simple as not answering the phone could be symptoms of heat illness.
Home Preparation: Keeping the Living Space Cool
Despite all of these increased risks from extreme heat, there are still many valuable ways you can ensure that your aging parents stay safe in the heat:
Cooling equipment and maintenance
— Get the air conditioning checked in the spring. Make sure it’s working well in time for summer (or even late spring) heat to get into gear. “Air conditioning is the gold standard,” Mueller says. “Particularly for our frail elderly, make sure that they are able to be in air conditioning during extreme heat.”
— Have working fans around the home if needed. These may be used in place of AC if that’s not available or can help bring cool air from a window AC unit to other rooms in the house.
Sun and heat prevention
— Make sure your aging parents have lightweight, light-colored clothing they can wear as temperatures heat up.
— Work with your parents to have awnings, blinds, shutters or other window coverings that can reduce the amount of sun that gets in the home.
Personal relief techniques
— Suggest that your older loved one use cool towels placed around their neck or handheld fans that spritz water.
— Suggest that your parents take cool baths or showers.
Outings and contingency plans
— If your parents have dogs, encourage them to take them outside in the earlier morning or the evening so both humans and canines avoid the extreme heat.
— If the home just doesn’t stay cool enough, plan a field trip to a library, museum, the mall or another location known for excellent AC.
— Find out about cooling stations in your community, designed for anyone vulnerable to the heat to visit and stay cool.
— Have a backup plan if there’s a power outage. If possible, add a generator to their home.
Remote monitoring in extreme heat
If you don’t live near your parents but still want to ensure their home stays cool enough during extreme heat, there are more smart devices than ever before to help out. These include smart thermostats that allow you to adjust the temperature from anywhere.
These devices also allow you to see what the temperature is inside the home, so you can confirm your parents’ home is cool enough at any given moment.
Physicians also encourage the use of a medical alert device with fall detection. A medical alert device may not directly cool the home, but it can alert you if your loved one needs help during an extreme heat wave.
Of course, there’s nothing like an old-school check-in from a friend or neighbor to make sure your aging parents are doing OK.
Or, plan on phone call or video call to see how they’re doing and ask them how they’re coping with the heat. “That allows us to better assess how they are than we could via messaging or an app,” says Dr. Ken Heinrich, executive vice president and chief medical officer for emergency medicine with SCP Health in Evanston, Illinois.
Hydration and Nutrition: Keeping Seniors Refueled
One major way you can keep aging parents safe in extreme heat is to make sure they’re hydrating enough. That’s because our bodies lose water in the heat, and we need to replace it.
Here are some ways to emphasize hydration and nutrition to keep them refueled and cool:
— Prompt your parents to drink water even before they feel thirsty. That’s because their sense of thirst may be dulled. Some health conditions that are more common in older adults, like heart failure, kidney disease or liver disease, may have fluid restrictions. Because of this, it’s best to check with your loved one’s healthcare provider to determine exactly how much water is OK to drink daily. If your loved one is bored with regular water, suggest they flavor it with fruits like lemon and oranges or veggies like cucumber.
— Avoid drinks that may dehydrate them further, such as alcohol and coffee or tea with caffeine. Gently suggest replacing alcohol and caffeine with flavored water or other hydrating drink alternatives.
— Check with their healthcare provider before recommending electrolyte beverages, like common sports drinks. Some people drink electrolyte beverages to replace sodium, potassium, and other minerals the body loses when sweating. Even coconut water has electrolytes. Yet electrolyte balance can be tricky in those with heart failure or kidney disease. “I think if someone is eating well, we don’t really need electrolyte drinks unless they’re doing extreme exercise,” Mueller says.
— Suggest your parents fuel up on foods with high water content. Berries, chilled soups, cucumbers, green leafy vegetables, smoothies, watermelon and yogurt are great options for hydrating foods.
Bottom Line
Planning for extreme heat to keep your aging parents safe and comfortable can feel like a lot of responsibility. Yet there are some real benefits.
“With some basic precautions and attention to important habits, we can all continue to enjoy the summertime and hopefully remain healthy,” Heinrich says. “If there’s any concern, contact your healthcare professional or go to your nearest emergency department.”
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How to Keep Aging Parents Safe During a Dangerous Heat Wave: Hidden Risks to Watch For originally appeared on usnews.com
