Friday, July 11, 2008

Seniors in the Heat

The Pennsylvania Department of Aging features on its website "Tips for Seniors in the Heat" (06/06/08, PDF, 1 page), by Nora Dowd Eisenhower, the PA Secretary of Aging, who warns "take precautions when it gets sunny and hot."

The tips, posted in the July 2008 issue of "Nora's Notes", are useful for any adult, but are particularly applicable to seniors:

  • Be aware of the signs of heat-related illness: cramps, dizziness, headache, nausea and difficulty breathing. Get immediate medical help if you experience any of these symptoms.
  • Drink more water. Avoid beverages containing caffeine and alcohol, which can increase the risk of dehydration.
  • Dress in loose-fitting, light colored clothing.
  • Stay out of the sun as much as possible. If you venture outdoors, use sunscreen and wear sunglasses and a brimmed hat.
  • Avoid strenuous activities during the hottest part of the day. Limit outdoor activity to early morning or later in the evening, and carry water with you.
  • Do not stay in a car with the windows closed. It is very dangerous and can lead to serious medical problems or even death.
  • Eat smaller meals frequently. Don’t leave foods that require refrigeration out in the heat. Don’t use the oven at the hottest times of the day.
  • Draw shades or blinds to keep the sun and heat out – but have fresh air circulating.
  • Take a cool shower, stay near a fan or go to an air-conditioned library, mall, community or senior center.
  • Check on your senior friends, family and neighbors and remind them to call for help if they need it.
We associate extreme heat more with southern and western states, than with northeastern states. However, Pennsylvania suffers its share of heat-related deaths. See: "Heat-Related Deaths -- Philadelphia and United States, 1993-1994" (07/01/94), posted by the Centers for Disease Control.
Mortality from all causes increases during heat waves, and excessive heat is an important contributing factor, particularly among the elderly. During 1979-1991, a total of 5224 deaths in the United States were attributed to excessive heat. * * *

During 1987-1988, 1092 death certificates listed excessive heat as either the primary or a contributing cause of death.

The 118 deaths associated with the 1993 heat wave in Philadelphia underscore the need to recognize risk factors for and institute strategies to prevent heat-related illness. * * *

Persons at increased risk for heat-related illness include the very young (particularly infants), the elderly (i.e., persons aged greater than or equal to 65 years), persons who are physically active in hot environments and fail to rest frequently or to drink enough fluids, and those unable to obtain adequate fluids or avoid hot environments.

However, any person is at risk for severe or fatal heat-related illness if sufficiently exposed. Heat can contribute to or exacerbate underlying illness as well as be the primary cause of illness or death. The use of certain drugs also may increase the risk for heat-related illness * * *

In addition, excessive alcohol consumption may cause dehydration and result in heat-related illness.

The risk for heat-induced illness is greatest before persons become acclimatized to warm environments. Ten to 14 days of exposure to heat are usually needed for acclimatization.

The use of air conditioning reduces the risk for heatstroke and heat-related illness, even if it is available for only part of the day. Because air conditioning is a protective factor, poverty is a risk factor for heat-related illness. * * *

[F]ans are not protective at temperatures higher than 90 F (32.2 C) with humidity greater than 35%.

Persons without home air conditioners should be encouraged and assisted in taking advantage of air-conditioned environments in private or public places (e.g., shopping malls, public libraries, and heat-wave shelters).

Cooling of the body also is possible by immersion in a tub of cool water * * *.

Persons should drink plenty of fluids and exercise only during cooler parts of the day to reduce their risk for heat-related illness. * * * [Footnotes omitted.]

One year ago, on June 18, 2007, a heat wave affecting Pennsylvania caused one county's commissioners to issue an alert, "Bucks County Commissioners Urge Awareness of Heat's Effect on County Seniors":
The Board of Bucks County Commissioners reminds seniors that extreme hot weather can cause serious heat-related illnesses such as heat stroke or heat exhaustion.

Though everyone should take precautions, seniors are especially vulnerable to effects from the heat.

The Bucks County Area Agency on Aging says the best precaution during a heat wave is to remain indoors with an air-conditioner or in a ventilated room with a fan. Unless restricted, drink plenty of water and/or non-alcoholic beverages to prevent dehydration.

The public is encouraged to check in on elderly neighbors, friends and family members. * * *
Those commissioners invited elderly folks to visit a local senior center: "We encourage seniors to visit one of Bucks County’s 13 senior community centers located throughout the county to enjoy activities, lunches and air conditioning."

A recent article posted on June 14, 2008, by Medical News Today, entitled "Extreme Heat Or Flooding Puts Elders At Risk" reinforces the dangers of extreme heat as a regional weather condition to all older residents, and particularly those who live alone or unsupervised:
Heat affects elders more than it does younger people. Dehydration could lead to cardiac or other medical crises. * * *

Elders with impaired judgment caused by mild dementia could be more at risk than their healthy peers as the weather threatens their well-being. * * *

Adult children of aging parents at a distance are stressed and worried. Calling a skilled professional in the area where aging parents live could be the difference between life and death.

A geriatric care manager is a skilled professional who can assist aging family members struggling amidst treacherous weather conditions.
Ignoring this advice can be deadly, and, as to others in care or custody, even criminal.

For a tragic example that occurred recently in White Plains, New York, read the events reported on June 18, 2008, in "NY man charged after dad dies in sweltering car", by Jim Fitzgerald, posted by Yahoo News and many other newspapers nationwide, including the San Francisco Chronicle.
Theodore Pressman left his parents in his black Suzuki in a Peekskill parking lot Monday, as outdoor temperatures reached the mid-80s, police said. The car was in full sun with its windows closed and temperatures inside reached well over 100 degrees, they said. * * *

Police said Pressman's 75-year-old mother, Joyce, was able to get out of the car Monday as the heat built up but was unable to help her husband, 85-year-old Joseph Pressman. The woman weighs about 80 pounds, Johansen said.

"It appears they did not have the physical or mental capacity to deal with the situation," he said. He would not detail the couple's infirmities.

When Pressman returned to the car, his mother was outside but disoriented and his father was unresponsive, police said.

After Pressman called 911, his father was pronounced dead and his mother was treated for heat exposure at a hospital and released.

Peekskill police Chief Eugene Tumolo said that after an autopsy, Joseph Pressman's death was declared a homicide. More charges against Theodore Pressman could be added later, police said.

Update: 07/21/08:

During the recent heat wave, the City of Philadelphia provided 300 fans to elderly residents, according to an article
entitled "Phila. will hand out free fans to senior citizens today" published July 17, 2008, by The Philadelphia Inquirer.
In response to the current heat wave, the Philadelphia Senior Center, in conjunction with Comcast-Spectacor, will give away 300 fans on a first-come, first-served basis this morning.

The fans will be distributed from 9 to 11 a.m. at the Senior Center's main branch, 509 S. Broad St. Fans will be given to people 55 or older who can present identification with a birth date on it.

Philadelphia Flyers ambassador Bob Kelly and Philadelphia Phantoms mascot Phlex will be on hand to help distribute the fans. * * *