Ask a Geriatrician

Dr. Suzanne Salamon, Chief Associate of Clinical Geriatrics at Beth Israel Deaconess Medical Center, answers your general questions about aging and geriatric medicine.2013_12_23 Think Stock Photo

Question: How can I stay safe during the cold weather of winter?

Answer: First try to avoid hypothermia, which means internally, our bodies get too cold. Infants and elderly people are most vulnerable – in fact, some medicines may prevent the body from controlling our body temperature normally.

Warning signs of hypothermia:
Muscles in the neck, arms or legs get stiffer than normal with some mild shaking.
Shivering is a sign that the body is having trouble keeping warm. The shivering response is frequently diminished or absent in older adults, and the fact that an older person is not shivering in a cold environment does not GUARANTEE that the person is not cold.
The face may become swollen.
The person often has difficulty walking and has problems with balance.
Breathing and heart rate get slower and may be very difficult to detect in severe hypothermia. The skin is cool or cold. Pay special attention to the stomach, lower back, arms, legs, hands, and feet. The skin color is usually very pale, but it may also have large, irregular blue or pink spots.
One can become confused and disoriented. Memory is affected and familiar things are often forgotten.
Apathy is common. Often the person doesn’t care what happens and will do nothing to help reduce the danger; he or she may become irritable, mean and aggressive.
To avoid being harmed by hypothermia, here are some things you can do:
If you live alone, arrange for a daily check-in call with a friend, neighbor, relative, etc. 
Insulate your home properly.
Wear warm clothing. Instead of tight clothing, wear several loose, warm layers. Wear a hat and scarf to avoid significant heat loss through our head and neck. Stay dry. Moisture from perspiration, rain or melting snow can damage the insulating value of clothing.
Use extra blankets at night.
– Eat healthy foods and exercise moderately; proper diet and physical conditioning help protect you against abnormal heat and cold.
Get proper rest; fatigue makes you more vulnerable to subnormal heat and cold.
Drink adequate amounts of liquids. Limit your alcohol intake because alcohol intake speeds up body heat loss.

If you believe someone may be a victim of hypothermia, call an ambulance or rescue squad immediately. Until help arrives, here are some things you can do:

– Cover the victim with available covering such as blankets, towels, pillows, scarves, or newspapers.

– Do not attempt to rewarm the victim too fast: hot baths, electric blankets, and hot water bottles can be dangerous.

– Do not give the victim any food or drink.

– If the victim is unconscious, do not raise the feet. This will cause blood from the legs to flow into the body “core” and further depress the body temperature.

“Ask A Geriatrician” by Maureen Cosgrove-Deery
December 23, 2013

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