Harsh winters create hardships for seniors
By Dr. Eric Appelbaum
Director of the Emergency Department at St. Barnabas Hospital.
As tough as it is for all of us, the harsh winter weather is particularly tough and can at times become dangerous for seniors.
“Winter can force many older people to become virtual prisoners in their own homes,” said Dr. Appelbaum. “They can become easily isolated and greatly restricted in their activities. It can compromise their health and adversely affect them in a number of different ways.”
According to Dr. Appelbaum, there are limited remedies in winter, but families need to get aging loved ones involved as much as possible in activities that are functional and interactive.
“For example, they should look to get them involved in adult day care programs, which by offering pickup and drop off services, can alleviate transportation problems at this time of year,” he said. “Other social activities or recreational outlets also need to be explored. At times, medication may also be necessary to overcome this problem.”
In addition, winter can cause the following problems among the elderly:
- Increased rate of hypothermia. This is a problem as the elderly are far more prone to than younger people. “It starts with making sure seniors dress warmly whenever going outside,” said Dr. Appelbaum. This includes wearing loose fitting clothes, layering whenever possible. Seniors, he said, should never venture out without wearing a head cover, since as much as 50% of one’s body heat is lost through the head. Gloves should be worn to prevent frostbite and a scarf or mouth covering to protect the lungs against cold air. Problems can also occur inside, which is why he recommends thermostats be set to at least 68 to 70 degrees. Plastic sheeting used to cover windows can help insulate the home and prevent drafts. Typical signs of hypothermia include drowsiness, slow or slurred speech, memory loss, disorientation and a sense of exhaustion. “If any of these symptoms become apparent, the victim needs to be gradually warmed, their wet clothes removed, and medical attention sought promptly,” said Dr. Appelbaum.
- Too much heat at home can cause dehydration. Many seniors turn the heat up to excessive temperatures because they always feel cold. As a result, dehydration then becomes a potential danger. It is not just a concern in hot weather. Our bodies, which are 60% to 70% water, drop to about 50% water after age 60. “Seniors get dehydrated much more quickly because they’re not eating or drinking as much, so they take in less water,” he said. “Dehydration leaves the body more susceptible to colds, headaches, disorientation, and heart disease. Chronically dehydrated seniors can develop kidney stones and arthritis.” Symptoms of dehydration include dry, sticky mouth, muscle weakness, dizziness, little or no urination (or urine a dark yellow or amber color), sunken eyes, rapid heartbeat, and fever. To prevent this, he recommends that seniors drink six to eight glasses of water daily, and avoid caffeine or alcohol.
- Protection against falls. This is a major concern for seniors, who are prone to falls because of limited mobility and vision, and to serious injury should they fall because of weakened bones. To protect against slipping outside, shoes need to have a good rubber tread. If canes or walkers are used, rubber tips need to be in good condition. Homes can also be minefields as a result of wires and cables, stairs, throw rugs and other objects that can cause accidents. In fact, half of all falls happen in the home. Exercises like tai chi, said Dr. Appelbaum, which improves balance and coordination, can reduce the chances of falling. In addition to removing potential obstacles, seniors should consider grab bars placed next to toilets and in the shower or tub, the use of non-slip mats in the bathtub and on shower floors, handrails on all staircases, and improved lighting. Medications should also be discussed with a doctor or pharmacist to see if they lead to drowsiness or light headedness.
- Poor nutrition. Health issues and physical limitations sometimes make it particularly difficult at this time for seniors to get the nutrients they need for a balanced diet. Poor nutrition and malnutrition occur in as many as 50 percent of the elderly. The symptoms of malnutrition (weight loss, disorientation, lightheadedness, lethargy and loss of appetite) can easily be mistaken for illness or disease. Surveys have found that 30 percent of seniors skip at least one meal a day, and that a significant percent of seniors consume fewer than 1000 calories a day, which is insufficient to maintain adequate nutrition. Those seniors who live alone should keep canned and non-perishable foods in the cupboard in case weather or health problems make it difficult to get out.
“There are no easy answers, but there are some very definite steps that families can take to minimize the chances of their elderly loved ones running into trouble at this time of year,” said Dr. Appelbaum. “Since many elderly don’t want to be a burden and won’t complain, families need to pay close attention.”