Accidental Hypothermia
The Cold Can Be Trouble for Older People
Introduction
Cold weather can be risky for anyone, but especially for older people. Almost everyone
is familiar with winter hazards such as broken bones from falls on ice or breathing
difficulties triggered by cold air. But the winter chill can also lead to a temperature
drop inside the body that can be deadly if not found quickly and treated properly. This
lowered body temperature, usually brought on by staying in a cool place for a long time,
is called hypothermia (hi-po-ther-mee-uh). It is a special problem for older people, who
often have other illnesses or take medications that can interfere with the body’s
ability to regulate its temperature.
What is hypothermia?
Hypothermia is marked by unusually low body temperatures, below 96° F (35.5° C) -
well below the body’s normal temperature of 98.6° F (37° C). What may seem like a
mere couple of degrees can have a devastating effect. Severe hypothermia can cause an
irregular heartbeat leading to heart failure and death.
Body temperature is a balance between how much heat is produced and how much is lost. The
brain acts as a thermostat, sending and receiving signals to and from parts of the body
that affect temperature: the spinal cord, muscles, blood vessels, endocrine system, and
skin. The body has many different reactions to cold. Shivering by the muscles, for
instance, is one way the body produces heat. Muscles shiver in response to messages sent
by the nerves; shivering increases muscle cell activity, which in turn produces heat.
What to look for
How can you tell if someone has hypothermia? If a person says he or she is unusually
cold, check their temperature with a thermometer. Older people may be reluctant to
complain, or are unaware of how serious the cold can be. Look for these signs of
hypothermia:
- Confusion or sleepiness
- Slowed, slurred speech, or shallow breathing
- Weak pulse; low blood pressure
- A change in behavior during cold weather or a change in the way a person looks
- Excess shivering or no shivering; stiffness in the arms or legs
- Chilly rooms or other signs that the person has been in a cold place
- Poor control over body movements or slow reactions
To figure out whether someone is suffering from hypothermia, take his or her
temperature with a thermometer. First shake the thermometer to below its lowest point.
Then, if the temperature appears to be below 96° F (35.5° C) or it can’t be read on
an oral thermometer, take the person’s temperature again using a rectal thermometer
for a more exact reading. If the thermometer still does not show the temperature or is
below 96 degrees F, call for emergency help. The only way to tell accurately if a person
has hypothermia is to use a special thermometer that can read temperatures below 94° F
(34° C). Most hospitals have these thermometers.
Treatment and recovery from hypothermia
The most important step in treating hypothermia is to make a person warm and dry. He or
she must be seen by a doctor, preferably one who knows about the condition and who is
located in a well-equipped hospital emergency room. There, the doctors will warm the body
from inside out. For example, they may give the person warm fluids intravenously (I.V.).
If you suspect that a person has hypothermia and emergency help is not available right
away, move the person to a warmer location, if possible, and wrap him or her in a warm
blanket to stop further heat loss. You can also use your own body heat to keep the person
warm. Lie close to the victim, but be gentle and do not handle the person roughly. Rubbing
the person’s arms and legs, as many rescuers are tempted to do, can make the problem
worse.
Chances for recovery depend on how long a person was exposed to the cold and his or her
general health. If body temperature has not dropped below 90° F (32.2° C), chances for a
total recovery are usually good. If body temperature has fallen to between 80° F (26.6°
C) and 90° F (32.2° C), most people will recover, but some lasting damage is likely. If
the temperature goes under 80° F (26.6° C), most victims will not survive.
Some Safety Tips!
- Guarding against hypothermia
Living conditions, illness, and some medicines (those affecting the body’s ability
to respond to cold) increase the risk for hypothermia.
- Environment
People who live in poorly heated homes risk getting accidental hypothermia when the
weather is cold. Even mildly cool temperatures of 60° F (15.5° C) to 65° F (18.3° C)
can trigger the condition. Homes can have inadequate insulation, or people with low
incomes and little savings may keep temperatures in the dangerous range as they try to
keep heating bills down.
Some help is available. To improve insulation, some states fund programs to help low
income families “weatherize” their homes. You can contact your state or local
energy agency or the local power or gas company for more information. Weatherizing your
home, or heating only one or two of the in-use rooms of a house, will keep the heating
bills down.
In addition, some low-income families may qualify for help in paying their heating bills.
State and local energy agencies, or gas and electric companies, have special programs. You
can contact them for details. Also, if a person cannot pay a utility bill, many states and
cities now have laws that stop landlords from cutting off gas or electricity in cold
weather, at least until other plans are made. Do not wait for winter to find out about
these programs.
Check with your local government about the laws that may apply, then pass this information
along to a relative or an older person’s legal representative.
Older people may be vulnerable to hypothermia even when they live in nursing homes or
group facilities. These institutions have to be careful when lowering temperatures,
because patients who are already sick may have special difficulty keeping warm.
Being knowledgeable about the weather can help reduce risks too. For example, brisk winds
cause more rapid heat loss than calmer weather. Weather forecasters call this the
wind-chill factor. They often suggest, even when the temperature itself is not very low,
that the wind-chill factor is low enough for people to stay indoors.
- Health
Some illnesses and medications place a person at risk because they affect the way the body
handles cold temperatures. Illnesses that may blunt the response to cold include:
- Slow thyroid (hypothyroidism) or other disorders of the body’s hormone system.
- Stroke or other disorders that cause paralysis and reduce awareness.
- Severe arthritis, Parkinson’s disease, or other illnesses that limit activity.
- Any condition that curbs the normal flow of blood.
- Memory disorders.
gerous and requires immediate medical care.
National Institute on Aging
U. S. Department of Health and Human Services
Public Health Service
National Institutes of Health
1993
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