In the latest installment of our occasional conversations with Fort Worth newsmakers, Dr. Nnyekaa Collins, a geriatrician at JPS Health Network and medical director of Magnolia Health Center, discusses why older adults are particularly vulnerable to heat and how caregivers can help them keep cool this summer.
This conversation has been edited for length and clarity. For more, please listen to the audio file attached to this article.
Alexis Allison: So Dr. Collins, how does the heat affect older adults?
Dr. Nnyekaa Collins: Older adults are more sensitive to higher temperatures. As we age, our body’s abilities to respond to the heat and to cool ourselves down decrease. So as we get older, we’re more susceptible to having heat-related illnesses as well.
As people get older, most people will develop some chronic diseases: Diabetes, high blood pressure. They may be taking multiple medications — being on multiple medications as well can reduce our body’s ability to withstand heat.
Essentially, our body has its own kind of internal mechanisms that can help us to respond when it gets too hot. If you’re younger and healthy, you feel really hot, you walk into a cooler area, you maybe get something to drink, you maybe splash some water on your face — things that help yourself cool off. Our bodies will naturally sweat. But as you get older, a lot of that changes. Our ability to sweat, to cool ourselves off, can decrease over time. If you have mobility issues or problems getting around, your ability to walk to another room to cool off or go to the shade can be decreased as well, too.
Allison: Thanks for sharing, that’s a great way to kick off this conversation. When we are talking about older people, what age are we talking about?
Collins: You know, it’s hard to give you just a magic number, like boom, you’re 60, you’re older, boom, you’re 65, you’re older. And, sometimes, people that have multiple medical conditions, those may happen younger in life.
As we get 60, 65 and older, that’s when that normal aging is happening that can reduce our ability to stay in the heat. But there isn’t a magic number. A lot of doctors like to say, ‘OK, you’re geriatric once you hit 65.’ That’s our magic Medicare number. But there is no number or one age.
Allison: There may be no magic number for this question either, but when we talk about increasing temperatures, is there a certain temperature that is particularly dangerous?
Collins: So those heat-related illnesses or those heat-related deaths happen not only when there’s a certain number, but when there’s like an abrupt or quick increase in temperature from what’s normal in that region’s climate. So, for here in Texas, people that may be a little bit more used to the 90’s come summertime, they may not have as much difficulty with that. But someone coming from another climate or moving to the Dallas-Fort Worth area, they move in the winter and then the summer hits, they may start to see that difficulty.
This past spring, which we didn’t really get much of, essentially it was cool. And then Mother’s Day weekend hit and it’s been 100 degrees already. So, going from our usual spring (temperatures) to 100 degrees for the last month-and-a-half, most older adults are going to be more susceptible with that abrupt change. You’re probably safe to say anything above 95 (degrees) is going to cause people problems.
Now, the temperatures inside your house are going to be much different. And usually what we’ll be seeing is, older adults have more problems when inside their homes or higher temperatures where they’re not able to cool it or they’re not able to have an air conditioned area to escape from the heat.
Allison: So if a person that you just described is listening to this audio, what best practices would you give them to help them stay safe from a heat-related illness?
Collins: Plan your day around the heat or the highest temps to try to avoid going out in the midst of the day, noon and later where it’s the hottest during the daytime. So if you have your doctor’s appointments, you have to go grocery shopping, you exercise outdoors, or you’re going for your walk or you like to garden, I tell them, do it as early as possible during the morning time (when) it’s the coolest of the day. So that you don’t have to be outside in the heat of the day with the most extreme temperatures. Or you could do those things later in the evening as the sun is going down or as it’s cooling off.
As a physician, it’s important that we check on our patients and see what their home life is like. So, I periodically ask my patients, ‘Do you have air conditioning in your home?’ Here, it’s a necessity. If you don’t have air conditioning in your home, knowing where your cooling centers are in the city, where you can go and cool off in the air conditioned area during the heat in the heat of the day. Knowing if there are programs in the community where you live that can either provide you with a small window unit, or air conditioning so that you can have a comfortable place to sleep at night time.
The other thing is staying well-hydrated. Drinking plenty of water when it’s warm out. Even if you are inside, it’s still important. Because in places like Texas where it’s not only warm, it’s also humid, we can have more difficulty with that as well. It’s important to make sure that you’re replenishing that hydration and that water that you may be losing.
Allison: You mentioned physicians checking in on their patients. I’m wondering about other caregivers, if they might be listening to this conversation. What would you recommend to caregivers of older adults?
Collins: I will recommend the caregivers to do the same: Check in with your loved ones and check in with them frequently. There’s no magic number, but a couple of times a week to check in to see how they’re doing. And that is not only a phone call, but going by where they live and see what it feels like. Some older adults, as they age, they’re a little bit more sensitive to the changes in the ambient temperature or indoor temperature. So sometimes older adults will feel cold a lot if they’re inside in the air conditioner. So they’ll turn their AC off and it can get really hot inside their homes before they are aware of it. Or they turn their AC off because they don’t have enough money to pay for the electricity bills or the utilities that are required to keep their home cool.
Older adults of that generation, the baby boomers and older, they’re a really proud generation, and they may not tell you if they need to help. So just go by and visit them every now and then. Knock on the door if they let you to see what it actually feels like inside their home. And if it’s hot and uncomfortable for you, it’s hot and uncomfortable for them. And having a discussion with them about, OK, how do we keep you cool? Maybe we need to go out to lunch a time or two during the week or come by my house on the weekend for a few days, just to give them a little bit more relief.
As well, (make) sure that you know who their doctors are, so you can reach out to them if you’re concerned. (Also know) in the community what other resources there are for older adults as far as paying utilities — especially if they have medical devices that they need, like oxygen. There are forms that the patient’s primary physician can complete that will allow their electricity to stay on so that it won’t be interrupted for non-payment if they have medical devices or medical equipment that need electricity to run.
Sometimes it takes a little legwork to get that done, but you can call their electricity provider and say, ‘Hey, we need this form. My loved one has an oxygen concentrator, they have insulin, they have medication that has to be refrigerated, you cannot interrupt their electricity if they can’t pay the bill.’ And so you can get that form filled out and and and help them to make sure that they have those resources available to them.
Some people that are more sensitive to heat-related illness can start to exhibit signs and symptoms of heat-related disease. And seeing if they’re having those symptoms when you talk to them, you can intervene and get them help. So if you talk to them, and they’re confused, or you see them and they look really hot, but they feel cold and clammy or they’re disoriented or they’re slow to respond — anything outside of what you normally see can be a result of a heat-related illness.
But really, we need to just do a better job. I mean, not not only as caregivers, but friends, family physicians as well, too, checking in on our older adults as they’re aging, and as we experience more global warming, and we’re having more higher temperatures, environmentally, and we’re seeing the effects of storms and in the different weather phenomena, our older adults are a lot more vulnerable to that.
Allison: Thank you for those tips. Is there anything else that you’d like to share?
Collins: For some of the people that have multiple medical conditions, there’s certain medications that can make you more sensitive to heat-related illness. So if you’re taking medications like diuretics — medications that make you lose more water through urine, or there’s certain blood pressure or depression medications, those medications can make it harder for people to tolerate the heat. Make sure that you’re aware of what you’re taking and that your family members are aware as well too. So that you know they can be a little bit more vigilant.
Make sure that, if you are running your errands during the daytime, you take a cool bottle of water, you take a bottle of water with you or a cup of iced water to sit in your car so that you’d have something to drink. One thing I always saw my grandmother do when I was younger: She always had frozen bottled water with her in her car driving around. That water can be life-saving. If you’re starting to feel really tired and faint while you’re out, you can take that ice water and put it on your forehead or put a little bit on the towel, rub it on the back of your neck to help yourself cool off and find a cool area as quickly as possible.
Alexis Allison is the health reporter at the Fort Worth Report. Her position is supported by a grant from Texas Health Resources. Contact her by email or via Twitter. At the Fort Worth Report, news decisions are made independently of our board members and financial supporters. Read more about our editorial independence policy here.
Noncommercial entities may republish our articles for free by following our guidelines. For commercial licensing, please email hello@fortworthreport.org.
