Last week, the National Weather Service issued yet another heat advisory for metro Atlanta. Hot temperatures combined with high humidity led to heat indexes approaching 110 degrees.
Extreme heat can be dangerous for people of all ages, but adults ages 65 and up are particularly vulnerable to extreme heat, said Joel Caschette, M.D., chief medical officer for UnitedHealthcare Medicare & Retirement, Southeast Atlantic.
“For an older adult, a short walk across a parking lot, waiting outside for a ride, or spending all afternoon in a home that feels slightly warmer than usual are everyday situations where prevention really matters,” Caschette said.
According to Decatur-based OB-GYN Kay Entrekin, M.D., this heat sensitivity in older adults is the result of a combination of factors, including impaired thirst mechanisms, decreased ability to regulate body temperature, common prescription medications, and certain medical conditions that cause heat intolerance.
From getting adequate hydration to developing a plan for exercise and heat management to know the warning signs of heat exhaustion, use these tips from local doctors to stay safe in the summer heat.
Getting proper hydration
Experts recommend that adults 51 and older drink between 9 to 13 ounces of water per day.
But as people age, brain signals that control thirst mechanisms get blunted.
Entrekin recommends that moderately active older adults plan out water intake and drink at regular intervals during the day, rather than relying on sensations of thirst.
“You can monitor your hydration status through your urine color, which should be pale yellow if you are getting adequate fluids in hot months,” she said.
When it comes to electrolyte drinks like Gatorade, Krista Prorok, lead registered nurse for Griswold, a home care agency with two Atlanta locations, said they are generally not necessary, unless someone is severely dehydrated from illness, suffering from mild heat exhaustion, or engaging in intense exercise for several hours.
“Plain water and regular meals with high-water content foods are enough to keep fluids and sodium balanced,” Prorok said. “Seniors with high blood pressure and heart disease can actually be harmed by too much sodium or potassium found in electrolyte drinks,” she continued.
Developing a heat management plan
Ninety percent of adults aged 65 and older rely on daily prescription medications to manage chronic diseases and illnesses. According to Entrekin, medical studies show that several common medications can elevate core body temperature, including overactive bladder medicines, beta blockers, diuretics, and cognitive- and mental-health related medications like antidepressants.
“Many older adults are doing exactly what they should be doing—taking their medications for blood pressure, heart disease, diabetes, allergies, bladder symptoms, or mood,” Caschette said. “The issue is not that these medications are bad; it is that hot weather can change the margin of safety, especially when several medications and chronic conditions overlap.”
He suggests that seniors speak with a physician or pharmacist to determine which of their medications increase heat sensitivity, so they can develop a plan for managing hydration and safety during hot weather. That includes any plans for exercising outdoors.
“If you can, work out early in the morning when it’s coolest, and avoid those peak heat hours of 10 a.m. to 4 p.m.,” Entrekin said.
“On high-risk days, I recommend my patients shift to a lower-intensity activity like walking instead of jogging if they’re going to be outside, or moving their workouts indoors to an air-conditioned environment like a pool or gym,” she continued.
Entrekin, who is in her early 60s, does her own morning runs on a treadmill, which keeps her out of the oppressive humidity and helps her avoid falls on dark streets and sidewalks.
For outdoor runs, she suggests wearing breathable, sweat-wicking fabrics and avoiding sunblocks like zinc oxide that impair sweat evaporation. Water-based chemical sunscreens of SPF 25 and higher are best.
Prevention is key
The most common signs of heat exhaustion are excessive fatigue, headache, muscle cramps, lightheadedness or fainting, nausea or vomiting, and rapid heartbeat.
But Caschette said older adults and their caregivers should be aware of more subtle clues of heat exhaustion.
“A senior adult who seems more confused than usual, feels weak getting up from a chair, has a new fall, or says they are just more tired than normal, those are small changes during a heat wave that deserve attention,” he said.
“Air conditioning is the most effective intervention for reducing heat-related mortality,” Entrekin said. But keeping fans running, or cooling off with a cold shower or bath can also help lower body temperature on extremely hot days.
And if someone experiences loss of consciousness, extreme confusion, seizures, difficult breathing, or body temperature above 103 degrees Fahrenheit, seek immediate medical attention, she said.
But the goal is to avoid serious heat-related illnesses altogether by having a plan that includes proper hydration, cooling strategies, and knowing individual limits and tolerance levels.
“My advice is to make heat safety part of the daily routine, not something people think about only once they feel ill,” Caschette said.
