Older Australians are particularly susceptible during heatwaves. Here’s an explanation – and guidance on how to remain safe

For those at risk, especially older Australians, the heat can be not only uncomfortable but also perilous. Elevated temperatures can exacerbate pre-existing health conditions and, in some instances, may even be life-threatening. Therefore, as temperatures rise, it is crucial to comprehend why certain individuals face a higher risk. Here’s how to identify if someone is struggling with the heat – and how to ensure safety.

What makes it more challenging for older adults to stay cool?

Our bodies employ various mechanisms to regulate temperature. Initially, the heart channels blood towards the skin, transferring heat from the body’s core to the surface. Subsequently, when we perspire and it evaporates from our skin, this facilitates the escape of excess body heat into the atmosphere.

However, as we grow older, these mechanisms become less effective. The blood circulation and sweating ability of older individuals are diminished in comparison to younger individuals. Consequently, their bodies retain more heat for extended periods.

The Dangers of Heat Exposure

Older Australians experience reduced blood flow and sweating compared to their younger counterparts. Image Credit: Shutterstock

The primary risk associated with high temperatures is not merely overheating; rather, it is the stress that heat places on the cardiovascular system, which includes the heart, blood, and blood vessels, as it attempts to manage two competing demands. In hot conditions, the heart must exert significantly more effort. It redirects blood to the skin to release excess heat while simultaneously striving to meet the oxygen requirements of other essential organs.

This phenomenon elucidates why, during heatwaves, hospitals do not see a surge of older Australians suffering from heatstroke. Instead, the predominant increase in emergency department visits is largely attributed to pre-existing health issues that exacerbate, such as diabetes and diseases affecting the heart, lungs, or kidneys.

Older Australians are more prone to having at least one chronic illness, and during prolonged heatwaves, these ailments can deteriorate rapidly. The likelihood of hospitalization during hot weather increases with the number of chronic conditions an individual has.

Additionally, common medications can disrupt the body’s natural cooling processes. Diuretics heighten the risk of dehydration, while beta-blockers and certain antidepressants may hinder sweating, as can anticholinergic medications, which are present in some treatments for bladder issues, allergies, and Parkinson’s disease.

Social Factors

In Australia, the number of air conditioning units has significantly increased over the last twenty years; however, the rising costs of energy may deter many older Australians from using their air conditioners.

Some individuals may live alone or have limited mobility. Additionally, cognitive impairments such as dementia can hinder a person’s ability to evaluate their own risk and remember to stay hydrated.

What to Observe

Be vigilant for indications that you or your loved ones are struggling to cope with high temperatures.

For older Australians, these signs can be quite subtle. Initial indicators of heat stress may include:

• unusual fatigue or lethargy
• loss of balance
• confusion
• shortness of breath
• reduced urination or dark urine (which may signify dehydration and strain on the kidneys).

For those with chronic health issues, monitor for any exacerbation of their typical symptoms.

Heat exhaustion is a more severe condition that necessitates hydration and rest in a cool setting. Symptoms of heat exhaustion encompass profuse sweating, nausea, headaches, and muscle cramps.

Heat stroke presents similar symptoms but constitutes a medical emergency that demands immediate attention. It is also marked by hot and dry skin due to the failure of the body’s heat regulation system. This condition arises when the core body temperature surpasses 40°C and can result in loss of consciousness and organ failure.

How to Ensure Safety

In addition to the standard recommendations of staying hydrated, seeking shade, and minimizing physical exertion, there are several straightforward strategies that can help lessen the effects of extreme heat for older Australians.

Air conditioning is the most effective means of protection against high temperatures. If you lack air conditioning at home, consider visiting locations such as shopping centers or libraries during the peak heat hours.

For those who do possess an air conditioner, setting it to a temperature of 26-27C and utilizing a pedestal fan can lead to a 76 percent decrease in electricity usage while enhancing comfort levels.

For individuals without air conditioning, fans can still provide some relief. Moistening the skin or clothing in conjunction with a fan enhances evaporative cooling without necessitating additional sweat production from the body.

However, for older Australians, who tend to sweat less, the efficiency of fans starts to decline when temperatures reach between 33 and 37C. When temperatures exceed 37C, fans may actually increase body heat more rapidly than sweating can counteract. Therefore, it is crucial for older Australians to keep their skin damp or explore alternative cooling methods when using a fan in temperatures above 37C.

Even a simple act such as submerging your hands and forearms in cool tap water for ten minutes every half hour has been proven to significantly reduce body temperature and alleviate stress on the heart.

Conclusion

During a heatwave, it is essential to check on older family members and neighbors. If you or someone you know exhibits signs of heat stroke, such as slurred speech, confusion, fainting, or hot, dry skin, please call 000 immediately.

How to stay safe

Beyond the usual advice to stay hydrated, seek shade, and reduce physical activity, some simple strategies can also help mitigate the impact of extreme heat for older Australians.

Air conditioning remains the most effective defense against the heat. If you don’t have air conditioning at home, consider going somewhere such as a shopping centre or library during the hottest part of the day.

If you do have an air conditioner, setting it to 26-27C and using a pedestal fan can result in a 76 per cent reduction in electricity consumption and improve comfort.

For those without air conditioning, fans alone can help. Wetting the skin or clothing in combination with a fan boosts evaporative cooling without requiring your body to produce more sweat.

However, for older Australians (who sweat less) the effectiveness of fans begins to diminish between 33 and 37C. Above 37C, fans may actually make the body hotter faster than sweating can compensate for. So, for older Australians, it’s important to keep the skin moist or find other ways to cool down if using a fan when the temperature is above 37C.

Even something as simple as immersing your hands and forearms in cool tap water – for ten minutes every half hour – has been shown to meaningfully lower body temperatures and stress on the heart.

The bottom line

In a heatwave, look out for older family members and neighbours. If you or someone you know has symptoms of heat stroke, such as slurred speech, confusion, fainting, or hot, dry skin, call 000 immediately.