Staying warm in winter is more challenging for the elderly

December 18, 2008

(PhysOrg.com) -- In 1980, when America was still dealing with the oil crisis from the previous decade, Ann Kolanowski, Elouise Ross Eberly Professor of Nursing at Penn State and director of the John A. Harford Foundation Center of Geriatric Nursing Excellence, wanted to see how high energy costs were affecting the elderly.

Kolanowski conducted a survey by visiting the homes of 100 elderly people living in Pennsylvania and compared the temperature in their homes with their core body temperatures. She found that many homeowners kept the heat in their homes pretty low -- below 70 degrees in most cases -- and a number of those people had core body temperatures as low as 96 degrees.

"In the middle of the energy crisis, there was a lot of concern that older people were turning down their thermostats due to cost," she said. "In a very rural part of the state I found an elderly couple huddled in their bed with their coats on — their home was not insulated and they had run out of oil. I was able to get them emergency fuel."

Kolanowski found that homeowners on a fixed income were keeping their temperatures down to make living affordable. However, the elderly renting apartments where heat was included with rent, or those receiving assistance, were living comfortably, with the average inside temperature of their homes at 83 degrees.

Senior citizens, Kolanowski said, have a higher risk of getting hypothermia for several reasons: they tend to have lower metabolic rates, making it harder to generate body heat. They often have chronic illnesses, like cardiovascular disease or hypothyroidism, that can interfere with maintaining body temperature. Some medications, such as tranquilizers, can cause a drop in body temperature. And living on a fixed income makes it harder to adjust to higher energy bills. Those on fixed incomes also tend to wear less expensive clothing, like polyester, which doesn't have the high insulation value of natural fibers, such as wool and silk.

"A lot of people also think if they take a shot of whiskey it will warm them up," she said. "But this is counterproductive. You lose heat because your blood vessels are dilating with the alcohol. So originally you feel warmer, but you're losing heat."

A lot can happen to someone who experiences hypothermia, Kolanowski said. The person's body temperature lowers, which can cause confusion -- he or she won't be thinking clearly and is more at risk of going outside without realizing the dangers of leaving shelter. An irregular heartbeat can result from lower body temperature, which can progress into a coma and then death.

"Hypothermia is a serious condition that needs to be treated," she said. "With older people, a body temperature of 96 degrees and below is concerning."

Those showing signs of hypothermia but who are awake and alert should immediately work to increase their body temperatures -- they should put on heavier clothing and a hat, have a bowl of warm soup and, if they can, move around to make themselves warm. On the other hand, Kolanowski said, someone who is confused or lethargic should be taken to the doctor immediately.

Kolanowski offers a few simple solutions to staying warm in the winter:

* Eat high-energy foods with complex carbohydrates, such as trail bars, raisins and other foods that produce more calories to generate more heat.
* Do a quick check around the house to look for drafts to block, cover windows with plastic, and shut off unused rooms so the whole house doesn't need to be heated.
* Keep physically active -- get up and move around to generate heat.
* Wear clothing with natural fibers, wear layers and a hat.
* The elderly can contact their Area Agency on Aging and receive assistance with energy bills and/or insulating their homes.

"If you've got an elderly person living by themselves in a rural area, it's a good idea to have someone call them at least once a day to make sure they're okay, in case they fall," Kolanowski suggested. "You want to find them as soon as possible because if they fall and lay unprotected for hours at a time, they could develop hypothermia that way."

Provided by Pennsylvania State University