Heat Stroke: How to Stay Safe as a Senior in Canada

Dr. Gabriel Neal, Clinical Associate Professor at Texas A&M University, provides tips about surviving a heat wave.

Many areas across Canada and the United States have been impacted by recent heat waves, causing many hospitalizations and even deaths.

Since elderly individuals are especially vulnerable, Dr. Neal joined us for this Golden Years Fireside Chat to explain the dangers of heat-related illnesses and how to stay safe.

Heat waves are especially dangerous when they affect areas that are not accustomed to higher temperatures. People in homes with no air conditioning or fans can be totally unprepared if experiencing days with temperatures at 37 degrees Celsius.

The primary concern in a heat wave is heat stroke, also known as non-exertional hyperthermia. Dr. Neal explained.

The “non-exertional” part refers to the fact that your body temperature gets greatly elevated even without exercise or other rigorous activity.

Heat stroke typically occurs when you are exposed to a high ambient temperature (40 degrees Celsius or higher) for a long time. Essentially, your body’s systems for regulating its temperature fail at this point and you begin experiencing lightheadedness and confusion.

Additionally, heat stroke damages your kidneys, your liver, and your muscles. Ultimately, this cascade of complications leads to death if treatment is not applied swiftly.

The hospital will usually give the heat stroke patient fluid resuscitation and apply cold packs to various parts of their body. The fluid helps the patient’s body get back into a position where it can regulate its own temperature, while the cold packs serve to immediately lower the body’s temperature below 40 degrees Celsius.

The survival rate for heat stroke depends on how quickly treatment is applied and on the other illnesses a person has in the background.

Dr. Neal also mentioned that heat-related illnesses exist on a spectrum, with a less severe example being heat exhaustion. Heat exhaustion describes the muscle aches and the increased rate of tiredness you feel when exposed to higher temperatures. An example given by Dr. Neal was that of a regular runner getting tired quickly when running in 32 degree Celsius weather.

This less severe form of heat-related illness can turn into heat stroke if not treated properly, for instance by sitting down and having a drink of cold water.

Elderly people are especially vulnerable to heat-related illnesses for a number of reasons, many of which relate to their underlying illnesses and required medications.

Lung disease, heart disease, diabetes and others increase the severity of heat-related illnesses.

Cognitive decline can make it so that the senior is unaware of a coming heat wave, leaving them susceptible. Diseases like Alzheimer’s and Parkinson’s prevent people from feeling thirsty, which depletes their body of fluid and disables its ability to regulate temperature.

Additionally, the autonomic nervous system, which regulates things like temperature, blood pressure, and thirst, weakens with age. This makes it more difficult for older individuals to endure high temperatures.

When it comes to medications, those for treating conditions related to blood pressure take fluid out of the body. This would normally be fine, but a heat wave means you need to have fluid in your body to regulate temperature.

Other medications that make you more susceptible to heat-related illnesses include antidepressants, anti-seizure medications, anti-anxiety medications, and anti-inflammatory medications.

Nearly everyone over the age of 65 is taking some kind of medication that puts them at risk for heat stroke, Dr. Neal noted.

If you are especially vulnerable to heat stroke, Dr. Neal suggests remembering the “85-85” rule: if the temperature is 85 degrees Fahrenheit (about 29 degrees Celsius) and the humidity is at 85 percent, you should be careful, stay cool, and perhaps limit your time outdoors.

At 90 degrees Fahrenheit (about 32 degrees Celsius) and 90 percent humidity, even people who are not especially vulnerable need to be more careful.

If you are living in an area facing a heat wave, staying hydrated is the best way to stay safe, since your body can generally handle its own temperature.

Dr. Neal advised that drinking water or even sports drinks when you are thirsty will usually suffice. However, drinking alcohol or coffee will leave you more dehydrated than before.

If you have a condition that impacts your ability to feel thirst, drinking at certain intervals throughout the day like clockwork may be necessary.

Heart failure patients need to be in frequent communication with their doctor to know how much water they should be drinking throughout the day.

Air conditioning and fans are very useful for lowering your body’s temperature, but if you have neither and are experiencing temperatures of over 40 degrees Celsius in your area, a cool bath or shower can also help.

Your local health department or city governance can direct you to any temperature relief centres in your area as well.

Exercising in a heat wave is possible, but you need to be very careful as even olympic athletes suffer from heat-related illnesses. Keep it short and get back indoors to cool down, Dr. Neal advised.

Clothing can play a factor in your body temperature. Dr. Neal suggested loose-fitting, light-coloured, and breathable clothes. Darker and heavier clothes will increase your body temperature and, consequently, your risk of heat-related illness.

Since time is a factor in the survival rate of heat stroke, it’s important to be able to recognize the symptoms in another person in order to stop the progress of the illness.

Early warning signs include a flushed face and hands, dry mouth, and increased respiratory rate. If the person is more confused than usual, this is an emergency situation and they need to be brought to a hospital.

To provide immediate help to someone who may be having a heat stroke, sit them down, wrap a wet towel around their neck, and give them cold water to drink. The next step is to bring them to the hospital so they can receive further treatment.

The fatalities in heat waves tend to be people who live alone and cannot look out for themselves or people who otherwise could, but the heat wave disrupts their ability to do so. For this reason, checking on your neighbours is very important for stopping preventable deaths in heat waves.

By looking out for each other, we can save many lives.