National Institute on Aging

AgePage

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Hypothermia:

A Cold

Weather Hazard

Tony is a retired mailman. He has lived

in New England his whole life and has

seen some harsh winters. None, however,

was as cold or snowy as one winter a few

years ago. First, the temperature dipped

to below zero and a snowstorm left 2 feet

of snow. Then an ice storm caused lots

of broken power lines. That meant Tony

had no heat in his house, but he also

couldn’t leave. The temperature inside

dropped to 60° F quite quickly. When

his neighbor rang the doorbell to check

on him the next day, Tony was confused,

and his speech was slurred. He was taken

to the emergency room. A doctor examined

Tony and warmed him up. When he left

the hospital Tony went to his brother’s

house until the heat came back on. Turns

out he’d had accidental hypothermia.

Almost everyone knows about

winter dangers such as broken bones

from falls on ice or breathing problems caused by cold air. But, cold

weather is also very risky for older

people. The winter chill can lower

the temperature inside your body.

That can be deadly if not treated

quickly. This drop in body temperature, often caused by

staying in a cool

place for too long

is called hypothermia

(hi-po-ther-mee-uh).

A body temperature below 96° F

may seem like just

a couple of degrees

below the body’s normal temperature

of 98.6° F. But, it can be dangerous.

It may cause an irregular heartbeat

leading to heart problems and death.

What To Look For

When you think about being cold,

you probably think of shivering.

That is one thing the body does

to stay warm when it gets cold.

Muscles shiver in response to messages sent by the nerves. Shivering increases muscle cell activity

and that, in turn, makes heat.

But, shivering alone does not

mean you have hypothermia.
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So, how can you tell if someone has hypothermia? It can be

tricky because some older people

may not want to complain. They

may not even be aware of how

cold it is. You should look for the

“umbles”—stumbles, mumbles, fumbles,

and grumbles—these show that the

cold is affecting how well a person’s

muscles and nerves work. Watch for:

✦ Confusion or sleepiness

✦ Slowed, slurred speech,

or shallow breathing

✦ Weak pulse or low blood pressure

✦ A change in the way a person

behaves or looks

✦ A lot of shivering; stiffness in

the arms or legs

✦ Chilly rooms or other signs

that a person has been in a

cold place

✦ Poor control over body movements or slow reactions

What Should I Do?

If you think someone could have

hypothermia, take his or her temperature with a thermometer. Make

sure you shake the thermometer

so it starts below its lowest point.

If the temperature doesn’t rise

above 96° F, call for emergency

help. In many areas that means

calling 911.

The only way

to tell for sure that

someone has hypothermia is to use a special

thermometer that can read

very low body temperatures.

Most hospitals have such thermometers. The person must be seen by

a doctor. If possible, the doctor

should know about hypothermia

and work in a well-equipped hospital emergency room. There, the

doctors will warm the person’s

body from inside out. For example,

they may give the person warm

fluids directly into a vein using

an I.V. Whether the person gets

better depends on how long he

or she was exposed to the cold

and his or her general health.

While you are waiting for

help to arrive, keep the person

warm and dry. Move him or her

to a warmer place, if possible.

Wrap the person in blankets,

towels, coats—whatever is handy.

Even your own body warmth will

help. Lie close, but be gentle.

You may be tempted to rub the

person’s arms and legs. This can

make the problem worse. The

skin of an older person may be

thinner and more easily torn than

the skin of someone younger.
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What Things Put Me At Risk?

There are some things that put any

older person at risk for hypothermia.

What can you do?

✦ Try to stay away from cold

places. Changes in your body

that come with aging can make

it harder to feel when you are

getting cold. It may be harder

for your body to warm itself.

Pay attention to how cold it

is where you are.

✦ Make sure you eat enough food

to keep up your weight. If you

don’t eat well, you might have

less fat under your skin. Fat

keeps heat in your body.

✦ See your doctor to keep any

illnesses under control. Some

illnesses may make it harder

for your body to stay warm.

Be careful of:

– Problems with your body’s

hormone system such as

low thyroid hormone

(hypothyroidism)

– Any health problem that

keeps blood from flowing

normally such as diabetes

– Some skin problems such

as psoriasis that allow your

body to lose more heat

than normal.

✦ Sometimes you need to put

on more clothes, use a blanket,

or move out of the cold. Health

problems may make that hard

to do. For example:

– Severe arthritis, Parkinson’s

disease, or other illnesses

that make it harder to

move around

– Stroke or other illnesses

that can leave you paralyzed and make clear

thinking more difficult

– Memory disorders

or dementia

– A fall or other injury

✦ Ask your doctor how the medicines you take affect body heat.

Some medicines often used

by older people can increase

the risk of accidental hypothermia. These include drugs

used to treat anxiety, depression,

or nausea. Some over-the-counter

cold remedies can also cause

problems.

✦ Do not drink alcohol before

bedtime when it gets colder

outside—and maybe inside,

too. Alcoholic drinks can also

make you lose body heat faster.

Use alcohol moderately,

if at all.
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✦ Wear several layers

of loose clothing when it is

cold. The layers will trap warm

air between them. Clothing

can make you colder or help

keep you warm. Tight clothing

can keep your blood from flowing freely. This can lead to loss

of body heat.

Staying Warm Inside and Out

Maybe you already knew that your

health, your age, what you eat or

drink, even your clothes can make

it hard for you to stay warm enough

wherever you are. What you might

not realize is that people can also

get cold enough inside a building

to get very sick. In fact, hypothermia

can even happen to someone in a

nursing home or group facility if the

rooms are not kept warm enough.

People who are already sick may

have special problems keeping

warm. If someone you know is

in a group facility, pay attention

to the inside temperature there

and to whether that person is

dressed warmly enough.

Homes or apartments that

are not heated enough, even with

a temperature of 60° F to 65° F,

can lead to illness. This is a special

problem if you live alone because

there is no one else to comment

on the chilliness of the house or to

notice if you are having symptoms

of hypothermia. Set your thermostat

for at least 68° F to 70° F. If a power

outage leaves you without heat, try

to stay with a relative or friend.

Avoid using space heaters if

your home seems cold or if you

want to keep the thermostat set

lower to keep your heating costs

down. Some types are fire hazards,

and others can cause carbon monoxide poisoning. The Consumer

Product Safety Commission has

information on the use of space

heaters, but here are a few things

to remember:

✦ Make sure your space heater

has been approved by a recognized testing laboratory.

✦ Choose the right size heater

for the space you are heating.

✦ Keep substances that can catch

fire like paint, pets, clothing,

towels, curtains, and papers

away from the heating element.

✦ Keep the door to the rest of the

house open for good air flow.

✦ Turn the heater off when you

leave the room or go to bed.

✦ Make sure your smoke alarms

are working.
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✦ Put a carbon monoxide detector

near where people sleep.

✦ Keep the right type of fire

extinguisher nearby.

Don’t forget that you need

to stay warm when it’s cold outside.

Remember that this means knowing if weather forecasts are for very

cold temperatures or for windy and

cold weather. You lose more body

heat on a windy day than a calm

day. Weather forecasters call this

the wind-chill factor. They often

suggest, even when the outside

temperature itself is not very low,

that the wind-chill factor is cold

enough for people to stay indoors.

If you must go out, dress correctly.

Be sure to wear a hat and gloves,

as well as warm clothes.

Is There Help for My

Heating Bills?

Sometimes older people need help

making sure their home will keep

them warm enough. Some help

is available. If your home doesn’t

have enough insulation, contact

your state or local energy agency

or the local power or gas company.

They can give you information

about weatherizing your home.

This can help keep the heating

bills down. You might also think

about only heating the rooms you

use in the house. For example, shut

the heating vents and doors to any

bedrooms not being used. Keep

the door to the basement closed.

If you have a limited income,

you may qualify for help paying

your heating bill. State and local

energy agencies, or gas and electric

companies, may have special programs. Another possible source

of help is the Low Income Home

Energy Assistance Program (LIHEAP).

This program supports some people

with small incomes who need help

paying their heating and cooling

bills. Your local area agency on

aging, senior center, or community

action agency may have information

on programs such as these.

Are you worried that your

landlord may want to cut off the

gas or electricity in

cold weather if

you cannot

pay a utility

bill? Many

states and

cities now

have laws to

protect you, at

least until other

plans are made.
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Do not wait for winter to find out

about these programs. Check with

your local government about the

laws that may apply where you live.

For More Information

Consumer Product Safety Commission

Washington, DC 20207-0001

1-800-638-2772

1-800-638-8270 (TTY)

www.cpsc.gov

To find your local area agency on

aging look in the telephone book

or contact:

National Association of Area

Agencies on Aging

1112 Sixteenth Street, NW

Suite 100

Washington, DC 20036

202-296-8130

www.n4a.org

Eldercare Locator: 1-800-677-1116

Low-Income Home Energy

Assistance Program (LIHEAP)

National Energy Assistance

Referral Hotline (NEAR)

1-866-674-6327 (toll-free)

www.ncat.org

For more information on health

and aging, contact:

National Institute on Aging

Information Center

P.O. Box 8057

Gaithersburg, MD 20898-8057

1-800-222-2225 (toll-free)

1-800-222-4225 (TTY toll-free)

To order publications (in English or

Spanish) or sign up for regular email

alerts, visit: www.niapublications.org.

The National Institute on Aging

website is www.nia.nih.gov.

Visit NIHSeniorHealth.gov

(www.nihseniorhealth.gov), a seniorfriendly website from the National

Institute on Aging and the National

Library of Medicine. This simple-touse website features popular health

topics for older adults. It has large

type and a ‘talking’ function that

reads the text out loud.

U.S. Department of Health and

Human Services

National Institutes of Health

August 2001

Reprinted July 2005