Clinic Newsletter Article Touches on Hypothermia and Dementia Care
Dawn Quaderer, RN, SANE/SART/SAFE
Community Health Dept.
LCO Community Health Center
I hope this newsletter finds you all well. I know this last year has been a rough one and I want to acknowledge everyone with much respect, admiration and pride for all the hard work I see happening to keep our community strong, safe and filled with unity. Chi Miigwech!
My topic for this months article is so extremely important this time of the year. Frostbite and Hypothermia, both quick and merciless.
When you are cold, you begin to lose heat faster than your body can produce it. Eventually, you will use up your stored energy, causing your body temperature to go down. Hypothermia affects the brain, making it hard to move or think clearly. That’s why it’s dangerous—because you may be unaware of what’s happening and how to stop it. While hypothermia is most common at very cold temperatures, it can occur even at cool temperatures (above 40°F) if you become chilled from rain, sweat, or being in cold water.
If you have a chronic condition such as diabetes, Parkinson’s, memory loss, or thyroid problems, you may take medicines that make it hard to regulate your body temperature. Ask your doctor if this is an issue for you or any questions you might have about hypothermia.
EARLY SIGNS include cold feet or hands, swollen face, slower-than-normal speech, and feeling sleepy, angry, or confused. The person’s skin may become pale, and they may begin shivering.
LATER SIGNS include jerking movements that the person can’t control in their arms and legs, slow heartbeat, slow, shallow breathing, and going in and out of consciousness.
Top 5 ways body heat is lost
Evaporation – Body heat turns sweat into vapor. Active work contributes to heat loss. To combat this, drink plenty of water and stay well hydrated.
Convection – Heat loss by wind or water moving across the skin surface. When exposed to cold air and wind, cover exposed skin and take shelter from the wind. The thicker the insulating clothing layer, the better it prevents convection.
Conduction – Direct contact with an object. For instance, sitting or lying on the cold ground removes heat from the body, until the ground and the body are the same temperature. The more dense the insulating barrier (think dense steel metal vs. a fluffy down pillow), typically the faster it can conduct heat. The thicker the barrier, the better.
Radiate – The body radiates heat and 40-45 percent of body heat is lost through the head and neck due to increased blood flow in comparison with the rest of the body. Combined with the wrists and ankles, this can approach 60 percent. These areas need to be covered!
5. Respiration – Breathing through the nose helps warm the air as it enters the body and lungs slightly more than breathing through the mouth. A balaclava or similar type clothing can help retain moisture and warmth. What is a balaclava used for?
Abalaclava is a piece of winter headgear that protects the head and face while leaving the mouth, eyes, and nose exposed. Some styles can also be pulled up over the nose and mouth to offer increased protection. Balaclavas are ideal for preventing cold exposure and frostbite to the face and ears. When in cold air for prolonged periods, pre-hydrate and continue drinking plenty of warm fluids!
Eat a healthy diet every day to make sure your body has enough energy to keep you warm. Make sure to stay hydrated. Limit your alcohol intake. Wear warm, thick clothing, including a hat and scarf if needed. Try to keep a blanket nearby. If you live alone, ask friends and family to check on you.
Cold weather facts
Wet clothing = 5Xs the heat loss
Immersion in water = 25X the heat loss. The more movement in the water, the faster the heat loss.
Overprotection danger — if a body sweats, then sits still, and the sweat layer stays against the skin, it can freeze, leading to further damage. (Think of sweating during and after shoveling)
If you see someone showing signs of hypothermia, call 911. While waiting for 911:
Move the person to a warmer place. Wrap them in warm, dry clothes, if necessary, remove all clothing and make skin-to-skin contact with the person to transfer body heat. Wrap yourself and the person in dry blankets to stay warm. Give them something warm to drink (no alcohol or caffeine).
Elders with Dementia/Alzheimers
About 1 in 4 people who have dementia live alone. People with dementia may not be aware of their surroundings or remember what to do if they are cold. Learn how to make a home safe for someone with dementia, and use the following tips to help someone with dementia stay safe during very cold weather: Remove portable space heaters and don’t leave the person alone with an open fireplace. Use safety knobs and use a stove with automatic shutoff settings. Advise the person to carefully use electric blankets or heating pads; explain they can cause burns. Put red tape around vents, radiators, and other heating components to remind the person to avoid touching them. Keep the water heater set to 120°F to prevent burns. Consider installing faucets that mix hot and cold water. (These are good safety measures for children in the home as well.) Leave an extra house key outside the home in case a caregiver or emergency responder needs to get inside. Elders are more sensitive to cold (and heat) than younger adults. Body temperature below 95°F, or Hypothermia, increases their risk of heart disease and kidney or liver damage, especially if they have a history of low body temperature or have had hypothermia in the past.
Take extra care in checking on elders who live alone during this time.
FOR ALL HOMES- Check your thermostat or an easy-to-read indoor thermometer often and keep the house around 68°F to 70°F. Maintain your heating and air conditioning system. Block off any unused rooms and drafts from windows and doors. If you use a fireplace or wood stove as your main heating source, have your chimney or flue inspected every year. If your home doesn’t hold heat well, have the insulation checked. Financial help is sometimes available for people who can’t afford to weatherize their home or pay their heating bills.
If you drive somewhere, be prepared in case you get stranded. Keep warm blankets and clothing in your car. Keep food and water in your car. Keep a phone charger in your car. Take any necessary medicines with you. Create a winter emergency supply kit to keep in your car. Wear warm, thick clothing, including a hat, scarf, and gloves, as well as loose layers to increase the amount of body heat. Change your clothes as soon as you get inside. Wearing wet clothes causes your body temperature to drop.
During these winter months, it’s important to make sure that surfaces are dry and safe for walking to reduce the risk of falling. These tips can you help prevent falls in icy and snowy weather: Make sure there is enough lighting outdoors, especially near walkways and stairs. Low lighting is a major cause of falls. Motion-sensor lights might be useful. Keep outside walkways and steps clear of snow, ice, and any objects. Make sure your steps are sturdy and have textured grip to reduce falls. If you use walking aids such as a cane, walker, or a wheelchair, dry the wheels or tips of each before entering your home. Keep a small table or shelf near the entry door to put items while unlocking the door. This reduces distractions and dangers of slipping or tripping while trying to enter your home.
As a friend, family member, or caregiver to an older adult during the winter months, you can: Consider having a remote indoor air temperature sensor or monitor installed. Have the name and contact information of a nearby family member or friend who can regularly check in on them. If you are checking in on an older adult, try to check in on them in person or by telephone as often as possible or at agreed times to make sure they are staying hydrated and are keeping warm.
Keep up the good work when taking care of each other…it shows!! I wish you all a safe, happy and warm Holiday Season!
Dawn Quaderer, RN