Summer is a great time to be active while enjoying the outdoors. While the sunny skies and warm temperatures provide many opportunities for recreation, this is also the time when risks of becoming dehydrated and sick from the heat are the greatest, especially for the elderly.

Dehydration simply means that the body does not have enough water, and this affects its ability to function normally. Elderly persons are at higher risk of dehydration because as we grow older our bodies have less ability to hold on to water and to feel thirsty.

It is important to understand the signs of dehydration and what to do.

The signs of dehydration                             

An older adult who becomes dehydrated may develop:

  • headaches
  • dizziness
  • muscle cramps
  • lack of energy
  • tiredness with minimal activity
  • dry mouth
  • low blood pressure
  • rapid heart rate
  • confusion
  • dark-colored urine
  • less urination

Dehydration can lead to serious complications.

Heat stroke in older adults

This happens when the body heats up faster than it can cool off, like a hot radiator in an overheated car. Older adults are especially vulnerable to developing heat stroke when temperatures are high because of the aging body’s decreased capacity to adapt to changes in body temperature.

Heat stroke is a medical emergency and can cause:

  • high body temperatures (103ºF or higher)
  • dry or damp, hot, red skin
  • fast, strong pulse
  • confusion
  • loss of consciousness

Immediate actions needed for heat stroke:

  • Call 9-1-1.
  • Move the person to a cool place.
  • Cool the body with cold, damp clothing or a cool bath.
  • Do not give anything to drink until stabilized.

Heat exhaustion

Heat exhaustion occurs due to exposure to high temperatures, especially in the presence of high humidity, when a person is involved in vigorous physical activity, or if heat stroke is not managed properly. In elderly people, this can develop even with mild to moderate activity due to a difficulty in remaining adequately hydrated.

Signs of heat exhaustion include:

  • heavy sweating, followed by no sweating
  • cold clammy skin
  • nausea and vomiting
  • other symptoms of dehydration, such as faint pulse, muscle cramps, tiredness, dizziness, headaches
  • fainting

Immediate actions needed for heat exhaustion:

  • Move elderly to a cool place.
  • Loosen tight clothing.
  • Place cool, damp clothing on body.
  • Provide water to drink or begin IV fluids.
  • Get immediate medical help in the event of nausea/vomiting, worsening of symptoms or symptoms lasting longer than an hour.

Heat cramps

Heat cramps involves muscle spasm and pain, typically due to strenuous exercise. Older adults are at higher risk for developing heat cramps as they easily become dehydrated.

Immediate actions needed for heat cramps:

  • Stop physical activity immediately.
  • Move person to a cool place.
  • Hydrate with fluids such as water or a sports drink.
  • Get medical help if symptoms persist longer than an hour, if the older person is on a low sodium diet or if he/she has heart problems.

Sun Burns and Older Adults

A sun burn occurs due to prolonged exposure to sun and appears as painful red and warm skin. Blisters can also develop on the exposed area.

Immediate actions needed for sun burn:

  • Move elderly out of the sun and have them avoid the sun until the skin heals.
  • Apply moisturizer to the sunburned area.
  • Do not break blisters.

Heat rash

Heat rash is a skin condition that usually occurs on the neck, chest, groin or in the elbow creases and appears as red clusters of small blisters resembling pimples.

Immediate actions to take for heat rash:

  • Move individual out of the sun and into a cool and dry place.
  • Keep the rash dry and use powder to soothe the rash.

How to prevent dehydration

As an older adult, you can avoid dehydration by taking the following precautions:

  • Drink plenty of fluids frequently regardless of level of activity. If you have health conditions such as heart failure, consult your physician regarding the amount of fluid you should consume in hot weather.
  • Don’t wait to drink until you feel thirsty.
  • Carry a water bottle with you when going outdoors.
  • Cut back on caffeinated drinks, as these are also dehydrating.
  • Check your body weight daily. Losing two pounds or more within 24 hours in the absence of medication changes such as an increase in diuretic dose may indicate dehydration.
  • Eat fruits and vegetables that are high in water content, including watermelon, cantaloupe, citrus fruits, tomatoes, cucumbers, and celery.

Tips on how to stay cool in summer

  • Wear appropriate clothing: light weight, light colored and loosely fitted.
  • Apply sunscreen: SPF 30 or higher, a half hour before going out in the sun.
  • While indoors, stay in air-conditioned areas.
  • Take cool showers or baths to remain cool.
  • When it is hot and humid, schedule outdoor physical activities or exercise during early morning hours or late evening hours when temperatures are relatively cooler.
  • Limit duration of physical exertion when humidity is high in the summer time. In this weather, your body cannot cool off appropriately and the sweat does not evaporate quickly enough to have the cooling effect it should.

Enjoy the summer, but please be safe! For more information on Lifespan services for seniors, visit our Geriatric and Senior Services website

Sakeena Raza, MD

Dr. Sakeena Raza is a geriatrician with Rhode Island and The Miriam hospitals, and an assistant professor of medicine at The Warren Alpert Medical School of Brown University.