Checking On Someone Over 65 in a Heat Wave

If they are confused, cannot be roused properly, have collapsed, or have stopped sweating in the heat, call 911. Do not wait to see whether it settles.

The CDC’s instruction is to check on an older adult at least twice a day during hot weather. Not once. Not a text message. Twice, and in person or by voice.

That sounds excessive until you read why, because the reason is not that older adults are frail. It is that the warning system is quieter.

The three reasons, and what they have in common

The CDC gives exactly three, and they are worth reading as a set:

“Older adults do not adjust as well as young people to sudden changes in temperature.”

“They are more likely to have a chronic medical condition that changes normal body responses to heat.”

“They are more likely to take prescription medicines that affect the body’s ability to control its temperature or sweat.”

Look at what all three describe. Not weakness — signalling. The body adjusts less, responds differently, and may not sweat the way it should. Every one of those is a fault in the alarm, not in the building.

Which is why “I am fine” is not information. It is not stoicism and it is not denial. The internal signal that would tell a thirty-year-old to stop and get cool may simply be fainter, and the person is reporting what they feel accurately.

So check the room, not just the person

Find out how warm it actually is where they are. People who grew up without air conditioning habitually under-run it, and a thermostat set for the electricity bill rather than for the body is the commonest version of this problem.

And a fan is not the answer. CDC is explicit: “Do not rely on a fan as your main cooling source when it’s really hot outside.” Above a certain point a fan moves hot air over a person who cannot shed heat to it. It feels like cooling and it is not doing the work.

CDC’s own preference is stated plainly — “Stay in air-conditioned buildings as much as possible.” If the house will not get cool, that is a solvable problem and there are places to go.

When you check, CDC says to confirm two things: that they have “access to air conditioning” and that they “know how to keep cool.” Access and knowledge, separately — because one without the other is not protection.

Water, and the exception that matters

CDC’s general line is “Drink more water than usual and don’t wait until you’re thirsty to drink.” Thirst arrives late, and later with age.

But there is an exception, and it is in CDC’s own words:

“If your doctor limits the amount of fluids you drink or has you on water pills, ask them how much you should drink during hot weather.”

If that is the person you are checking on, the number is their prescriber’s to give, not yours and not this page’s. Ask for it before the hot months. It is one of the few genuinely important questions that never gets asked, and medication is the whole reason.

The threshold is lower here, and that is deliberate

For an older adult, the CDC names muscle cramps, headaches, nausea or vomiting and says to seek medical care immediately.

That is a lower bar than for a healthy adult, and the difference is not an inconsistency. Our heat exhaustion or heat stroke page describes cramping in a clear-thinking adult as something to cool, hydrate and watch. For someone over 65, with the three risk factors above stacked on top, the same symptom is CDC’s trigger to get care. Same symptom, different person, different answer.

So the practical rule for anybody checking on a parent or a neighbour: you are not looking for somebody who seems to be collapsing. You are looking for cramps, a headache, feeling sick, or being off-colour in the heat — and that is enough.

Call 911 for confusion, unresponsiveness, collapse, seizure, or skin gone hot and dry after heavy sweating.

Come to an emergency room for the symptoms above, for vomiting that will not stop, or for anybody who simply is not right in a way you cannot account for.

Our emergency rooms are open every hour of every day and are walk-in — go to the nearest one, and if another emergency department is closer, that one is the right answer today.

If you are unsure, come in — this list is not exhaustive and you are not expected to assess somebody else’s heat illness from across a kitchen.

Questions people actually ask

They live alone and will not accept help. What can I actually do? Two calls a day and a reason to answer them. Then the two CDC checks — is the air conditioning working and being used, and do they know what to do when it is hot. Neither requires them to admit anything.

They insist the fan is enough. The CDC sentence above is short and quotable, and it lands better from a federal health agency than from a son or daughter.

Is 78 degrees inside all right? This page is not going to publish a number CDC does not give. The useful version is comparative: if the house is markedly warmer than it usually is, if it is not cooling overnight, or if they are avoiding running the unit, that is the thing to act on.

They had cramps yesterday and are fine today. CDC’s instruction for an older adult with cramps is to seek care, and “fine today” does not retire yesterday. Mention it to whoever sees them next, and act on it if it recurs.

They are on water pills and I do not know how much they should drink. Nobody can tell you that from a website. Ask the prescriber, and ask now rather than in July.

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Check twice a day, check the room as well as the person, and treat cramps or nausea in an older adult as a reason to be seen. If they are confused or collapsed, call 911. Both of our emergency rooms are open 24 hours a day, every day of the year — walk in, no appointment and no referral. Find your nearest emergency room →

Related reading: heat exhaustion or heat stroke · your medicine list and heat

Sources

24. Heat and Older Adults (Aged 65+) — Centers for Disease Control and Prevention. https://www.cdc.gov/heat-health/risk-factors/heat-and-older-adults-aged-65.html

This article is general information, not a diagnosis, and it cannot account for somebody’s history or their medications. If you are unsure, come in — this list is not exhaustive and you are not expected to assess an older adult’s heat illness yourself. If it might be an emergency, treat it as one and call 911.