Be sure your geriatric patients are aware of winter hazards and provide guidance on how to avoid the risk of falls and hypothermia.
Winter, although beautiful, poses health risks for our older patients. Every year during the colder months we get more consults for patients who present with falls and fractures, dehydration, and delirium. Older people tend to be more sensitive to the drop in temperature due to skin changes and a reduced thirst reflex. They may not feel thirsty and are thus at risk of dehydration. I recently saw an 85-year-old woman who lives independently, brought by EMS after a fall at home. In the ED, she was confused, with low blood pressure and reduced skin turgor. Her blood work suggested acute kidney injury due to low volume status.
Be aware that, commonly, older people fall outside the house while trying to get in or out of the car or clear snow. Inadequate clothing may put them at risk for hypothermia.
Each year, an average of 1,836 deaths and 136,309 injuries are attributed to icy and snowy roads. Drivers over the age of 70 who have vision and/or cognitive impairment are at highest risk of car accidents, sometimes resulting in death. People using certain high risk medications for sleep disorder, anxiety/ depression, pain, or allergy can also increase their risk of both car accidents and falling. Discussing these hazards with your older patient during this season can save lives and preserve health.
Be sure to tell your older patients:
1. Set thermostats at 68 degrees or higher.
2. Wear layers in winter weather to stay warm. When going outside, bundle up with warm socks, gloves, hat, and a winter coat.
3. Stay inside during icy conditions to avoid falls. If you must go outside, wear non-skid footwear with good traction. Once you get back inside, remove the shoes as soon as possible: ice and snow on footwear can cause people to slip and fall.
4. Drink plenty of fluids to stay hydrated. As always, eat a variety of nutritious foods.
This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.