SUPPORTING VULNERABLE PEOPLE
DURING COLD WEATHER
Advice for care home managers and staff
January 2016
What is hypothermia?
Hypothermia occurs when the body’s internal temperature drops below 35°C (96°F)
and if this condition – (where the body becomes dangerously cold) - is not recognised
and treated immediately, it can be fatal. It can be caused by brief exposure to extreme
cold or by prolonged exposure to mild cold.
What are the symptoms?
One must watch out for episodes of mental confusion that may be accompanied by
slurring of speech. There may also be symptoms that show a gradual reduction in
coordination of muscles and movement, and a falling level of consciousness. The
symptoms, which continue to progress and gets worse, as the person’s temperature
continues to drop, include:
1. Initially, involuntary shivering, loss of complex motor skills (but still able to walk
and talk), shutdown of blood vessels in the hands and feet.
2. As the body temperature falls below 35°C (96°F), violent shivering, impaired
consciousness, loss of fine-motor coordination, especially in the hands, slurred
speech, illogical behaviour, loss of emotional cognition - an 'I don't care' attitude.
3. As the body temperature
falls below 34°C (92°F), the situation becomes life
threatening, shivering become intermittent and then stops, the person curls into the
foetal position, muscles become rigid, pupils dilate, pulse rate drops.
Who is very often affected?
Hypothermia is a serious concern especially for older people who may be prone to falls
or
collapses.
People
with
chronic
respiratory
disease,
cardiovascular
and
cerebrovascular conditions, severe mental illness, Parkinson’s disease, and difficulties
with mobility are all especially susceptible to the effects of a cold enviroment.Some
medicinals may also effect how the body reacts to the cold, and those elderly who are on
medication for high blood pressure, nervousness, depression or sleeping disorders are
at greater risk.
How can hypothermia be prevented?
1. One must take all measures to keep the Residential Home warm. Having the
building properly insulated, keeping curtains drawn and windows and doors
closed will reduce the amount of supplementary heating required to ensure an
adequate ambient temperature in the rooms used most by the residents.
2. One must ensure that there is an adequate supply of heaters and heating
appliances.
3. The management must ensure that there are enough blankets/quilts on the
residents’s bed. The residents should be encouraged to wear socks and a
nightcap and perhaps long underwear which will help keep a person warm while
sleeping. If possible, the home sould make use of flannel sheets and a wool or
sheepskin mattress.
4. Room temperatures should ideally not be lower than 21°C (70°F) during the day
and not lower than 18°C (64°F) during the night. Regular monitoring of the
ambient temperature (early morning and evening) through the use of wall
mounted thermometers would ensure that such temperatures are being
maintained.
Other ways to prevent hypothermia in residents include:
1. Limiting Residents exposure to cold enviroments especially in the outdoor.
2. Ensuring that Residents eat regularly and ensuring that the diet presented
includes plenty of carbohydrates. (the body needs a reliable and constant energy
supply to generate heat) Regular supply of warm drinks is also important.
3. Residents must be encouraged to keep as active as possible.
4. Residents must be encouraged to avoid alchohol as this causes dilation of
peripheral blood vessel, leading to increased heat loss.
5. Residents must be encouraged to avoid caffeine as this is a diuretic and increases
the risk of dehydration, and aggravates heat loss.
6. Residents must be encouraged to avoid smoking as nicotine constricts blood
vessels and increases the risk of cold damage.
7. Residents must be encouraged to wear multiple thin layers of clothing .This
helps to trap heat, better than when wearing one thick jumper.
8. Residents must be encouraged to wear a hat and gloves if they have to go
outside.
Things that should NOT BE DONE:
1. Warming up an elderly person using a bath, as this may send cold blood from the
body's surfaces to the heart or brain too suddenly, causing a stroke or heart
attack.
2. Applying direct heat (hot water or a heating pad, for example) to the arms and
legs, as this forces cold blood back to the major organs, making the condition
worse.
3. Giving the person alcohol to drink, as this will decrease the body's ability to
retain heat.
4. Rubbing or massaging the person’s skin, as this can cause the blood vessels to
widen and decrease the body’s ability to retain heat.
How is a case of Hypothermia dealt with?
The basic principles are to stop heat loss and preserve the heat the person has, and
provide body fuel to generate more heat.The following measures must be taken:
1. Additional layers of clothing should be worn and any wet clothes should be
replaced with warm dry ones immediately.
2. Residents should be enciuraged to move and increase their activity
3. Initially hot liquids should be encouraged. Carbohydrates provide a rapid source
of energy while fats can provide a prolonged source of fuel.
4. Keeping a hypothermia blanket in the home would help deal with warming up
the elderly person.
5. Severe hypothermia needs urgent medical attention. Kindly refer to attached list
of useful telephone contacts.
Ms Patricia Galea
Director
Health Care Standards
List of useful Telephone Contacts
AMBULANCE
MATER DEI HOSPITAL, ADMITTING
AND
EMERGENCY
112
2545 4050 or 2545 4041
CIVIL PROTECTION
2393 0000
METEOROLOGICAL OFFICE
23696689
HEALTH PROMOTION AND DISEASE 23266000
PREVENTION DIRECTORATE
HEALTH CARE STANDARDS
DIRECTORATE
25953326
DIRECTORATE FOR ELDERLY
21441311
SECRETARIAT FOR HEALTH
22992 000 or 22992 777