What is it?
A condition in which a person, usually elderly, becomes very cold and can die. Technically speaking it occurs when the body temperature falls below 35°C (95°F)-the normal is 37°C (98.6°F). Obviously this is a somewhat arbitrary cut-off point as many individuals will be able to live at this temperature whilst others will be severely ill.
The outward signs of the condition are drowsiness, slurred speech, unsteady movement, a pale and puffy face, mental confusion, a slow pulse and breathing, and cold-feeling skin. Treatment involves slow, gentle, re-warming. A doctor should always be called because the condition is usually much more serious than at first appears.
What causes it?
Younger people can tolerate very wide swings in ambient temperature without any danger to their bodies. Their natural thermostat keeps the body temperature steady at around 98.6°F. Their skin temperature may fall but the ‘core’ of the body remains at the correct temperature. For various reasons to do with the ageing process, and as a result of inactivity, poor food intake and poor clothing, many older people easily get extremely cold so that even the very core of their bodies cools down.
The condition often goes undiagnosed because the standard clinical thermometer does not go down as low as 35°C.This can be a very serious hazard because the condition is fatal-killing as it does nearly 1,000 old people a year in the UK alone.
Prevention
• Move the individual’s bed into the warmest room of the house-usually the living room-and keep that room at 70°F. Ensure that all heating appliances give sufficient heat, and are safe, easy to manage, and economical.
• Check for rising damp and damp coming through the walls (from blocked drains and gutters). Ensure that there is adequate ventilation to combat condensation.
• Arrange for frequent, small meals throughout the day-meals on wheels if necessary. Take frequent, small, hot drinks throughout the day from a thermos flask.
• Ensure that at least one meal a day is hot.
• Use an electric blanket but ensure that it is switched off when you are in bed.
• Wear several layers of thin clothing made of closely woven fabric. Air is the best insulator so the principle is to trap as much air as possible between the layers of clothes. Down-filled clothing is the most effective insulator. Wearing long underwear does not actually make much difference to how much heat we lose but it does make us feel warmer. It is also amazing how much warmer putting on a hat can make you.
• The body acclimatizes to the cold by producing more heat and scientists can measure this. On exposure to cold the fingers of a person who has adjusted to the cold have a greater blood supply and warmer temperature than those of one who has not adjusted. One of the best ways to adjust to cold is to exercise. Riding a stationary bicycle or ‘conducting’ an imaginary orchestra perhaps to the accompaniment of the radio or record player works wonders. This activity creates heat. When sleeping or sitting in a chair the body burns about 100 calories per hour but just standing up raises it to 140 and doing gentle household chores raises it by another 40.
• Fats and carbohydrates are the best fuel for the body to use to make heat. Healthy sources are whole meal bread, nuts, grains and fruit. Eating hot meals and drinking hot drinks raises the core temperature of the body and so works wonders in warming it up where it matters most.
• Low levels of vitamin Ñ are related to a decreased resistance to cold, as is a low level of vitamin B. Supplementing both these in full doses therefore helps prevent hypothermia.
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