Temperature regulation and hydration often inefficient with age

Dear Carol: Even at 83, my mother lives comfortably on her own. She’s installed aging-in-place safety gadgets like grab bars and, as far as I can tell, her memory and thinking are fine. What concerns me is that she keeps her condo heat at 78 degrees and still wears a sweater. She says her blood work is good and that while on the thin side, her weight is fine. Her doctor agrees that her weight is normal for her. I understand that being cold is common for older people, but I still wonder if something needs to be treated. It’s like her temperature regulator is broken. Some insight would be appreciated. – KA

Dear KA: As you mentioned, most older adults like warmer room temperatures than younger people, so this isn’t surprising. Still, since your mom might not have thought that this was worth mentioning to her doctor, you could suggest that she do so during her next checkup. She’s probably fine, but problems with hemoglobin, thyroid and blood sugar can affect temperature regulation.

Potential diseases aside, challenges with body temperature regulation are, for the most part, a normal part of the aging process. Thin, dry skin and less fat under the skin mean older adults have less insulation than when they were younger. Additionally, even in healthy older adults, most physical systems including circulation are less efficient. There is one practical thing you could check. Drafts can make people feel chilled, so check her windows to see if they need more insulation.

Whatever the reason for her chilliness, it’s important that she’s comfortable in her home, so cozy sweaters, shawls and robes are her friends. If at times she’s wearing unfashionable layers, no big deal.

Related to temperature regulation is how easily older adults can become dehydrated in the summer heat. You may feel that since your mom needs extra heat during the winter, hot weather should be good. Maybe so, maybe not, but if she enjoys being out in the heat, remind her to stay hydrated, since this too is an aging issue.

Just as body temperature regulation gets more complicated with age, so does the ability to stay properly hydrated. This is one reason you read about so many elder deaths during heat waves. What happens is that fluid reserves become smaller with age. Our ability to recognize when we’re thirsty may be blunted, as well. Additionally, medications such as diuretics for high blood pressure can increase the risk, as can some chronic conditions such as diabetes.

A note for dementia caregivers: People with mid-to-late dementia cannot tell you if they are cold or hot, and they are at risk for both extremes. Either may cause them to act anxious or angry, yet they can’t tell you why. Remember to check for these issues if the person you care for is unsettled.

Fortunately, KA, your mom can adjust her heat and clothing so neither extreme should limit her enjoyment of life. Continue to celebrate her good health!