Ask any elder about the dangers of winter and they will tell you without hesitation that slips and falls on icy walkways are number one. They, of course, are correct but there are a host of other hazards placing elders at risk of falling during winter. Here are some potential health problems to be aware of: 

Dehydration  

• 68-year-old Martha has high blood pressure and is extremely careful about her diet and medication. But last week, Martha felt weak and collapsed while preparing to go out for an evening walk; doctors at the emergency room diagnosed severe dehydration. Martha didn't realize that she was not drinking enough water; her tea/coffee intake had gone up due to the drop in temperature (both tea/coffee have diuretic properties that can lead to dehydration). Martha’s health was restored with some fruit juice/lemon water.

Dehydration among elders goes up with the onset of winter because people generally drink less water in the cold weather. This can lead to dehydration, fluid imbalance and fall risk. In elders who are on medication for blood pressure and other long-term health problems, dehydration can even prove fatal. To avoid dehydration:

• Reduce or eliminate dehydrating beverages such as coffee/ tea and soft drinks.
• Drink between 6-8 glasses of water daily.
• Eat lots of fruits and vegetables; most have high water content.

Feeling Blue

• Albert (age 71) was brought to the emergency room by his daughter with the complaint of slurred/incoherent speech, impaired balance and a recent fall. Doctors found that Albert’s sodium level had dropped way down due to a decrease in salt intake; lately he had been lonely and was not eating regularly, skipping a lot of meals. Albert’s nutritional imbalance (low salt intake) was triggered by his depression (feeling lonely/not eating), which resulted in his health problems.

Feeling down and in the dumps peaks during the winter months is a common complaint; short, dark, cold days, less activity, restricted outings, etc. can negatively affect an elder’s outlook, especially if they’re living alone. Moreover, elders face the risk of feeling depressed due to life changes, medication, and illness. During winter, when stress levels and isolation increase, it’s important for caregivers to:

• Spend time with their loved ones and help them connect with others during the cold winter months.
• Watch for signs of depression, such as persistent sadness, reduced energy, sleep problems, change in eating patterns, etc. Many elders are unwilling to admit being depressed for fear of being seen as weak or unstable.

Hypothermia

• Lou Ann (age 84) enjoys going for her daily 5-mile walk, even in very cold and snowy winter mornings. After arriving home during a recent outing, Lou Ann’s son noticed that she was confused, drowsy, and weak and her balance was way off.  He brought Lou Ann to the emergency room. The doctors said that she had hypothermia (low body temperature).
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Hypothermia can happen from exposure to cold temperatures; elders are especially susceptible. Hypothermia may develop over hours or days if the body can’t regulate heat as it should. Diseases of the endocrine glands (such as hypothyroidism; a condition of the thyroid gland), which triggered Lou Ann’s problems, may also cause the body to have trouble producing heat.

Hypothermia can usually be prevented by:

• Dressing warmly, being careful to stay warm and dry, and recognizing the early symptoms (e.g., feeling tired, confused or weak and problems walking).
• If planning to be outdoors for long periods in cold weather, wear layers of insulated or moisture-wicking clothing, including a hat. If you start to shiver, go inside.
• Avoid overexertion, eat enough food, drink enough fluids, and avoid alcohol.
• Postpone early morning walks by 2 hours or until it gets warmer.

Another cold weather problem is:

• Seasonal flu and pneumonia; a loss of balance and/or falling can sometimes be the first sign of an underlying respiratory infection. Elders with weak lungs and suffering from respiratory conditions (asthma, chronic bronchitis or emphysema) are especially at risk and should get a pneumonia and flu vaccination. Any signs of coughing, yellow sputum, chest pain, chest discomfort, shortness of breath and fever should prompt a call to the doctor.

As for Avoiding Slips and Falls...

Winter is the time for snowy weather, freezing temperatures, and plenty of ice. For elders, this signifies an increased chance of slips and falls, which can cause serious injuries in just a matter of seconds. So what’s the best way to avoid being injured this winter? Prevention is the place to start:

• Simple exercise for joints can help relieve age-related arthritis or pain in the joints, which worsens during cold weather, making you prone for slips and falls. Exercise to strengthen your legs. Strong leg muscles can help you steady yourself if a slip and loss of balance happens. Moreover, if fall occurs, it will be a lot easier for you to get back up.

• Check your footwear. Walking on snow or ice is especially treacherous and wearing proper footwear is essential. A pair of well insulated boots with good rubber treads is a must for walking during or after a winter storm. Better traction can help keep you stable on icy surfaces.

• When walking on an icy or snow-covered walkway, take short steps and walk at a slower pace so you can react quickly to any changes in balance.

• Slow down. It is when you rush that you end up losing your balance. Keep in mind that being a bit late is better than falling.

• Listen for weather advisories on television and radio before going outdoors in snowy weather. Always take a cell phone when bad weather is expected.

• Keep a bag of sand, cat litter or rock salt to spread on icy walkway to avoid slipping.

These simple safety tips, when used together, could make the winter elements a bit less perilous.

Click here to read Dr. Rein Tideiksaar’s article about suitable safety gifts for seniors.

Rein Tideiksaar Ph.D., PA-C (or Dr Rein as he is commonly referred to) is the president of FallPrevent, LLC, Blackwood, NJ, a consulting company that provides educational, legal and marketing services related to fall prevention in the elderly. Dr Tideiksaar is a gerontologist (health care professional who specializes in working with elderly patients) and a geriatric physician's assistant. He has been active in the area of fall prevention for over 30 years, and has directed numerous research projects on falls and has developed fall prevention programs in the community, assisted living, home care, acute care hospital, and nursing facility setting. To learn more, check out the Doctor’s professional profile on LinkedIn: http://www.linkedin.com/pub/dr-rein/6/759/592. If you have any questions about preventing falls, please feel free to email Dr. Tideiksaar at drrein@verizon.net.

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