Understanding Why Dementia Affects Body Temperature
People living with dementia are particularly vulnerable to the cold. As dementia progresses, it can damage the brain's autoregulation system, which is responsible for controlling blood flow and body temperature. This impairment means their body is less efficient at generating and retaining heat, and they may not be able to sense or communicate that they are cold. This can make their hands and feet feel cold, even in a comfortable room. Furthermore, conditions common in seniors, like a slower metabolism and reduced body fat, exacerbate this issue, increasing the risk for a dangerous drop in body temperature known as hypothermia.
The Layering Strategy: Clothing for Warmth and Comfort
One of the most effective methods for keeping someone with dementia warm is layering their clothing. Layers trap warm air close to the body and can be easily added or removed to adapt to temperature changes throughout the day.
Recommended Clothing and Fabrics:
- Base Layers: Start with a soft base layer, like long underwear made from cotton or a gentle synthetic blend.
- Mid Layers: Add insulating layers such as flannel shirts, fleece jackets, or wool sweaters. Natural fibers like cotton, wool, and fleece are excellent for retaining body heat.
- Outer Layers: If going outside, a waterproof and windproof jacket is essential.
- Accessories: A significant amount of body heat is lost through the head and neck. Always include a soft hat and a scarf. Gloves or mittens are crucial for protecting hands.
- Footwear: Warm socks and comfortable, non-skid slippers should be worn indoors. When outside in cold weather, ensure they have appropriate boots with good grip to prevent falls.
It's also helpful to choose clothing that is easy to put on and take off, such as items with elastic waistbands or Velcro fastenings instead of complex buttons or zippers.
Creating a Warm and Safe Home Environment
Maintaining a consistently warm living space is critical. The National Institute on Aging suggests setting the thermostat to at least 68–70°F, as even mildly cool homes can be dangerous for older adults.
Tips for a Warm Home:
- Seal Drafts: Use rolled-up towels at the base of doors and apply weather stripping around windows to prevent cold drafts.
- Use Curtains: Thermal curtains are a great investment to insulate windows and prevent heat loss, especially at night. During the day, open curtains to let in sunlight for natural warmth.
- Provide Blankets: Keep soft, accessible blankets and afghans on chairs and sofas so the person can easily cover themselves if they feel chilled.
- Warm the Bed: Flannel sheets can make a bed feel much warmer. You can also warm the bed before sleep with a hot water bottle or an electric blanket, but never leave an electric blanket on overnight. Always check for any folds or damage, as this can be a fire hazard. For individuals with incontinence or mobility issues, electric blankets are not recommended.
The Role of Diet and Hydration
Keeping warm uses a lot of energy, so regular, nutritious meals are vital. Warm foods and drinks can provide an immediate feeling of warmth and help maintain core body temperature.
- Warm Meals: Soups, stews, and oatmeal are excellent choices. They are not only warming but also hydrating and packed with nutrients.
- Warm Beverages: Offer warm drinks like herbal tea, hot chocolate, or warm milk throughout the day. Avoid alcohol, as it can cause blood vessels to dilate and lead to a rapid loss of body heat.
- Stay Hydrated: A warm house can increase the risk of dehydration. Ensure the person is drinking plenty of fluids, even if they don't express thirst.
Safe Warming Techniques & Comparison
When a person feels cold, it's important to warm them safely. Direct, high heat can be dangerous for older adults, whose skin is often thinner and more susceptible to burns. They may also have a reduced ability to sense when something is too hot.
Safe Options:
- Warm Towels: A towel warmed in the dryer can be safely placed over their lap or feet.
- Microwaveable Packs: Bean or rice-filled socks or commercially available heat packs can provide gentle, lasting warmth. Always test the temperature on your own skin first.
- Encourage Movement: Gentle activity boosts circulation. Encourage moving around at least once an hour, even if it's just wiggling toes and moving arms and legs while seated.
Comparison of Warming Blankets
| Blanket Type | Pros | Cons | Safety Considerations |
|---|---|---|---|
| Electric Blanket | Provides consistent, adjustable heat. | Fire/burn risk if folded, damaged, or used with incontinent individuals. Can't be left on overnight. | Must have auto shut-off. Not for those with mobility issues, paralysis, or diabetes who may not feel overheating. |
| Weighted Blanket | Provides calming pressure. Warmth from insulation. | Can be too heavy for frail individuals. Does not generate its own heat. | Ensure the weight is appropriate for the user's body size (typically 10% of body weight). |
| Cordless Heated Blanket | Portable, no trip hazard from cords. | Limited battery life (1.5-3 hours). Higher initial cost. | Good for wheelchair users. Must be charged. Still requires caution regarding heat levels. |
| Fleece/Wool Blanket | Very safe, no burn risk. Inexpensive. | Provides insulation only, does not generate heat. | The safest option. Layering multiple blankets can increase warmth. |
Conclusion: Proactive Warmth is Key
Knowing how to keep a dementia patient warm is a proactive and essential part of caregiving. It requires vigilance in monitoring their comfort and recognizing the subtle signs of being cold, such as pale skin or confusion. By combining strategies—layering appropriate clothing, maintaining a warm and draft-free home, offering warming foods and drinks, and encouraging movement—caregivers can create a safe, comfortable environment that protects against the serious risks of hypothermia. For additional resources and support, consider visiting the National Institute on Aging.
