What to do if an old person is shivering? A Comprehensive Guide

According to the CDC, older adults are at a higher risk of hypothermia because their bodies lose heat faster and they have a harder time sensing temperature changes. Knowing exactly what to do if an old person is shivering is a crucial skill for caregivers and family members to ensure their safety and well-being.

Quick Summary

If an elderly person is shivering, move them to a warmer area, remove any wet clothing, wrap them in dry blankets, and offer a warm (not hot), non-alcoholic beverage. Assess for signs of hypothermia and seek emergency medical help if they exhibit concerning symptoms like confusion or slurred speech.

Key Points

• Assess for Urgency: The most critical first step is to determine if the shivering is a simple cold response or a potential sign of hypothermia, which is a medical emergency.

• Rewarm Gradually: Safely move the person to a warmer area, remove wet clothes, and cover them with dry blankets, focusing on the torso and head, avoiding rapid warming.

• Offer Warm Fluids: If the person is conscious and able to swallow, provide a warm, non-alcoholic, sweet beverage to help raise their internal temperature.

• Monitor for Emergency Signs: Watch for symptoms like slurred speech, confusion, or a cessation of shivering, as these indicate severe hypothermia requiring immediate 911 contact.

• Address Underlying Causes: Shivering can be caused by more than just cold; consider and investigate other potential causes like fever, medication side effects, or low blood sugar.

• Preventative Measures are Key: Implement long-term strategies like maintaining a warm home, using layered clothing, and ensuring regular warm meals to prevent future incidents.

Immediate Action: First Aid for Shivering

When you see an elderly person shivering, the first priority is to stabilize their body temperature. This can often be a sign of their body's natural response to being cold, but in an older adult, it can quickly escalate into a more serious condition like hypothermia. Immediate action can be a lifesaver.

Step-by-Step Guide to Warming an Elderly Person

1. Move them to a warmer place: If they are outdoors, get them inside immediately. If they are indoors, increase the room temperature and move them away from drafts.
2. Remove wet clothing: Wet clothes, especially those made of cotton, draw heat away from the body. Gently and quickly remove any wet garments and replace them with dry clothes.
3. Cover with dry blankets: Layering is key. Use several dry blankets, towels, or coats to cover the person. Pay special attention to covering their head and torso, as these areas lose the most heat.
4. Offer warm fluids: Give them a warm, sweet, non-alcoholic drink, like tea or broth, if they are conscious and can swallow safely. Avoid hot beverages, which could cause burns. Do not give them alcohol, as it can hinder the rewarming process.
5. Use gentle rewarming techniques: For additional warmth, apply warm (not hot) compresses or use an electric blanket on their neck, chest, and groin. Never apply direct, intense heat, which can stress the heart and blood vessels.

When Shivering is a Sign of a Medical Emergency

While shivering can sometimes be easily remedied, it can also be a critical warning sign. For an elderly person, a body temperature below 95°F (35°C) is considered a medical emergency (hypothermia) and requires immediate professional help.

Signs that Require a 911 Call

Call emergency services immediately if you observe any of the following symptoms alongside shivering:

• Shivering has stopped (a sign of advanced hypothermia).
• Drowsiness, fatigue, or unusual lethargy.
• Confusion, memory loss, or a vacant stare.
• Slurred or slowed speech.
• Weak, slow pulse or slowed breathing.
• Clumsy, stiff, or jerky movements.
• Cold, pale, or bluish skin.

Hypothermia versus Essential Tremor

It's important to distinguish between shivering due to cold and shaking from other neurological conditions, such as essential tremor. While both involve involuntary movements, they have different causes and require different responses.

Feature	Shivering Due to Cold	Shaking from Essential Tremor
Cause	Low body temperature, infection (fever)	Neurological condition, stress, anxiety, medication side effects
Sensation	Feeling cold, goosebumps, teeth chattering	Can be triggered by movement, emotional stress, caffeine
Appearance	Generalized shaking to generate heat	Often localized (hands, head, voice), may worsen during tasks
Treatment	Rewarming, addressing infection	Identifying triggers, medication, therapy, relaxation techniques
Urgency	Can indicate medical emergency (hypothermia)	Typically not a medical emergency unless debilitating or new symptoms appear

Common Causes of Shivering in the Elderly

Understanding the root cause is vital for proper care. Shivering in seniors can stem from several conditions, not just cold exposure.

Medical Conditions

• Hypothermia: As mentioned, older adults are more susceptible to dangerously low body temperatures, even indoors.
• Infections and Fevers: A fever is a common cause of chills and shivering as the body attempts to raise its core temperature to fight an infection, like pneumonia or a UTI.
• Thyroid Disorders: An underactive thyroid (hypothyroidism) can cause increased cold sensitivity.
• Neurological Issues: Conditions like Parkinson's disease or stroke can sometimes cause tremors and alter the body's temperature regulation.
• Poor Circulation: Reduced blood flow, especially to the extremities, can cause a constant feeling of coldness and shivering.

Medication Side Effects

Certain medications commonly prescribed to older adults can interfere with their body's ability to regulate temperature. This includes some anti-seizure medications, sedatives, and antidepressants. It's always wise to discuss potential side effects with a healthcare provider.

Low Blood Sugar

Low blood glucose levels, or hypoglycemia, can cause shakiness and shivering. This is particularly relevant for elderly individuals with diabetes. If the person is diabetic, checking their blood sugar is a critical step. A simple sugar source like fruit juice can help if they are alert and conscious.

Prevention and Long-Term Strategies

Preventing shivering is better than reacting to it. Several strategies can help keep an elderly person warm and safe.

Environmental Adjustments

• Maintain adequate indoor temperatures: The National Institute on Aging recommends keeping the thermostat at 68°F or higher.
• Seal drafts: Use caulk or weather stripping around windows and doors to prevent cold air from entering.
• Utilize space heaters safely: If using a space heater, ensure it has an automatic shut-off and is placed away from flammable materials.

Personal Comfort

• Layer clothing: Encourage wearing several thin layers rather than one thick one. Layers trap warm air and allow for easy adjustment.
• Cover extremities: A significant amount of heat is lost through the head, hands, and feet. Make sure they wear hats, gloves, and warm socks and slippers indoors.
• Stay active: Gentle indoor exercise, like seated stretches or walking around, can promote circulation and generate body heat.

Nutritional Support

• Eat warm meals: Regular, nutritious, warm meals and drinks help maintain body heat. Soups and broths are excellent choices.
• Stay hydrated: Staying properly hydrated is essential for overall health and helps with temperature regulation.

Conclusion

While a shiver might seem like a minor issue, when it happens to an elderly person, it demands immediate attention. Acting quickly to warm them up and assess their condition is critical. By understanding the potential causes, from simple cold exposure to more serious medical conditions like hypothermia, you can take appropriate action. Remember to always seek emergency medical help if there are signs of hypothermia or other severe symptoms. Taking proactive, preventive measures in their environment and daily routine is the best way to ensure their safety and comfort, especially during colder months. For more comprehensive information on senior health and cold-weather safety, consult authoritative sources like the National Institute on Aging website.

Frequently Asked Questions

What is the very first thing I should do if an old person is shivering?

Immediately move them to a warmer place, away from any drafts or cold sources. If their clothes are wet, remove them and replace with dry ones, then cover them with dry blankets.

When should I call 911 for an elderly person who is shivering?

You should call 911 immediately if you suspect hypothermia. Warning signs include a core body temperature below 95°F, slurred speech, confusion, a weak pulse, or if they have stopped shivering.

Can medication cause an elderly person to shiver?

Yes, some medications, including certain antidepressants, sedatives, and anti-seizure drugs, can affect the body's ability to regulate temperature, leading to shivering or increased cold sensitivity. Always consult a healthcare provider about medication side effects.

Is there a difference between shivering from cold and shaking from a medical condition?

Yes. Shivering from cold is a full-body response to generate heat, while shaking from conditions like essential tremor or Parkinson's disease is often localized and can be triggered by stress or movement. An emergency is more likely with cold-induced shivering if other symptoms of hypothermia are present.

What kind of drinks are safe to give a shivering elderly person?

Offer warm, non-alcoholic, and preferably sweet drinks like tea, broth, or fruit juice. Avoid alcohol, which can cause further heat loss, and very hot drinks, which could cause burns.

How can I prevent an old person from shivering in cold weather?

Prevention includes keeping their living space warm (68°F+), ensuring they wear layers of dry clothing, covering their head and feet, providing regular warm meals, and limiting cold exposure, even indoors. Encourage gentle activity to improve circulation.

What if the shivering is from a fever, not cold?

If the shivering is due to a fever, which is the body's way of resetting its temperature, you should still keep them comfortable with blankets but avoid overheating them. Treating the underlying infection and managing the fever with appropriate medication (if prescribed) is the priority. Consult a doctor for proper diagnosis.