Hospital consultant backs our Surviving Winter campaign

AN expert in elderly care at the Great Western Hospital is warning people to be on the lookout for the effects of winter cold on relatives and neighbours.

Each year 300 older people die in Wiltshire due to cold-related illness and consultant geriatrician Sarah White, the Great Western Hospitals NHS Foundation Trust lead for dementia care, says many deaths are preventable if the signs are spotted early.

She is backing the Wiltshire Community Foundation’s Surviving Winter campaign, which gives £300 grants to those living in fuel poverty to help keep their homes warm. “I think it is brilliant, that money could make such a difference,” she said.

Last year the foundation gave 265 grants, benefitting 405 households after raising £77,00. This year it hopes to raise £100,000 and is appealing for people to donate their £200 government Winter Fuel Allowance if they don’t need it.

 Mrs White, 39, said: “Older people are more prone to the effects of the cold weather because of changes in the body as we age,” she said. “As you get older you lose heat faster and you lose the ability to detect temperature differences, so an older person might not realise the room is colder.”

She said there are many factors that make older people more vulnerable to the cold. “Older people are more prone to the effects of hypothermia because they don’t move as much, they often have other conditions such as thyroid disease that affects the body’s ability to regulate its temperature; diabetes, which impairs the blood flow or arthritis, which could impair a person’s ability to dress well or cook for themselves,” she added.

She believes older people are less likely to eat well, either because they cannot afford to buy good quality food as well as heat their homes, or are just not motivated to cook for themselves.

She added: “It is a bit of an effort to cook for one and some people just can’t be bothered, or the arthritis in their hands is playing up, or maybe it is just too much effort to get to the shops. Body fat plays an important role in keeping you warm and if you are just living on tea and toast you just won’t have the nutrition inside you to actually make heat to keep you warm.”

Not staying warm takes a gradual toll, eventually triggering potentially fatal conditions, such as hypothermia, pneumonia, flu or other respiratory conditions.

Last year’s long and cold winter saw temperatures dip below -5 degrees Centigrade, with the frostiest months being February and March. GWH bore the brunt of the effects of the weather with A&E and wards jam-packed.

Mrs White said: “One of the key things we see in the hospital is that during the colder spells we see a lot of older people coming into hospitals with hypothermia. Between five and ten per cent of our admissions over the age of 65 are because of hypothermia

“If you are over 70 and your body temperature is less than 32 degrees Celsius then you have a 50 per cent mortality rate. If you have conditions like respiratory problems and are not keeping warm over a long period of time you’re a sitting duck really.”

The tell-tale signs that an older person is slipping towards a potentially-fatal bout of hypothermia are pale, cold skin, a puffy or swollen face and slow or slurred speech. “If they are suffering from mild hypothermia they may also be a bit muddled or confused,” said Mrs White.

“As that gets worse, and as their body temperature gets lower, they start to become much slower in their movements and their reaction times, they become quite stiff and they have blackouts. The heart rate slows down and that’s when you are really in trouble and need to be admitted to hospital.”

Mild hypothermia can be tackled with warming the room, putting on extra clothing and hot drinks, soup, or high-energy, sugary food. But alcohol, caffeine should be avoided because they promote heat loss. Hot baths or electric blankets should be avoided. “They can warm the body too quickly and cause cardiac arrest,” said Mrs White.

She added: “I always find it strange that in places like Siberia, where it is much colder than here, there are almost no excess deaths in winter, yet we have so many here. You have got to ask why that is. It probably comes down to awareness and people looking after each other.”

Pictured: Consultant geriatrician Sarah White, the Great Western Hospitals NHS Foundation Trust lead for dementia care