Lifesteps Adult daycare client relax outside under the shaded patio at Lifesteps in Butler Twp on Monday August 1, 2016.(Justin Guido photo)

With highs in the upper 80s forecast for the next two weeks, the hot weather, especially when combined with certain medications, can prove especially hazardous to the elderly.

“Heat illnesses are very bothersome to seniors,” said Dr. Brian Negrini, who works at Sunnyview Nursing and Rehabilitation Center and the emergency room at Butler Memorial Hospital.

“In the last decade, 40 percent of all heat-related deaths in the United States, 3,000, have been those over 65.”

The reason for that, Negrini said, is that older people's heat regulation mechanisms don't work so well. “The elderly don't sweat as much as younger folks,” Negrini said. “Seniors store fat differently as well and this leads to decreased cooling.”

And older people are usually on a daily medication regime that can make them more susceptible to heat-related illnesses said Dr. Fred Fioravanti, the medical director at Concordia in Cabot, senior living center and a family practice physician specializing in geriatric medicine.

“For example, a patient that may have congestive heart failure may be on a diuretic,” said Fioravanti, which acts on the kidneys to encourage water loss.

“Evaporation is the primary mechanism for heat loss in a hot environment,” said Fioravanti, and less water in the body means less sweat which means less cooling.

John Valentino, the co-owner of the Institute Hill Pharmacy, 937 E. Jefferson St., said other drugs that can combine with the heat to negatively affect the elderly include antidepressants and antihistamines (suppress activity in the area of the brain that controls sweating) and, beta blockers (inhibit the body's ability to handle stress).

“It's not a high potential for side effects from the meds,” said Valentino. “I'd say 95 percent of the people would have no issues. But for people with health risks, age would certainly play a factor, yes.”And it's not just prescription medication that can play havoc with an older person's reaction to heat, said Rich Zabinski, director of the in-house pharmacy at Concordia.Over-the-counter remedies such as Sudafed and Benadryl can also interfere with the body's ability to cool itself, Zabinski said.“You need to use more caution if you know it is going to be a hot day,” said Zabinski.He said it can be difficult to tell whether a senior citizen is suffering from heat stroke or another debilitation.“You might notice first some confusion in the elderly. You won't know for sure until you go to the doctor to see if they are, in fact, dehydrated,” said Zabinski.Negrini said other signs are fatigue, decreased appetite, infrequent urination and an increased desire to sleep.“In the most severe cases, there is passing out and seizures,” said Fioravanti.Fran Kilgore, senior director of the adult day services program at Lifesteps, 383 New Castle Road, said three staff members, one a registered nurse, oversee the location's adult day care program for about 20 attendees, most over the age of 60.“Our staff is taught to look for the symptoms of heat stroke and heat exhaustion, as well as prevention,” said Kilgore.“We do training for the staff on what to be on the lookout for when the heat and the humidity are high,” said Kilgore.

Concordia at Cabot dietitian Natalie Kolish said the hot weather can also disrupt the elderly's nutritional equilibriumKolish said, “When it gets hotter outside, the risk of nutritional deficiencies increase. Hunger decreases, the motivation to cook can be decreased, dehydration risks are heightened.”“Working in the heat, you can tire out faster, but there are ways to help stop this,” she said.“There are a lot of foods people can eat. Fruits like watermelon, oranges, cantaloupe, strawberries and vegetables like peppers cucumbers, lettuce and carrots have water that can lesson the chances of dehydration,” Kolish said.Kolish said it's easy to make a homemade version of Gatorade to combat dehydration.“It's sugar and salt mixed with water, that's basically what Gatorade is,” Kolish said. “For one liter of water add two tablespoons of sugar and a teaspoon of salt. You can boil it so it dissolves a little better, but you don't have to.”If an aged relative or acquaintance is suffering from heat stroke or heat exhaustion, Fioravanti said, there are a number of remedies to try, at least until the victim can receive medical attention.“You can try ice packs. If they are alert enough to drink, keep them hydrated. If they are alert enough to take fluids they should. If they are lethargic, they could aspirate,” he said.“Call 911 and get medical help,” Fioravanti said.

According to the federal Centers for Disease Control and Prevention the symptoms to watch for are:Heat ExhaustionHeavy sweatingWeaknessCold, pale, and clammy skinFast, weak pulseNausea or vomitingFaintingHeat StrokeHigh body temperature (above 103°F)Hot, red, dry or moist skinRapid and strong pulsePossible unconsciousness<h3>What you can do</h3>Dr. Brian Negrini, an emergency room physician at Butler Memorial Hospital, who also works at Sunnyview Nursing and Rehabilitation Center, said the following precautions should lessen seniors' chances of heat stroke or heat exhaustion.If the temperature is above 80 degrees, have an 8-ounce glass of water or juice with every meal. Avoid caffeine and alcohol which make you lose twice as much fluid as you take in.Wear loose, light-colored clothingTake cool showers and bathsAvoid using the oven and stove during hot spellsAvoid physical activity during the hottest part of the day between 10 a.m. and 6 p.m.Check on neighbors

Dr. Fred Fioravanti at Concordia in Winfield Twp. on Friday, 7/29/16 (Dave Prelosky photo)

Resident Eleanor Magnus chats with dietician Natalie Kolish in the pantry of one of the kitchens at Concordia.

Pharmacist Rich Zabinski at Concordia