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Thousands of older Americans "freeze to death" each winter in their own homes. At present, Americans are poorly informed about the problem.

Hypothermia means low body temperature (95 degrees F or lower). When body heat is lost faster than it is replaced, body temperature falls and hypothermia results. A simple drop in skin temperature is not hypothermia. While hypothermia can sometimes develop slowly, it usually occurs fairly quickly, over a period of days in most cases.An estimated 2.5 million older Americans are especially vulnerable to hypothermia. One of the leading experts has conservatively estimated that 25,000 older adults die from hypothermia each year in the United States. This estimate ranks hypothermia as the sixth leading cause of death among older adults in the U.S.

Among the elderly, those most likely to develop hypothermia are the chronically ill, the frail, the very old, the poor who are unable to afford enough heat and those who do not know how to keep warm when exposed to low indoor temperatures. Moreover, many prescription drugs can make older adults much more susceptible to the threat of hypothermia.

For millions of older Americans, economic hardship has necessitated difficult choices between expenditures for food, transportation, clothing, home heating, and medicine. For thousands, it is not just a question of heat or eat. The real dilemma of hypothermia is heat or die.

Although the condition almost always occurs in a cold environment, temperatures do not have to be below freezing for death to result. Lower room temperature can be lethal to older adults who are forced to reduce indoor temperatures out of economic necessity.

What are the signs?

Most older adults develop hypothermia over a period of three days to one week. These warning signs may indicate hypothermia:

- Confusion and reduced alertness.

- Trembling on one side of the body or in one arm or leg.

- Shivering in the early stages, then as condition worsens, the shivering stops.

- Cold and stiff muscles.

- Cold abdomen and back.

- Difficulty in speaking.

- Slow breathing.

- Bloated face, pale and waxy skin.

- Forgetfulness.

- Drowsiness.

- Unconsciousness.

- Low body temperature.

Treating hypothermia

The victim must be rewarmed, preferably by a physician who is familiar with hypothermia. Rewarming is best done in a hospital or clinic setting.

If a person's temperature is below 95 F (only sure way is to use a special low-reading rectal thermometer), an ambulance should be summoned. If emergency medical help is slow to arrive, further heat loss can be prevented by wrapping the victim in a warm blanket. Avoid giving any food and drink.

If blankets are not available the body heat of another person lying close to the victim will aid in rewarming. Handle the victim very gently and don't rub them. Sudden movement or rough handling can easily cause a fatal heart attack (ventricular fibrillation).

Do not place the victim in a hot bath or shower because it could cause fatal rewarming shock or a sharp drop in body temperature. Do allow them to walk or move around.

Cold weather and the hazard it presents to the health, safety, and welfare of every American, especially the elderly, is a national problem.