Research Applied to Clinical
We have all seen an elderly person wear a sweater on a hot summer day. Thermoregulation is a finely controlled process that maintains the body's core temperature in the range in which most biochemical processes work best (99° to 99.6° F) (Worfolk, 1997). Thermoregulation is affected in 2 ways; endogenous via cardiovascular, respiratory, neuroendocrine, neuromuscular, and gastrointestinal systems, and exogenous via medication and nutrition (Knies, 1996).
While the basic components of homeostasis are intact, the ability to detect changes in external and internal environments and the speed and effectiveness of the response to these changes are often decreased or lost in the very old or debilitated. Thermal, chemical and mechanical receptor density and sensitivity decrease with age. Therefore the elderly have a delayed perception to the cold or hot. Due to this loss of cutaneous receptors or decrease in their sensitivity, the body's temperature control centers (hypothalamus and brain stem) are slow or ineffective in their response to the temperature changes (Sanders, 1996). Also as the skin becomes thinner and subcutaneous fat diminishes, the insulation against cold and the ability to radiate heat off the body, just doesn't occur.
What does this mean to the clinician?
When attempting to compensate or prevent hypothermia, there is no ideal temperature, it is individually patient related. Even in the summer we must assist the elderly in keeping warm. When you are examining a patient or assisting in bathing, only keep the area in which you are working uncovered, then re-cover quickly; a thin sheet is not enough, warm cotton blankets are the ideal.
"Research Applied to Clinical Practice: Geriatric Thermoregulation"
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