Keeping older adults safe in cold weather: indoor hypothermia, checking on neighbors, and heating help¶

寒冷天氣對老年人來說比大多數人意識到的要危險得多，而且大部分危險發生在室內。老年人在感覺寒冷的客廳裡可能會出現體溫過低的情況，因為老化會改變身體感知寒冷、產生熱量和保持熱量的方式。冬天還會帶來冰凍、心臟緊張、流感、因暖氣不良導致的一氧化碳，以及出現問題時獨自一人的風險。

本指南適用於老年人、他們的家人和鄰居。它解釋了為什麼隨著年齡的增長，感冒的風險更大，如何讓家中保持安全溫度，如何識別室內體溫過低，如何安全和友善地檢查鄰居，以及如何在美國、加拿大、英國和其他國家尋求取暖費用幫助。它還涵蓋藥物、食物、跌倒、一氧化碳和停電。看 老年人應急計劃 用於總體規劃。

現在就這樣做¶

1. 檢查老年人居住的房間和臥室的溫度。居住區域的溫度目標至少為攝氏 18 度（64 華氏度），如果患者感到寒冷、虛弱或不適，則應提高溫度。如果他們感覺不舒服，請將他們轉移到溫暖的房間或地方。
2. 尋找警訊：皮膚冰冷、發抖或根本不發抖、困倦、言語不清、意識混亂、動作緩慢或臉部浮腫、蒼白。如果您看到它們，請撥打當地的緊急電話號碼（美國和加拿大為 911，歐盟地區為 112，英國為 999）。看 緊急號碼。
3. 添加衣物、帽子、保暖襪子和毯子，並幫助患者吃喝溫暖的東西。脫掉潮濕的衣服並使其遠離氣流。
4. 檢查一氧化碳警報器和煙霧警報器是否正常運作，並且沒有使用烤架、露營爐、發電機或瓦斯爐加熱。
5. 透過電話或在門口查看年長或獨居的鄰居，並同意在寒冷時期每天檢查一次。留下一個他們可以撥打的電話號碼。
6. 如果停電或暖氣失敗，請儘早將人轉移到溫暖的親戚家、暖氣中心或避難所，而不是等到房子非常冷時才轉移。

為什麼老年人面臨的風險更大¶

隨著年齡的增長，一些變化會讓感冒更難處理。它們都不是錯誤或失敗。它們是正常的，幾個簡單的步驟就可以預防它們。

• **冷感較弱。 **老年人通常要等到體溫下降後才會感到冷。他們可能會說自己很好，但實際情況並非如此。
• **身體熱量減少。 ** 肌肉質量和新陳代謝隨著年齡的增長而下降，因此身體產生的熱量減少。較薄的皮膚和較少的身體脂肪會降低隔熱效果。
• **顫抖速度較慢。 ** 顫抖是身體短期內產生熱量的主要方式，對於老年人來說，顫抖可能會較弱或可能提前停止。
• **血液循環較差。 ** 血管狹窄、心臟病、糖尿病和某些藥物會減少流向皮膚和四肢的血液。
• **醫療狀況。 ** 心臟病、肺病、甲狀腺問題、糖尿病、帕金森氏症、失智症、中風和關節炎都會增加風險。疾病和感染會改變溫度控制。
• **藥物。 ** 一些治療睡眠、焦慮、憂鬱、過敏、高血壓和心理健康的藥物會影響身體感知或處理溫度的方式，有些會導致頭暈或混亂。
• **行動受限和孤立。 ** 行動不便、獨居或很少外出的人可能不會注意到房子很冷，也可能無法獲得幫助。
• **成本擔憂。 **許多老年人為了省錢而保持低溫供暖，有些人不吃飯或不吃藥來支付能量。這是感冒相關疾病的主要原因。
• Alcohol. A drink can feel warming but speeds heat loss.

冬季與寒冷相關的死亡通常是由於心臟病發作、中風和肺部感染，而不僅僅是體溫過低。寒冷會使血壓升高，使血液更容易凝結，因此在寒冷的天氣裡，心臟和血液循環問題會急劇增加。國家衛生服務中心（英國）、疾病管制與預防中心（美國）和加拿大衛生部都對這些室內風險發出了警告。

Indoor hypothermia¶

體溫過低是指身體的核心溫度降至攝氏 35 度（95 度）以下。它可以發生在涼爽的室內，尤其是在幾天內，並且它可以緩慢地形成，以至於沒有人注意到。該人可能看起來疲倦、安靜或困惑，家人可能會將其歸咎於年齡或疾病。

警告標誌¶

Because older adults may not shiver, absence of shivering does not mean they are fine. Look for other signs such as cold skin on the stomach or back, confusion, slow speech, unusual sleepiness or a strange change in behavior.

What to do¶

1. Call your local emergency number if you see signs beyond mild shivering, or if the person is confused, very sleepy, unresponsive or not shivering despite feeling cold.
2. Move the person to a warm room if you can do so gently. Do not allow them to walk if they are weak.
3. Remove wet clothing and replace it with dry layers. Wrap them in blankets, with a hat or cloth around the head and neck, and put insulation under them.
4. Give warm, sweet, non alcoholic drinks if they are awake and can swallow. Do not give food or drink to someone who is drowsy.
5. Place warm, not hot, water bottles wrapped in cloth against the chest, armpits and groin. Do not use a hot bath, heating pad on bare skin, or a hair dryer.
6. Handle gently and do not rub the arms or legs.
7. Stay with them and check breathing. If they are unresponsive and not breathing normally, start CPR. See 心肺復甦。

For full care steps read hypothermia and frostbite。

Safe temperatures at home¶

Health agencies give guidance on indoor temperatures. The World Health Organization and many national health services suggest that living rooms be kept at about 18 degrees Celsius (64 degrees Fahrenheit) or higher for healthy adults. Older people, those who are unwell, and those who are not very active may need it a little warmer, such as 20 to 21 degrees Celsius (68 to 70 degrees Fahrenheit) in the room where they sit. Bedrooms are often advised at around 18 degrees Celsius (64 degrees Fahrenheit) or slightly cooler for sleep with warm bedding.

These figures are general. Use a simple room thermometer in the living area and in the bedroom, and do not trust how the room feels. A thermometer with large numbers helps people with poor sight.

Keeping a home warm without risk¶

• Heat the rooms that are used most, and close doors to others. It is better to heat one room well than to heat the whole house poorly.
• Stop drafts with draft excluders, tape and curtains. Keep curtains closed at dusk and open them during the day to let in sun.
• Use a thermostat set steadily, rather than turning heating on and off. Constant moderate heat is often cheaper than short bursts, and safer.
• Dress warmly indoors: several thin layers, a cardigan, socks, slippers, and a hat if the house is cold. Wear a hat in bed if needed.
• Use blankets and a hot water bottle wrapped in a cover, or a modern electric blanket that is in good condition and is used according to the instructions. Do not use an electric blanket that is old, frayed or damaged, and do not use one if the person is incontinent or has dementia without medical advice.
• Sit with the legs raised and covered, and avoid sitting still for long periods. Stand up and move every hour.
• Eat regular hot meals and warm drinks. Food gives the body fuel for heat.
• Avoid alcohol, which causes heat loss and increases the risk of falls.

Checking on neighbors¶

Many older adults live alone, and some have no family nearby. A simple check by a neighbor can be the difference between a minor problem and a tragedy. Cold snaps, storms and power outages are the times when checks matter most.

How to check in kindly¶

1. Make a plan before the weather turns. Knock, introduce yourself, and offer your phone number. Ask whether they would like a daily call or visit during cold weather, and who else should be contacted in a crisis.
2. Agree on a signal. For example, a blind raised in the morning, a phone call at a set time, or a card in the window. If the signal is missing, someone checks.
3. Call first if you can. A call lets the person speak without feeling intruded on, and you can tell if their speech is slurred or they are confused.
4. Visit in person during emergencies. Knock, wait patiently, and speak clearly. Some people take time to get to the door.
5. Ask open questions. How warm is the house? Do you have heat and power? Have you eaten today? Do you have your medicines? Have you fallen?
6. Look for signs. Is the house cold, with the heating off? Is mail or snow piling up? Are curtains still closed in the afternoon? Is there a smell of gas or smoke?
7. Offer practical help. Offer to shop, clear snow, collect medicine, charge a phone or move them to a warmer place.
8. Respect independence. Offer rather than insist, and avoid talking down to the person. Many people are proud, and they are more likely to accept help from someone who treats them as an equal.

If no one answers¶

• Call the person on the phone and any known contacts, such as family, a caregiver or a friend.
• Look through the window and listen from the door for sounds of distress, calls for help, or a television running all day.
• Check for a key holder or a spare key if you have been given one, but do not enter a home that smells of gas or smoke, or where you suspect carbon monoxide.
• If you are worried, call your local emergency number and ask for a welfare check. Tell them what you know: the person's age, health, how long since contact, and any signs.
• Do not break in unless you see someone in obvious trouble and cannot wait. Give details to the dispatcher first.

Community networks¶

Some neighborhoods run block captain programs, volunteer check in schemes and registries of residents who need support. See neighborhood CERT mutual aid block captain plan and vulnerable neighbor registry. Ask local government, senior centers, faith communities, libraries, and charities about check in services, meals delivered to the door, and winter outreach teams. In the United Kingdom, Age UK and local councils run schemes. In the United States and Canada, local Area Agencies on Aging and Meals on Wheels programs often include wellness checks.

Heating assistance programs by country¶

Money worries are a major reason older adults keep homes too cold. Help exists, but programs and rules change often, so check the current details with the official source. A phone call to a local senior center, community organization, or social services office is a good start. Never wait until the heat is cut off to ask for help.

In the United States¶

• Low Income Home Energy Assistance Program (LIHEAP). A federal program that helps eligible households pay heating and cooling bills, and in some places helps with emergency repairs and crisis situations. Apply through your state or local energy assistance office. Dialing 211 connects you to local services in many areas.
• Weatherization Assistance Program. Helps eligible households make homes more energy efficient through insulation, sealing and heating system repairs.
• Utility protections and payment plans. Many states restrict winter shutoffs for customers who are older or seriously ill, and many utilities offer budget billing, discounts and medical certificate programs. Call your utility before you fall behind and ask.
• Local help. Area Agencies on Aging, community action agencies, faith groups, the Salvation Army and similar charities often give emergency fuel or bill help.

In Canada¶

• Provinces and territories run their own programs, such as low income energy assistance, home energy efficiency grants, and winter heating benefits. Utility companies often run hardship funds. Check your provincial government website, your utility and local community services.
• Federal and provincial seniors benefits, tax credits and housing programs may offer support. Service Canada and your province can tell you which apply.
• Health Canada gives advice on cold weather safety and carbon monoxide.

In the United Kingdom¶

• Winter Fuel Payment and Cold Weather Payment. These government payments have eligibility rules that have changed in recent years, so check the current rules on the GOV.UK website.
• Warm Home Discount. A discount on electricity bills for eligible households, through participating suppliers.
• Priority Services Register. Free service from your energy supplier and network operator that gives extra support during power cuts to people who are older, disabled or who depend on medical equipment. Ask your supplier to add you.
• Energy efficiency and grants. Schemes and local authority programs help with insulation and heating upgrades.
• Charities such as Age UK, Citizens Advice and local councils give free advice on benefits and bills, and sometimes grants.

In Ireland, Australia, New Zealand and elsewhere¶

• 愛爾蘭透過社會安全部提供燃料補貼和其他支持，愛爾蘭永續能源管理局負責運行能源升級計畫。
• 澳洲為退休金領取者和老年人提供各州的能源優惠和回扣。檢查您所在州政府和能源零售商。
• 紐西蘭透過政府機構向符合資格的人員提供冬季能源付款和隔熱計劃。
• 在歐盟，支持因國家而異。尋找國家或地方暖氣補貼、社會關稅和能源貧窮措施。您當地的市政當局、社會服務機構和消費者諮詢中心可以提供協助。
• 在其他國家/地區，請聯絡地方政府、社會服務機構、宗教團體和慈善機構。即使在沒有正式計劃的地方，社區團體也經常在寒冷時期提供毯子、燃料和食物。

獲得幫助的提示¶

1. 收集基本文件：身分證、收入證明、最近的能源帳單以及年齡或殘疾證明。
2. 請值得信賴的親戚、鄰居或社工幫忙填寫表格。
3. 在您錯過付款之前致電您的能源供應商並詢問困難計劃。
4. 請在賽季初申請，因為資金可能會用完。
5. 謹防詐騙。切勿向聲稱自己來自供暖援助計劃的來電者或訪客提供銀行詳細信息，也不要預先支付政府補助金。使用官方網站和電話號碼。

寒冷中的食品、藥品和健康¶

食物和液體¶

老年人在寒冷中可能不會感到口渴或飢餓，但身體仍然需要燃料和液體。定期提供熱餐、湯和熱飲，並在家中存放不易腐爛的食物，以防暴風雨。如果購物困難，可以考慮送餐上門。檢查冰箱和冷凍庫是否正常運作，斷電的食物是否安全。參見 食物變質和冰箱停電。

藥品¶

• 如果處方醫生允許，冬季在家中至少保留一到兩週的藥物，並保留所服用藥物的清單。在暴風雨之前要求補充。
• 了解哪些藥物需要冷藏，例如胰島素，並制定停電計劃。參見 停電時對溫度敏感的藥物。
• 保持明確的服藥習慣，避免重複服藥或漏服。參見 多重用藥和藥丸整理器錯誤。
• 詢問藥劑師或醫生您服用的藥物是否會使您對寒冷更加敏感或更容易跌倒。
• 接種季節性疫苗，例如流感疫苗和衛生服務機構建議的其他疫苗，以減少冬季疾病。

醫療設備¶

如果有人依賴氧氣、呼吸機、CPAP 機、電動床或透析機，請提前告知公用事業公司，保留備用電池或儲氣罐，並計劃在停電時轉移到安全的地方。看 制氧機、呼吸器和 CPAP 斷電。切勿在氧氣附近吸煙或使用明火。

瀑布、雪和冰¶

Falls are the leading cause of injury in older adults, and winter ice increases the risk. A broken hip or a head injury can change an older person's life, and people on blood thinners can bleed inside the head even after a mild knock. Stay inside on icy days when possible, arrange deliveries, and wear boots with good grip and a cane with an ice tip if needed. If a fall happens, read slipping on ice: how to fall and when to seek care 和 elderly fall recovery when unable to stand。

Do not let an older person with heart disease shovel snow. See shoveling snow safely, and arrange for help clearing paths and steps.

Dementia and wandering in cold weather¶

People with dementia may wander outside in thin clothing and become lost or hypothermic within an hour. Install door alarms or chimes, keep a recent photo and an ID bracelet, and tell neighbors who to call if they see the person outside. If someone wanders in freezing weather, call your local emergency number at once, because the risk rises quickly. See wandering senior in freezing or heatwave weather 和 dementia wandering and missing senior。

Power outages and winter storms¶

An outage in winter is a major risk for older adults. Plan before the storm.

• Talk through what you will do if power fails: where to go, who to call and how to get there.
• Keep a battery radio, torches (flashlights), spare batteries, a power bank for the phone, warm clothing, blankets and a sleeping bag.
• Keep a list of medicines, doctors and emergency contacts in a wallet and on the fridge. See 緊急聯繫卡產生器。
• Do not use a generator inside, and put a battery powered carbon monoxide alarm in the home. See 發電機安全。
• Leave early if the house is getting cold. Do not wait until it is dangerous.
• After the storm, check pipes and heating carefully before restoring normal heat. See ice storm, tree limbs and restoring heat safely 和 winter power outages and prolonged blackouts。

Decision flow for checking on an older neighbor¶

flowchart TD
    A["Cold weather or power cut"] --> B["Call the older neighbor"]
    B --> C{"Do they answer and sound clear?"}
    C -->|"No answer"| D["Visit and knock<br/>and call their contacts"]
    C -->|"Confused or slurred"| E["Call emergency number<br/>and go to them"]
    C -->|"是的"| F{"Is the home warm<br/>and do they have food?"}
    D --> G{"Still no answer<br/>and you are worried?"}
    G -->|"是的"| H["Call emergency number<br/>and ask for a welfare check"]
    G -->|"否"| F
    F -->|"否"| I["Help move them to warmth<br/>or arrange heat and food"]
    F -->|"是的"| J["Agree on the next check<br/>and share your number"]

Comparing ways to stay warm at home¶

Checklist for a safe winter home¶

• Room thermometer in the living area and bedroom, set to at least 18 degrees Celsius (64 degrees Fahrenheit).
• Working carbon monoxide alarm and smoke alarm, tested this month.
• Heating serviced this year, and chimney or flue checked if used.
• Draft proofing, curtains, blankets, hat and warm socks ready.
• At least a week of food, and medicines refilled.
• Phone charged, list of contacts and a power bank.
• A neighbor or relative who will check in daily during cold weather.
• Details of heating assistance and the utility's priority list.
• A plan for where to go if the heat or power fails.
• Grip boots, ice tip cane, and help with snow and ice clearing.

Supporting a family member from a distance¶

Many families live far from their older relatives. You cannot check a thermostat from another city, but you can set up a system that gives early warning. Start with a conversation before winter about what the person wants and what worries them, and agree on a few routines that feel respectful rather than controlling.

• Arrange a regular call at a fixed time each day in cold weather, and agree what you will do if it is missed.
• Ask a trusted neighbor, friend or local volunteer to be a second contact, and give them your number.
• Consider a smart thermostat or a simple temperature sensor that sends an alert to your phone if the home falls below a set temperature. Ask the person for permission first, and explain what is being monitored.
• Consider a personal alarm or fall detector that can call for help, and check that it is charged and worn.
• Arrange grocery and medicine delivery, and meal services, so that the person does not have to go out on ice.
• Pay or help with energy bills if you can, and help to apply for assistance. Many older adults are reluctant to ask.
• Visit before the cold arrives to check alarms, draft proofing, heating, ice grips for boots and the stock of food and medicine.
• 隨身攜帶該人的醫生、藥房和鄰居的聯絡方式，並了解誰擁有備用鑰匙。

If you cannot reach the person and are worried, call a neighbor first, then call your local emergency number and ask for a welfare check. Give the dispatcher the address, the person's age, any health conditions and the time of the last contact.

常見問題¶

What temperature should an older adult keep their home?¶

Many health services advise at least 18 degrees Celsius (64 degrees Fahrenheit) in the rooms where people spend time, and a little warmer, around 20 to 21 degrees Celsius (68 to 70 degrees Fahrenheit), for people who are frail, unwell or not very active. Use a room thermometer rather than relying on how the room feels. Move the person to a warmer place if the home cannot be kept warm.

What are the signs of hypothermia in an older person?¶

Look for cold skin, tiredness, slurred speech, confusion, clumsiness, a puffy pale face, slow movement and slow breathing, and note that shivering may be weak or absent. Call your local emergency number if the person is confused, very drowsy or unresponsive. Warm them gently with dry layers and blankets while you wait.

How can I help an older neighbor without being intrusive?¶

Introduce yourself before bad weather, share your number, and offer a regular phone call or a signal such as a blind raised in the morning. Offer help with shopping, snow and warm meals, and let the person decide what they want. If you cannot reach them and you are worried, call your local emergency number and ask for a welfare check.

Where can I find help paying for heating?¶

Start with your energy supplier and your local senior center or social services office, which can point you to current programs. Examples include LIHEAP and weatherization in the United States, provincial energy programs in Canada, and Warm Home Discount, Cold Weather Payment and the Priority Services Register in the United Kingdom. Check the official government website for current rules, and do not give bank details to anyone who calls or visits unasked.

來源已檢查¶

本指南根據疾病管制與預防中心（美國）關於寒冷天氣和老年人的頁面、國家老齡化研究所（美國）寒冷天氣安全建議、Ready.gov 和聯邦緊急事務管理局（美國）冬季風暴指導、兒童和家庭管理局關於低收入家庭能源援助計劃的指導、國家氣象局（美國）風寒頁面、美國紅十字會冬季安全建議、國家衛生服務（英國）關於預防和預防的頁面進行了檢查和預防服務。體溫過低、英國健康安全局寒冷天氣指南、GOV.UK 關於冬季付款和溫暖之家折扣的頁面、Age UK 冬季建議、英國氣象局冬季頁面、加拿大衛生部關於極冷和老年人的頁面以及世界衛生組織住房和健康指南。計劃規則發生變化，因此請透過官方來源進行驗證。

學習急救¶

實踐急救課程教您辨識體溫過低、應對跌倒並自信地進行心肺復甦術。紅十字會、聖約翰救護車和當地提供者提供適合老年人和家庭照顧者的課程。與與您同住或居住在附近的人一起攜帶一份。

相關指南¶

• 老年人應急計劃
• 體溫過低和凍傷
• 制氧機、呼吸器和 CPAP 斷電
• Elderly fall recovery when unable to stand
• 冬季風暴安全：家庭取暖和寒冷生存