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Heat: How to help those in need of care

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Heat: How to help those in need of care

After a short pull on the straw, Brigitte Richter immediately takes her glass filled with coffee away from her lips. “Shit, it’s cold,” she curses. So nurse Ramona Rössner goes back into the kitchen and puts the glass in the microwave.

Richter, sitting on her bed in Berlin-Schoeneberg on this summer morning in a T-shirt, is waiting. Rössner returns with the glass, Richter takes another sip. “Now it’s good,” says the 97-year-old.

It doesn’t matter whether it’s warm or cold – Rössner, who has been a nurse for 20 years, is happy when the elderly people she cares for at home drink at all. This can be essential for survival, especially in summer. According to the Robert Koch Institute (RKI), high outside temperatures regularly lead to significantly higher death rates in summer, especially among the elderly.

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The reasons are varied: There are deaths from heat stroke, but also more complex cases, for example if cardiovascular or lung diseases previously existed. For the summer of 2022, the fourth warmest since records began in 1881, the RKI estimates that there will be around 4,500 heat deaths nationwide. According to the Berlin-Brandenburg Statistics Office, more than 400 people died in Berlin in 2022 due to the heat.

In the summer months, Rössner therefore takes a very close look. “If you know the patient, you can tell when they’re talking when they haven’t drunk enough,” says the 47-year-old. Speaking is then more difficult, the patients are jittery or have a dry tongue.

She regularly has to remind them to drink and put water bottles in several places in the apartment. “Some say one sip is enough for them.” Richter, whom she lovingly addresses with “my sweetheart”, repeatedly asks her to take another sip or clink glasses with her: “You drink, I drink.” Half joking the 97-year-old replies: “That too!”

During a home visit, Ramona Rössner talks to Andreas Seltzer, who is in need of care, and encourages him to drink

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Source: Monika Skolimowska/dpa

Older people often feel less thirsty. According to the managing director of the deaconry in Schöneberg, Michael Nehls, the loss of fluids increases in the heat. Nehls heads the outpatient nursing service that Rössner works for.

In outpatient care, a closer look at sufficient fluid intake is all the more important because the patients spend a lot of time alone, i.e. unobserved. It is often about older people who are severely demented or age-forgetful. There is also another problem: “Older people who are incontinent tend to drink less to get their incontinence problem under control,” says Nehls.

According to the trained nurse, some patients notice the symptoms of dehydration, but do not attribute them to the little drinking. When the temperature rises above 30 degrees Celsius, Rössner’s patients and their colleagues have a little reminder: “We give our employees appropriately designed bottles as eye-catchers for people to take with them, so that they remember to drink more .”

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The blue and orange label on the water bottle reads “Take care of yourself!” or “Drink more!”. There are also other tips on the bottles and the number of the Diakonie Schöneberg in case of an emergency.

Rössner wakes her next patient from her nap around 11 a.m. Andreas Seltzer, a small man with gray hair, is first handed a glass of water while he is still sitting on his bed, a bit dazed. He received his Parkinson’s diagnosis six years ago. “You drink too little,” Rössner admonishes him in a firm but loving tone.

Seltzer, who declined to give his age, says he doesn’t feel thirsty at all. “I have to be encouraged to drink, so to speak.” Besides, he just doesn’t like water. His favorite drink is beer, he says and laughs.

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Nehls developed a heat action plan last year so that the nursing staff at Diakonie Schöneberg can identify symptoms at an early stage. The approximately 30-page document lists, among other things, characteristics that indicate health problems. These include shortness of breath, sudden confusion, vomiting or feeling weak.

Nursing measures (light clothing, no thick blankets, little sunlight) or tips for the kitchen (cold soup, fruit rich in water, favorite drinks) and the right ventilation are listed. Employees are also given tips on how to protect themselves from the heat. From next year, the topic should be firmly integrated into the training program.

Even though Rössner never tires of setting up water bottles, preparing favorite drinks and toasting with water or coffee, she knows: “We can’t force people to drink.” But with a little persuasion, it usually works. If a patient is in a burnable condition, the doctor must be called in an emergency. But: “I haven’t had a case like that, thank God.”

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