Dressing for Warmth
INTRODUCTION
Older people, the very young and those with disabilities are particularly vulnerable to the cold. When considering ways to keep warm, the role of clothing must be considered together with methods of heating, life style, finance and the general environment. Where people try to keep warm simply by maintaining a room temperature there can be considerable expenditure on heating and other occupants who are not so susceptible to the cold can feel uncomfortably warm.
Dressing for warmth should be practised from the start of cooler days if it is to be of real benefit later in the year. Not only will it make a substantial difference to someone's ability to be comfortable during a cold spell but it will also make a positive contribution to preventing the development of sub-clinical hypothermia.
At night, body temperature control mechanisms are at their least stable, and room heating is often switched off. Bedding absorbs considerable moisture from the air during each day, even though it is slept in each night. If a person sleeps in an unheated bed their body heat will be required to evaporate that moisture. Hot water bottles or electric blankets should be used to warm the bed for a couple of hours before it is used. An electric overblanket costs the same to run all night as boiling a nightly kettle to fill a hot water bottle and eliminates the risk of scalds as well.
People can lose a lot of body heat both during dressing and undressing especially if this is done in a room which hasn't heated up properly or which has been allowed to cool down prior to going to bed. When someone undresses the warm insulating layer of air round the body is lost and body heat has to be used to warm the new layer.
MICROENVIRONMENT
One of the best ways of preventing hypothermia is to create a microenvironment or cosy corner within a room. A high screen placed around a chair, preferably one with both a high back and wings, will reduce draughts and encourage reflected heat. The benefits of this cosy corner can be further enhanced by sensible dressing.
Potentially one of the most dangerous misconceptions about keeping warm is that this is automatically achieved by wearing several layers of clothes. It is actually possible for several thick layers to keep someone less warm than several light fluffy layers. Heavy layers of clothes will have minimal amounts of air trapped between them because the weight of each layer pushes the air out.
The older clothes are, the less warm they become as a fabric becomes both compressed and compacted with age and so relatively heavy. Jackets and coats many years old were made with much heavier linings and interlinings than are used today and so do not keep people as warm.
HOW CLOTHING CAN HELP
Clothing keeps people warm by acting as an insulator or more accurately by enabling air to act as that insulator. A garment traps air between it and the skin. This is then warmed by body heat and effectively prevents further heat loss.
Clothing cannot create warmth; it can only maintain your body warmth, so movement and exercise are important to generate that warmth before you dress.
To be really warm it is not just a question of donning gloves and socks. The whole body needs to be insulated. While warm hands and feet may be the key to feeling comfortable, body warmth is actually achieved by keeping the trunk and limbs well covered.
FABRIC
It is not only what is worn but also the fabric from which it is made and how that fabric has been constructed which determines how warm it keeps someone. Inside the home, fluffy knitted garments are both warm and comfortable. Outside in cold weather the same garment is useless as it allows even the slightest breeze to penetrate so that the wearer gets cold very quickly.
Wool, though very warm may be difficult to wash, expensive and relatively heavy. Garments made with acrylic fibres are virtually as warm, much lighter, cheaper and easier to wash. However care must be taken when tumble-drying something made of acrylic or it will lose its shape.
Any fabric with a piled, terry or textured finish should trap air between the layers and insulate against the cold.
However, some corduroy or velvet fabric may look thick and warm, byt check by holding it up to the light to see how closely woven the fabric is. some corduroy and velvet is very loosely woven and therefore does not trap air beneath it. Closely woven fabrics like moleskin and drill will be warmer.
Jersey (knitted) fabrics in silk, cotton, viscose or synthetic fibres will trap air within their construction and therefore act as a good insulator, especially when worn layered with other garments.
SIMPLE, PRACTICAL ADVICE
There are many simple ways in which clothing can be used to minimise heat loss and help keep the body temperature stable so enabling people to be safe and comfortable in a cold environment.
- Firstly make use of what people already have, but if possible also buy one or two new items each winter. This is both a morale boost and ensures that garments are available which take full advantage of new advances in warm wear.
- The more layers of clothing which cover the body, the warmer the wearer will be. Long sleeved vests, long johns or combinations for both sexes could be life-savers. Ski departments and outdoor pursuit shops sell warm colourful versions. These are both fun to wear and easy to get on and off.
- A long sleeved jumper worn under a shirt or blouse serves much the same purpose as a long sleeved vest.
- Legs represent over one third of our body surface area. Trousers with a complete under layer either from long johns and socks or warm tights, will save heat.
- On average 20% of heat is lost through a person's head and an older person with thin hair and less body fat over their skull will loose more. Wearing nightcaps will prevent heat loss at night, but they may not be to everybody's choice. If the older person has no hat for daytime or cap for night, suggestions as to how to turn a long scarf or a head square into a turban would be helpful.
- Dressing gowns and slippers should always be put on as soon as someone gets up whether it is during the night or in the morning. Even the quick trip to the toilet in the middle of the night without slippers or dressing gown, could be disastrous if it results in a fall as the person may be unable to get assistance for some time. Short dressing gowns are safer for older people. Full-length gowns even though they will cover more leg may cause the wearer to stumble when going up/down stairs.
- When out of doors an older or disabled person may be as susceptible to the wind chill factor as a skier or cyclist who is normally recognised as being at risk. This is because they are slow moving and so exposed for longer to chilling winds. To minimise chilling try to ensure that as much as possible of the body is covered. Hats, scarves, and gloves are essential and coats should be as wind proof as possible. Shower-proof outer garments such as raincoats and skiwear offer a much greater resistance to the wind than a traditional winter coat or jacket.
Skiwear is very lightweight and well padded, but raincoats should always have plenty of layers underneath.
USEFUL PUBLICATIONS
The Access Directory
A directory of assistive technology, aids and appliances suppliers and services published annually. Available from:
Access and Mobility Ltd
6 Ticknock Dale
Sandyford
Dublin 18
Tel: 01-206 3387
Email: accessandmobility@gmail.com
Website: www.accessandmobility.ie
Energy for Older People
A joint collaboration between Age Action and ESB Customer Supply, this publication outlines issues involving heat, light, hypothermia, using electricity safely and paying for supply. Available from:
Age Action Ireland
30-31 Lower Camden Street
Dublin 2
Tel: 01-475 6989
Fax: 01-475 6011
LoCall: 1850 372 372
Email: info@ageaction.ie
Website: www.ageaction.ie
And
ESB Customer Supply
Lower Fitzwilliam Street,
Dublin 2
Customer Service Centre
Tel: 1850 372 372
E-mail: service@esb.ie
The full services offered are outlined in an information booklet entitled
For Older People and People with Disabilities
This booklet outlines a wide range of services provided by the ESB for older customers and those with physical disabilities who may need additional help. The booklet is also available on audiotape. Available from:
ESB Customer Supply
Lower Fitzwilliam Street,
Dublin 2
Customer Service Centre
Tel: 1850 372 372
E-mail: service@esb.ie
USEFUL ADDRESSES
Age Action Ireland
30-31 Lower Camden Street
Dublin 2
Tel: 01-475 6989
Fax: 01-475 6011
Email: info@ageaction.ie
Website: www.ageaction.ie
Association of Occupational Therapists of Ireland (AOTI)*
Ground Floor Office
Bow Bridge House
Bow Lane
Kilmainham
Dublin 8
Tel: 01-633 7222
Email: aoti@eircom.net
Website: www.aoti.ie
*It should be noted there is currently no statutory system of registration to either an independent chartered institute or representative professional body for allied health professionals eg occupational therapists, chartered physiotherapists and speech and language therapists in Ireland. This is likely to change soon as the Health and Social Care Professional Bill published in October 2004 sets out a system of legal registration for health and social care professionals irrespective of whether they work in the public or private sector or are self-employed.
Disabled Living Foundation (DLF)(UK charity providing advice and information and a comprehensive up-to-date database of disability equipment available in the UK)
380-384 Harrow Road
London
W9 2HU
England
Tel: 0044 207 289 6111
Email: dlfinfo@dlf.org.uk
Website: www.dlf.org.uk
Ricability(independent research body in UK which produces guides for older and disabled consumers based on professional research)
30 Angel Gate
326 City Road
London
EC1V 2PT
England
Tel: 0044 207 427 2460
Fax: 0044 207 427 2468
Email: mail@ricability.org.uk
Website: www.ricability.org.uk
