Body Temperature
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Someone with dementia or poor mobility may be unable to control their own body temperature by adjusting clothing or room heating. They may also be unable to communicate well how they're feeling, and it can be difficult to help keep them at the right temperature - neither too cold nor too hot.
Needs change
You don't want to wrap them up so much for fear of them being cold that you make them uncomfortably hot. It's important to note it's more than a matter of keeping the room at a constant temperature - meals, sleep, activity etc can all influence how warm their body gets. Obviously direct sunshine coming through a window or when you're outside in the summer can also greatly increase temperature, and wind when you're outside can feel much colder.
Checking
It's worth getting a measure of whether temperature tends to be a problem for your loved one (and bear in mind this may change as the disease progresses). Every now and again ask whether they're too cold or too hot or just right, or if they're unable to answer then look for signals in their body language. It's useful to compare how much they're wearing to how much you are, and to establish what the difference should usually be (with poor circulation and less activity they're likely to need more to keep them warm). Bald people are likely to feel colder than others in the absence of a hat.
It's also very useful to check how warm their skin feels to you - their hands, their cheek, and the back of their neck or shoulder. You may get a different impression from these different places - cold hands may indicate these need to be warmed whilst at the same time their back might indicate their body is fine or too warm. Remember that a chair back and seat or a mattress will act as thick insulation, and they may not need as much to keep them warm as you might otherwise think.
An ear thermometer has limited use outside checking for illness, as it's only likely to pick up rather extreme problems in body temperature.
Clothes
See our section on clothes for things that are useful for adjusting temperature or for keeping warm outdoors, especially:
- shawls (easily put on and taken off as needed)
- a snood (a scarf ring that's easy to seal out cold with)
- a warm hat with 'deerstalker' flaps
- a sun hat
- a large headscarf (to keep the sun off the neck as well as the head).
Fan for summer
An electric fan is also useful to have ready for hot days in the summer. Make sure the flex isn't a trip hazard.
Night temperature
One thing to consider is the temperature at night. This shouldn't be allowed to get too cold - perhaps only lower than the day temperature by as little as 3 or 4 degrees Centigrade (5 to 7 degrees Fahrenheit). Low body temperature thickens the blood and increases the risk of a stroke, and low air temperature increases the risk of catching a cold, the flu or norovirus. If the person gets up in the night because they're time disoriented and they don't wrap up warm then that should be considered too. However, being too warm or too cold may disrupt sleep, and a slight lowering of room temperature might form a cue that it's night time.
In the same way that shawls or something similar should be available during the day, consider how easily the person can adjust their warmth for themselves at night by rolling bedclothes layers up or down.
Consider whether spare rooms, particularly bedrooms, should be heated in case the person with dementia gets lost and spends time in them.
Smart thermostats
For completeness, we'll also mention that existing central heating can be controlled and monitored remotely via the internet by retrofit systems. In the UK, see the British Gas Hive website, the Google Nest website, or there are several other smart thermostat systems. These can be retro-fitted to most existing boilers very easily (by a qualified person), and have several advantages:
- they come with a thermostat that measures air temperature in the room, which gives a far more constant temperature as the weather changes outside than a heating system that doesn't already have an air thermostat
- you can set a daily profile to have many different temperatures according to time of day and night
- you can remotely monitor the current temperature, for example to check that an old boiler is still working, including receiving an alert if the temperature goes outside a set range
- you can remotely adjust the target temperature.