My first summer doing home visits, I walked into an apartment three blocks from the beach where the windows were shut, the shades were down, and it was 88 degrees inside. The woman I was there to see — 81, sharp as a tack — was wearing a long-sleeve blouse and a cardigan. She offered me tea. Hot tea.

I asked if she was warm. She said no, she was fine. And she believed it. That is the part that scares me most about summer.

On the Westside we tell ourselves the ocean handles the heat. Most days it does. But the marine layer burns off, an inland ridge pushes toward the coast, and for three or four days the people most likely to get hurt are the ones who never feel it coming.

Why older bodies don't register the heat

Aging changes the thermostat. The body's ability to regulate its own temperature declines with age, and the sensation of thirst fades along with it. The National Institute on Aging warns that adults over 65 are at real risk of hyperthermia — a group of heat-related illnesses that includes heat exhaustion and heat stroke. The Centers for Disease Control makes the same point plainly: older adults are among the most vulnerable to extreme heat.

It is not about being frail or forgetful. It is physiology. An older adult can be dangerously overheated and dehydrated before their body sends the signals — thirst, sweat, discomfort — that would make you or me reach for water and turn on a fan.

Medications quietly make it worse

Here is what does not make the intake form. A number of common prescriptions interfere with how the body sheds heat and holds onto fluid:

  • Diuretics (water pills for blood pressure or heart failure) increase fluid loss.
  • Beta-blockers can reduce blood flow to the skin, where the body dumps heat.
  • Anticholinergics — found in some bladder, allergy, and sleep medications — can reduce sweating.
  • Certain antidepressants and antipsychotics can blunt the body's temperature control.

None of these are reasons to stop a medication — that is a conversation for the prescribing doctor, never for a hot afternoon. But if your parent takes any of them, their margin for error in a heat wave is thinner than yours, and that is worth knowing going in.

The reasons the AC stays off

When I ask why the air conditioning is not running, I rarely hear "I did not think of it." I hear something more human:

  • "It costs too much." A generation that lived carefully does not run the AC for one warm afternoon.
  • "I do not want to catch a chill." Real discomfort with cold air, especially first thing in the morning.
  • "It is not that hot." And they mean it — because they cannot feel it the way you would.
  • "The unit is broken, or I do not know how the thermostat works." More common than families realize, and rarely mentioned.

Many coastal homes on the Westside and up the Ventura coast were built with no central air at all, because for decades nobody needed it. That works until the one week a year it does not.

What to watch for

Heat illness escalates. The early signs are easy to wave off as "a tired day":

  • Heavier fatigue than usual, weakness, or dizziness
  • A headache, muscle cramps, or nausea
  • Skin that is flushed and dry, or cool and clammy
  • Confusion or unusual irritability — a change in how they are thinking or acting

Confusion, a body temperature at or above 104°F, a rapid pulse, or fainting are signs of heat stroke, which is a medical emergency. Call 911. Heat stroke can look like a sudden change in behavior before it looks like anything else — which is exactly why a family member on the phone, or a caregiver in the room, is often the first to catch it.

The danger with heat is not the 105-degree day everyone is talking about. It is the quiet 88-degree apartment nobody is worried about.

What actually helps

None of this requires drama. It requires someone paying a little attention on the warm days:

  • Fluids on a schedule, not on thirst. Since thirst is an unreliable signal, offer water at set times — with meals, with medications, mid-afternoon.
  • Get the AC or fans working before the heat, not during it. Test the unit in June. Write the "comfortable" thermostat number on a piece of tape next to it.
  • Dress and shade for the day. Light clothing, shades drawn on the sunny side, the hottest hours spent in the coolest room.
  • Have a cool place to go. A library, a mall, a relative's house — Los Angeles County opens cooling centers during heat events, and one air-conditioned afternoon can break a dangerous stretch.
  • Check in more often when it is hot. A daily call or visit during a heat wave is not overkill. It is the whole ballgame.

This matters even more for someone living with dementia, who may not recognize the heat or be able to say they feel unwell. If that is your family, our dementia care approach is built around exactly this kind of quiet, daily watching. The same is true after a hospital stay, when someone recovering at home is least able to manage a hot day alone — that is what our post-surgery care is for.

The point of having someone in the room

A heat wave does not send a warning. It arrives on an ordinary Tuesday, and the person most at risk is often the last to know something is wrong. That is the entire case for not leaving an older adult to weather it alone — not because they are helpless, but because the one signal that matters most, "something is off today," is the one their body has stopped sending clearly.

CarePali provides non-medical, in-home daily-living care across the Westside of Los Angeles and the coastal Ventura communities — the steady presence that notices the shut windows and the untouched water glass. Plans start at $1,700 a month.

If summer has you worried about someone, the first step is a short conversation. Call us at (310) 818-3217, email reach@carepali.com, or start care here.