A hot shower is a must for many people to either
start or finish the day. For the elderly, it can be
the same, but also a risky undertaking. In all age
groups, tap water scalds are the second most common
cause of burn injuries. Elderly loved ones, however,
are at a greater risk for scalding than other
populations for a variety of reasons.
The Burn Foundation says that hot water causes
third-degree burns in one second at 156 degrees F,
in two seconds at 149 degrees F, in five seconds at
140 degrees F, and in 15 seconds at 133 degrees F.
Scalding is a second-degree burn that is deep and
results in splitting of skin layers and/or
The solution would seem to be to simply decrease
the water temperature; the Occupational Safety and
Health Administrationís (OSHA) manual on
Legionnaireís disease (a potentially fatal
infectious disease) says differently, however. Water
is to be stored at a minimum of 140 degrees F, but
can be delivered at a minimum of 122 degrees F to
ensure harmful bacteria are killed.
A caregiver must first recognize the level of
risk their loved one has for scalding, and also know
ways to prevent unnecessary burns, while maintaining
a safe water temperature.
The number one risk an elderly person has for
scalding is simply a decreased reaction time. Many
seniors will unknowingly subject themselves to the
danger of severe burns and realize it too late.
There are a couple things to know about skin changes
as people age. First, elderly people have thinner
skin, which burns at a lower temperature than those
who are younger. It also burns faster. In addition,
an elderly loved one is 50 percent less likely to
survive a severe burn.
The mental capacity of a loved one will also
affect their ability to prevent scalding while
alone. Whether Parkinsonís, dementia or another
illness that affects mental reasoning, a caregiver
must realize that a person may not have the ability
they previously had to determine a safe water
temperature. The risk is further heightened by
mobility issues, increased falls and trips that may
unintentionally cause a slip on a bathroom fixture.
The same precedent goes for a loved one who has
just had surgery, and may think a wound is healed
enough for a warmer water immersion, when it
actually is not.
Caregivers are on not off the hook, either. If an
inexperienced caregiver leaves a love one
unattended, runs water at too high a temperature, or
allows a person to change the water temp without
assistance, the chances for scalding increase
greatly. What may feel warm to a caregiver could be
a very hot experience for a loved one.
As with many tasks involving an elderly loved
one, not rushing through bathing is important.
Scalding is more likely to occur when a caregiver is
in a hurry, stressed or distracted.
Itís also risky to leave a loved one with a
history of heart attacks and/or strokes alone. It is
not uncommon for a loved one to have a medical
emergency in the shower and, while losing
consciousness, accidentally turn the water hotter
and end up with severe, debilitating burns.
Another possible risk for scalding is the
potential for hot water ďspikesĒ that occur when
someone nearby flushes a toilet, starts the washing
machine or runs water from a different tap.
With all these risks, itís hard to manage all the
possibilities. A caregiver can take a look at
their loved oneís health and lifestyle, and then
determine which is the best action for them.
If a loved one is scalded, the first thing to do
is reduce the skin temperature and pain level, and
prevent wound infection. Here are some tips on steps
for a caregiver to take:
- Keep calm.
- Immerse or rinse the wound with cold water
for at least 10 minutes to reduce temperature
- Do not apply ice pack directly to the wound
to avoid further tissue damage.
- Remove objects such as watches, wristbands,
rings, tight clothing, belts, boots or shoes as
the wound may become swollen.
- Do not remove clothes stuck to the wound
because they may tear the skin and increase the
risk of infection.
- Do not pierce the blisters to prevent wound
- Do not apply herbal oil, toothpaste, lotion,
soap or cooking oil to the wound to avoid
irritation and further tissue damage.
- Cover the wound with sterile lint-free
dressing or clear cling film for protection.
- Do not put adhesive materials such as a
cotton wool swab or adhesive bandage directly on
Aspirin or acetaminophen may help reduce the
pain. A burn that is painful for longer than 48
hours needs to be seen by a physician. If a severe
burn is unmanageable by a caregiver, it also needs
prompt attention and may necessitate
hospitalization. The Mayo Clinic says that large
portions of hands, feet, face, groin or buttocks
require immediate care.
The number one preventative measure for scalding
is testing the water temperature. If itís too hot,
the Burn Foundation recommends setting the water
heater thermostat at low, about 120 degrees F, for
safety. Few people bathe above 110 degrees F anyhow.
A tap water temperature of 120 to 125 degrees F is
hot enough for washing clothes and dishes.
To check the tap water temperature, let it run
hot for three to five minutes and use a candy, meat
or water thermometer. When getting into the tub,
move a hand rapidly and carefully through the water
flow. Itís recommended to run the cold water first,
and then add hot; for a bath, 100 degrees is
Elderly or handicapped people are prone to
falling. They should never be left alone in the tub,
even momentarily. Non-slip mats on the bathroom
floor and in the tub and shower can prevent
unnecessary falls. Mobility problems may
prevent getting out quickly, increasing the risk for
serious burns even more. If left alone, a loved one
may not have an opportunity to escape the source of
Not only does reaction time decrease as people
age, sensory perception decreases as well. An older
person may be bathing in too hot water and not
If the water that comes out of the tap is too
hot, valves can be installed in the plumbing lines
to reduce the temperature of the water delivered by
mixing in cooler water. Another option is to install
anti-scald devices at individual taps and shower
heads, which slow the water drastically if it
becomes overly hot.
A caregiver can also place a padded safety cover
over the tub spout to protect against the sharp
edges and hot surface. A washcloth wrapped around
the faucet will work well, too.
Hospital Association reports that more than 112,000
people are admitted to emergency rooms each year for
scald-related injuries. In many cases, these
injuries are preventable. A caregiver can take some
precautionary measures ahead of time to help keep a
loved one safe, yet still able to enjoy the comfort
of a hot bath or shower.
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