For older adults in New York City, extreme heat and cold are medical risks, not just discomfort. Heat stroke (body temperature above 104°F, confusion, fainting) and hypothermia (core temperature below 95°F) are both emergencies: call 911. The rest of the time, protection comes down to a cool home in summer, a home kept at 68°F or warmer in winter, and someone who checks in regularly.
Why are older adults more vulnerable to heat and cold?
The National Institute on Aging says older adults typically do not adjust as well to sudden temperature changes, are more likely to have chronic conditions that affect the body’s response to temperature, and are more likely to take medicines that alter its ability to control temperature or sweat. The CDC says the same of people 65 and over.
NIA’s added heat risks include heart, lung or kidney disease, several prescriptions at once, alcohol, dehydration, and no air conditioning or fans. The temperature need not be extreme. For cold, NIA names diabetes (blood flow), thyroid problems, Parkinson’s disease and arthritis (harder to add layers or leave a cold room) and memory problems (forgetting to dress for the weather).
Heat exhaustion vs heat stroke: how do you tell them apart?
Heat exhaustion is a warning; heat stroke is an emergency. Confusion, fainting, or no sweating in the heat points to heat stroke.
| Heat exhaustion | Heat stroke | |
|---|---|---|
| Skin and sweat | Heavy sweating; skin may feel cold and clammy | Not sweating even when hot; dry, flushed skin |
| How the person feels | Thirsty, dizzy, weak, uncoordinated, nauseated | Confusion or acting strangely; fainting |
| Pulse | Sometimes rapid | Strong and rapid, or slow and weak |
| Body temperature | May stay normal | Rises above 104°F |
| What to do | Rest in a cool place, drink fluids; if not better soon, get medical care | Call 911 or go to an emergency room immediately and start cooling the person |
Sources: NIA and NYC Emergency Management, which also lists hallucinations, trouble breathing and vomiting as heat stroke signs.
What to do while waiting for help
- Call 911.
- Move the person out of the sun into the shade or indoors.
- Start cooling: cool clothes, a cool bath or shower, fans (NIA). CDC/NIOSH adds cold wet cloths or ice on the head, neck, armpits and groin.
- Stay with them until emergency medical services arrive.
What are the signs of hypothermia in an older adult?
NIA defines hypothermia as a core body temperature below 95°F. It can happen in cool weather too: above 40°F if the person is chilled by rain, sweat or cold water. Because it affects the brain, the person may not realize anything is wrong. Early signs:
- cold hands and feet, pale skin, a puffy face
- shivering
- slowed or slurred speech
- feeling sleepy, angry or confused
Later signs include stiff, jerky movements, a slow heartbeat or breathing, and loss of consciousness. NYC health department guidance adds sluggishness, dizziness and unusual behavior. Hypothermia is a medical emergency: call 911, move the person somewhere warmer, offer a warm drink, and wrap them in dry blankets, towels or coats.
How warm or cool should the home be?
| Season | What the official sources say |
|---|---|
| Winter | NIA: set heat to at least 68°F. Even mildly cool homes at 60 to 65°F can lead to hypothermia in older adults. Dress warmly indoors, use extra covers at night, and ask someone to check on you. |
| Summer, home above 90°F | NYC Emergency Management: close shades, avoid the stove and oven, take a cool shower or bath, drink water even if not thirsty, and set an air conditioner to 78°F or “low cool.” |
| Fans | CDC: do not rely on a fan as the main cooling source; use fans only when indoor temperatures are below 90°F, because above that a fan can raise body temperature. |
Per NYC, kerosene and propane space heaters are illegal in the city, and a gas stove should never be used to heat a home. NIA advises older adults to avoid shoveling snow, which carries fall and heart attack risk.
Which medications make heat more dangerous?
The CDC’s clinical guidance on heat and medications lists classes that may raise heat risk, including diuretics (“water pills”), ACE inhibitors and ARBs (especially combined with a diuretic), beta blockers and calcium channel blockers, anticholinergics, some psychiatric medicines, lithium, stimulants and NSAIDs. CDC labels this expert opinion for clinicians.
For a family: ask the prescriber or pharmacist whether any medicine affects heat tolerance, ask how much to drink if fluids are limited or a diuretic is prescribed, and do not stop or change a medicine on your own.
What NYC programs help with heat, cold and bills?
| Resource | What it does | How to reach it |
|---|---|---|
| Cooling centers (NYC Emergency Management) | City opens cooling centers in heat emergencies. Call ahead before going. | 311 (TTY 212-504-4115) or the Cooling Center Finder at finder.nyc.gov/coolingcenters |
| Notify NYC | Free city emergency alerts, including heat emergencies | Text “notifynyc” to 692-692, nyc.gov/notify, or 311 |
| HEAP Cooling Assistance | One air conditioner or fan per household, up to $800 with installation ($1,000 for an existing wall sleeve). Households with a member age 60+ are eligible if they have no working AC or one five years old or older (plus income or benefit tests) | HRA HEAP line 718-557-1399. The 2025-26 round closed 5 June 2026; ask when the next opens |
| HEAP heating help | Regular benefit toward heating costs; Emergency benefit for shut-offs or running out of fuel (once per heating season) | Online via ACCESS HRA, or 718-557-1399. NYC residents can also call 311 |
| HERR and Clean and Tune | HERR: homeowner heating equipment repair (up to $4,000) or replacement (up to $8,000), once every ten years. Clean and Tune: up to $500. Both opened 1 October 2026 | 718-557-1399 |
| Life-support equipment registry | Utility contacts you in an outage if you rely on powered medical equipment | Con Edison: coned.com/SpecialServices, 1-877-582-6633 or 1-800-752-6633. National Grid (NYC): 718-643-4050 |
HEAP details: NYC HRA and the state’s HEAP page. Regular benefit eligibility depends on income, household size, heating source, and whether the household includes someone under 6, age 60 or older, or permanently disabled. The state page points to early November for Regular and 4 January 2027 for Emergency benefits, but was inconsistent when we checked, so confirm dates by phone.
If your building has no heat
NYC building owners must provide heat from 1 October to 31 May. Per HPD, that means:
| Time | When heat is required | Minimum indoor temperature |
|---|---|---|
| 6:00 AM to 10:00 PM | When the outside temperature is below 55°F | 68°F |
| 10:00 PM to 6:00 AM | Regardless of outside temperature | 62°F |
| All year | Hot water | 120°F |
Contact the landlord first. If nothing changes, call 311 (TTY 212-504-4115) or file through 311 Online; complaints can be anonymous.
Where does a caregiver or home care aide fit in?
The CDC’s checklist for caretakers is simple: visit the person at least twice a day in hot weather, and ask four questions. Are they drinking enough water? Do they have air conditioning? Do they know how to keep cool? Do they show signs of heat stress? NYC likewise suggests contact at least twice a day during a heat wave.
For a family that cannot do this in person, a home health aide or personal care aide can remind the person to drink, keep a thermometer in the room, close shades, help with layers, go with them to a cooling center, and notice a change in alertness or behavior and call the family or 911. Memory problems call for extra structure (see dementia care at home), as do conditions like Parkinson’s, where adding or removing layers is hard (Parkinson’s care at home). An aide does not diagnose or change medication; medicine and fluid questions belong with the prescriber or a nurse.
Heat and cold checks our home health aides make: nurse director’s notes
Anna Klyauzova, RN, MSN, MPA, Director of Patient Services at ProLife Home Care, on what she sees in practice:
Our aides check the temperature in the apartment first, then whether there is water to drink, whether the air conditioner or heat works, and how the person looks and feels. People with dementia or chronic illness need closer watching, because an older person often doesn’t notice they are too hot or too cold.
In New York we see overheated apartments in winter and stuffy ones in summer, especially on upper floors. The riskiest client is the one who can’t open a window, switch on the air conditioner or call for help.
When there is no working air conditioning or heat, we check on the person’s safety and call the family. If needed we help find a safe place for a few days and point them to city programs such as HEAP Cooling Assistance. If the conditions threaten the person’s health, we act right away, and the aide tells the nurse or coordinator.
We are a licensed home care agency in Brooklyn and Queens (New York State Department of Health licence #2572L001). To work out how often a parent needs a check-in, or whether regular aide visits would help (see personal care services, what Medicaid covers and cost), call (718) 232-2777 or use our contact page.
This is general safety information, not medical advice; for symptoms or medication questions, speak to a doctor, and in an emergency call 911. Sources checked on 8 October 2026: NIA, CDC, NYC Emergency Management, NYC HPD, NYC HRA, New York State (ny.gov) and Con Edison. Programs, phone numbers and HEAP dates change; confirm with the agency before relying on them.
Frequently asked questions
What is the difference between heat exhaustion and heat stroke?
Heat exhaustion causes heavy sweating, clammy skin, weakness, dizziness and nausea, and the person can usually be cooled down by resting in a cool place with fluids. Heat stroke is an emergency: body temperature rises above 104°F, sweating may stop, and the person may be confused or faint. Call 911.
When should I call 911 for an older adult in hot weather?
Call 911 if the person is confused, acting strangely, has fainted, or has hot, dry skin and is not sweating. If heat exhaustion does not improve with rest, a cool place and fluids, get medical care promptly; NIA says headache, confusion, dizziness or nausea in the heat should be checked by a doctor or emergency room.
How cold is too cold inside for an older person?
NIA recommends setting the heat to at least 68°F and warns that even mildly cool homes at 60 to 65°F can lead to hypothermia in older adults. In NYC, tenants are entitled to at least 68°F during the day when it is below 55°F outside, and 62°F overnight, during heat season (1 October to 31 May).
How do I find a cooling center in NYC?
Call 311 (TTY 212-504-4115) or use the Cooling Center Finder at finder.nyc.gov/coolingcenters. Cooling centers open during heat emergencies; outside them the map is not real-time, so call the location before you go.
Can New York help pay for an air conditioner or heating?
Yes, through the Home Energy Assistance Program (HEAP). It covers one air conditioner or fan for eligible households, plus heating benefits and heating emergencies. In NYC, call 718-557-1399; the 2025-26 cooling round closed on 5 June 2026, so ask when the next one opens.
How do I register medical equipment with Con Edison?
If you rely on electric-powered medical equipment, you can register as a life-support equipment customer through coned.com/SpecialServices or by calling 1-877-582-6633. Con Edison requires certification by a medical doctor, nurse practitioner, physician’s assistant or local board of health official.
Can a home care aide help during heat waves and cold snaps?
Yes. An aide can check in, remind the person to drink, watch room temperature, help with layers, and call the family or 911 if they notice confusion or other warning signs. They do not diagnose or change medications.
