"Can Elders Get Frostbite at Home?"
— Helen Oliff for National Relief Charities

One day National Relief Charities was making home visits with a partner from a Fort Apache tribal program. We found Boyd D. a White Mountain Apache Elder, at home shivering under a blanket. He was rushed to the hospital, possibly for low blood pressure, low blood sugar, or hypothermia. Severe hypothermia can result in frostbite and fingers, toes, even arms and legs being amputated. It can even result in death.

Frostbite is any cold injury in which an area of the body is frozen.

* Extreme cold may freeze tissues, sometimes destroying them and surrounding tissues.
* Frostbite areas may be numb, white, swollen, blistered, or black & leathery.
* Frostbite areas should be re-warmed in warm water as soon as possible.
* Most frostbite areas heal over time, but some require surgery to remove dead tissue.

But how does frostbite occur when sitting in one’s own home?

For any elderly person, surviving extreme winters can be difficult, but Native American Elders are especially vulnerable and it is good to keep a close check on them. When you combine severe temperatures with severe poverty in remote communities, like Bull Creek on the Rosebud Reservation or Sweetwater on the Navajo Reservation, it can mean higher risk.

Many of the Native American communities that NRC serves top the list of poorest counties in the nation. Some Elders living on fixed incomes run out of winter fuel, putting them in grave danger. Many live in substandard and un-insulated housing, or lack warm coats, scarves, gloves, boots, and hats or blankets, increasing their risk further. On the reservations where NRC works:

* Social security averages $300 to $600 a month.
* Unemployment of working-age members averages 35 to 85% (varies by reservation).
* A cord of firewood or a full propane tank is costly — many Native Elders lack the funds or are forced to choose between food and fuel.
* Access to firewood is limited by available vendors and transportation.
* Elders live in regions so remote that they are isolated, and may not have a phone to call for help when they run out of wood.
* Many Elders resort to burning clothes, furniture, and garbage when their wood runs out.

Exposure to below-freezing temperatures puts any part of the body at risk. The extent of the damage (blood clots, decreased blood flow and oxygenation, dead tissues, inflammation caused by the release of toxic chemicals into the blood stream) depends on how cold it is and how long the exposure. People at greatest risk of frostbite are those with poor circulation due to diabetes or arteriosclerosis, or a blood vessel spasm (caused by smoking, some neurologic disorders, or certain drugs). Tight-fitting boots or gloves can cause constriction of blood flow and lead to frostbite — but exposed hands, feet, and/or face can also lead to frostbite. Contact with wetness or metal is also dangerous as this accelerates freezing.

Extreme cold + Extreme poverty = Winter risk for Elders

On the Blackfeet Reservation in Browning, MT, temperatures are below freezing as early as mid-October. Tribal members there deal with subfreezing temperatures an average of 196 days a year. At its coldest, the bitter Browning temps can freeze human skin in less than half an hour and force a frostbite-related amputation.

One Elderly couple from the Pine Ridge Reservation faced peril when a blizzard hit in November, 2009. Both feeble, he went out to bring in extra firewood but, before he could make it back to the house, fell and broke his ankle. They had no phone, so she crawled out to the end of their long dirt driveway and put up a sign that said “Please help.” It was several days before someone came and, gratefully, found them alright. Shortly after, they were among a group of Elders that got help with firewood and disaster relief supplies from NRC.

In the Southwest, people tend to think of the desert, they don’t realize the weather gets cold.
Remember, the temperature only has to be “below freezing” for frostbite to occur.

An Elder’s situation can quickly turn from cold to crisis in a rapid weather shift like the one last November in Thoreau, NM and Teec Nos Pos, AZ, forcing some Elders to burn their wood supply early.

A few years ago, Jim J., a Navajo Elder, lived with his sickly wife in a community so remote that even the social workers didn’t know they were there. When National Relief Charities and our partner from Thoreau showed up with a delivery of firewood, Jim fell to his knees and wept. He said he had been burning sagebrush, but it was so dry that it burned up before the house ever got warm, and he had prayed for some help and felt that his prayers were answered.

This year, when we first met Rosarita R., a White Mountain Apache Elder, she was sitting on her porch shelling walnuts. She wanted to sell them in order to get enough money to buy toilet paper and light bulbs. We quickly bought them all to help Rosarita, who has dialysis three times a week and was told she may be going blind due to diabetes. Rosie was not ready for the coming winter. NRC repaired her windows and doors, while our partner from the White Mountain Elderly Services worked on getting Rosie some firewood.

It takes constant vigilance to ensure that vulnerable Elders are safe. This is why National Relief Charities, in its AIRC, SWIRC, and other programs, goes to significant expense to ensure their winter safety. We provide firewood and winter fuel vouchers for hundreds of Elders. We distribute winter emergency boxes with food, water, flashlights, batteries, scarves, hats, gloves, and winter emergency blankets. We caulk and put up plastic around Elders’ doors and windows to keep out the cold and keep in precious heat. And we provide emergency disaster relief when blizzards and other winter weather creates risk.

Winter Tips for Helping Our Elders

* Make note of any Elder who lives in an isolated area and lacks a phone or transportation.
* Let others in the community know about these Elder(s) too.
* Visit them regularly, every couple of days if you can, or take shifts with other people to do this.
* Bring fresh drinking water and check on their wood and fuel supplies when you visit.
* Report anything of concern to the local CHR (community health representative) or Senior Center immediately.
* Stay informed of bitter cold and storms by calling NOAA or monitoring their weather site at http://www.noaanews.noaa.gov/stories/s794c.htm.
* Remember this rule of thumb: If you're cold, Elders are probably colder.

This story was originally published in Whisper ‘n Thunder Magazine, Winter 2012 Issue.   Download PDF >>