After a short pull on the straw, Brigitte Richter immediately takes her glass filled with coffee away from her lips. “Shit, it’s cold,” she curses. So the nurse Ramona Rössner goes back into the kitchen and puts the glass in the microwave. Richter, sitting on her bed in Berlin-Schoeneberg on this summer morning in a T-shirt, is waiting. Rössner returns with the glass, Richter takes another sip. “Now it’s good,” says the 97-year-old.
It doesn’t matter whether it’s warm or cold – Rössner, who has been a nurse for 20 years, is happy when the elderly people she cares for at home drink at all. This can be essential for survival, especially in summer. According to the Robert Koch Institute (RKI), high outside temperatures regularly lead to significantly higher death rates in summer, especially among the elderly.
The reasons are described as varied: There are deaths from heat stroke, but also more complex cases, for example when cardiovascular or lung diseases previously existed. For the summer of 2022, the RKI assumes an estimated 4,500 heat deaths nationwide. According to the Berlin-Brandenburg Statistics Office, more than 400 people died due to the heat in Berlin alone.
When the tongue gets dry
In the summer months, Rössner therefore takes a very close look. “If you know the patients, you can tell when they talk if they haven’t drunk enough,” says the 47-year-old. Speaking is then more difficult, the patients are restless or have a dry tongue. She regularly has to remind them to drink and put water bottles in several places in the apartment.
Richter, who affectionately addresses her as “my sweetheart”, repeatedly asks her to take another sip or clink glasses with her: “You drink, I drink.” Half jokingly, the 97-year-old replies: “That too!”
Older people often feel less thirsty. According to the managing director of the deaconry in Schöneberg, Michael Nehls, the loss of fluids increases in the heat. Nehls heads the outpatient nursing service that Rössner works for. In outpatient care, a closer look at sufficient fluid intake is all the more important because the patients spend a lot of time alone. It is often about older people who are demented or age-forgetful. There is also another problem: “Older people who are incontinent tend to drink less to get their incontinence problem under control,” says Nehls.
Rössner wakes her next patient from her nap around 11 a.m. Andreas Seltzer, a small man with gray hair, is first handed a glass of water while he is still sitting on his bed, somewhat dazed. “You drink too little,” warns Rössner in a firm but loving tone.
Heat action plan developed
Seltzer says he doesn’t feel thirsty at all. “I have to be encouraged to drink, so to speak.” Also, he just doesn’t like water. His favorite drink is beer, he says and laughs. He finds it annoying that Rössner and other nurses so often remind him to drink. “Behind this there is always the pedagogical index finger.”
Nehls has developed a heat action plan so that the nursing staff of the Diakonie can identify symptoms at an early stage. Listed are, among other things, characteristics that indicate health problems. These include shortness of breath, sudden confusion, vomiting and feeling weak. Nursing measures (light clothing, no thick blankets, little sunlight) and tips for the kitchen (cold soup, fruit rich in water, favorite drinks) as well as the right ventilation are listed. Employees are also given tips on how to protect themselves from the heat.
Even though Rössner never tires of setting up water bottles, preparing favorite drinks and toasting with water or coffee, she knows: “We can’t force people to drink.” But with good persuasion it usually works. If a patient is in a precarious condition, a doctor must be called in an emergency. But: “I haven’t had a case like this, thank God.”
