Every heatwave in Russia hits older people hardest. A few simple everyday habits can significantly reduce the risk of overheating, but people usually only think of them once someone has already been taken ill.

It's a familiar scene: it's 32°C outside, the flat is stuffy, and Grandma insists she's "fine" and that there's "no need for the fan, it'll give me a chill." By evening she has a headache and her blood pressure is all over the place, and at night she can't sleep because the air in the room hasn't cooled below 25°C.

This isn't just the weather playing up: across the country, situations like this end in thousands of ambulance call-outs every summer. And the problem isn't that the heat itself is unbearable, but that the body copes with it very differently after 60 than it did in youth.

Why Older People Find the Heat Harder

With age, the body's temperature control works less well: this isn't a feeling, it's physiology. In people over 60, the sweat glands become less active: the body literally sweats less, which means it cools down less effectively. The blood vessels in the skin dilate more slowly, so heat is carried away from the internal organs less efficiently.

On top of that, the sense of thirst becomes blunted with age. A person can be dehydrated without feeling the need to drink. And without enough fluid, sweating drops even further: a vicious circle.

Roman Vilfand, scientific director of Russia's Hydrometeorological Centre, has repeatedly warned that it's not only the daytime heat that's dangerous but also hot nights. If the temperature stays high overnight, the body doesn't get a chance to recover during sleep, and that's especially hard on older people with heart and circulatory conditions.

How Heat Exhaustion Differs From Heatstroke

These are two different conditions, and between them lies a window when you can still help without calling an ambulance.

Heat exhaustion is a warning sign of heatstroke. The skin is pale and clammy, and the person feels weak, dizzy and nauseous, sweats heavily and may have their vision go dark. They feel unwell but remain conscious.

Heatstroke is the next stage, when the body can no longer cope. Body temperature rises above 40°C, and the person may become confused, behave strangely, slur their speech or faint. The skin often becomes hot and dry, but not always: the person may keep sweating.

Vomiting and an irregular heartbeat may follow. This is a medical emergency that requires an ambulance. The key warning sign is a change in mental state, not dry skin.

In older people, heat exhaustion can turn into heatstroke faster than in younger people, precisely because the body is less able to cool itself. That's why it's so important not to "tough it out" but to act at the first signs.

How Serious Is It? The Numbers

According to estimates by the WHO and weather services, heat is one of the deadliest weather hazards. In 2010, when an extreme heatwave engulfed central Russia, around 41,000 more people died in August alone than a year earlier, according to Rosstat, Russia's statistics agency.

In Moscow, according to the heads of the city's health department, deaths on the peak days of that heatwave doubled, to 700 a day. Most of the increase came from coronary heart disease and strokes: in other words, the heat hit hardest those who already had heart and circulatory problems. And that usually means people over 60.

In 2026, researchers from Stanford University (in the journal The Lancet Planetary Health) showed that in people over 60, the point at which the body can no longer maintain a normal temperature is reached in conditions 4.7–7.5°C milder than for younger people. The reason is the same: reduced sweating, a weaker response from the blood vessels and a slower perception of heat.

What to Do at Home

Most cases of overheating in older people happen not outdoors but at home, in a stuffy flat without proper ventilation. Here's what really helps:

Don't open the windows during the day if it's hotter outside than in. It's counterintuitive, but when it's 35°C outside, letting the hot air in just heats up the flat. It's better to air the rooms at night and early in the morning, and to keep the windows closed and the curtains drawn during the day. Heavy light-coloured curtains or blinds can lower the room temperature by several degrees.

Air conditioning isn't a luxury. If possible, keep the indoor temperature at around 24–25°C. A fan helps as long as the room isn't too hot: at 33–35°C and above, it barely cools an older person at all.

In that kind of heat, air conditioning or a cool public place (a shopping centre, a library, a clinic) is more reliable. Without air conditioning, a cool shower or a rub-down with a damp towel helps: water evaporating from the skin cools the body.

Drink water before you feel thirsty. This is perhaps the most important rule. Older people often don't notice that they're thirsty. A glass of room-temperature water every hour is a simple habit that can prevent dehydration. Mineral water and weak tea are fine too.

An important caveat: people with heart failure or kidney disease are often told by their doctor to limit their fluid intake, so they should check with their doctor how much to drink in the heat. Alcohol works against the body in hot weather, and coffee is best drunk in moderation.

What to Do Outdoors

On the hottest days, older people are better off staying indoors between noon and 4pm, when the sun and air temperature are at their peak. But if you have to go out, to the shops, the clinic or the dacha, a few simple steps reduce the risk:

  • Light-coloured, loose clothing made from natural fabrics. Dark and close-fitting clothes heat up in the sun and stop the body from shedding heat.

  • A wide-brimmed hat, such as a sun hat or panama. A baseball cap protects the face, but not the neck and ears.

  • A bottle of water with you. Not fizzy drinks or juice, just plain water. Sip a little every 20–30 minutes without waiting to feel thirsty (with the same caveat for those whose doctor has limited their fluid intake).

  • Avoid open areas of tarmac without shade. Tarmac heats up to 50–60°C and radiates heat from below: standing in an open car park or square at midday is much harder going than being in a park.

If there's an air-conditioned shopping centre or pharmacy on your way, go in and spend 10–15 minutes inside. It's not an indulgence but a way of "resetting" your temperature control when your body is starting to overheat.

What to Do If Someone Feels Unwell

At the first signs of overheating, such as weakness, dizziness, nausea or darkening vision, act straight away:

  • Move (or carry) the person into the shade or a cool room.

  • Lay them down and remove any excess clothing.

  • Put a cool, damp towel on their forehead. You can also wipe their neck, wrists and the insides of their elbows with cool water, where the blood vessels are close to the surface of the skin.

  • If the person is fully conscious and isn't vomiting, give them one or two glasses of water to drink in small sips. If they're confused or vomiting, don't give them anything to drink: they could choke.

If the person is talking nonsense, doesn't know where they are, loses consciousness or clearly has a raised body temperature, these are signs of heatstroke. In that case, call an ambulance and keep cooling them until it arrives.

Night-Time Temperature: The Hidden Factor

Few people pay attention to the temperature at night, yet it's one of the key factors. During the day the body overheats; at night it should recover. But if the flat stays at 26–28°C even at night, there's no recovery, and the strain on the heart and blood vessels builds up day after day.

A prolonged heatwave with no drop in temperature at night is the most dangerous scenario. Most people cope with a single hot day. But when the heat lasts three to five days in a row and doesn't let up at night, that's when problems start, and older people are the first to be affected.

If there's no air conditioning in the bedroom, you can try cooling the bed before going to sleep: put the sheet in the freezer for 15–20 minutes, or place a bowl of ice-cold water in front of a fan, so the air passes over the cold surface and cools slightly.

What to Know in Advance

  • Keep an Eye on the Forecast

The Hydrometeorological Centre warns of heatwaves several days in advance, and "orange" and "red" alert levels mean the strain on the body will be significant. If forecasters predict 30°C or more for three days in a row, that's your cue to prepare the flat in advance: check the curtains, buy water, and make sure the fan or air conditioner works.

  • Check on Older Relatives

If your grandparents live alone, call them every day during a heatwave. Ask whether they're drinking water, whether the flat is stuffy, whether they have a headache. Older people often don't complain and don't notice they're overheating until they feel really unwell.

Anyone taking several medicines or being treated for chronic conditions should ask their doctor in advance how to manage in the heat.

  • Adjust Routes and Schedules

Trips to the shops or the market are best moved to early morning, before 10am, or to the evening, when the temperature starts to drop. Gardening and dacha chores should be done only in the morning or after 5pm, with breaks in the shade.

Heatwaves in Russia are a seasonal phenomenon, but with every decade, spells of extreme heat are becoming more frequent and longer-lasting. Preparing for them isn't a matter of panic but of habit: a supply of water, closed curtains, a phone call to your parents, and the common sense not to play the hero in the blazing sun.