Monsoon Illnesses and Older Adults: Prevention

The main monsoon risks

• Mosquito-borne fevers: dengue, malaria, chikungunya; see dengue and malaria in older adults: warning signs.
• Water and food-borne infections: diarrhoea, vomiting, typhoid, hepatitis A and E, cholera; see diarrhoea and dehydration in seniors.
• Leptospirosis, from contact with floodwater or water contaminated by rat urine.
• Respiratory infections: colds, influenza, pneumonia, and flares of asthma and COPD; see pneumonia in older adults: prevention and recovery and COPD at home guide.
• Mould and damp: allergy, wheeze, cough; see pest, damp and mould at home.
• Skin and nail infections: fungal infections between toes and in skin folds, wounds that do not heal, especially in people with diabetes; see diabetic foot care at home and foot, nail and skin problems that affect walking.
• Slips and falls on wet floors and steps; see falls risk assessment at home.
• Electric shocks from wet wiring and appliances.
• Power cuts and flooding: interrupted oxygen, refrigeration of medicines, lifts and communication; see power cuts and older adults.

Safe water

• Drink only safe water: boiled and cooled, or from a maintained filter or purifier. Boil for at least a minute at a rolling boil, cool in a clean covered container.
• Store drinking water covered, in a clean container with a tap or a clean long-handled ladle; do not dip hands or cups.
• Clean the filter or purifier on schedule and keep storage tanks covered and cleaned.
• Ice and street drinks: avoid ice of unknown source, roadside juices and cut fruit left uncovered.
• After flooding or discoloured tap water, boil water, even if you normally use only a filter.
• Wash hands with soap before eating or feeding someone, after toilet use and after handling dirty linen; see infection control for home caregivers.

Safe food

• Eat freshly cooked, hot food; avoid leftovers kept at room temperature for hours, and refrigerate promptly.
• Wash vegetables and fruits thoroughly in clean water; leafy vegetables and salads can carry germs in the monsoon, so cook them well or soak and rinse carefully.
• Avoid raw or undercooked meat, fish and eggs, and street chaat for older adults at this time of year.
• Keep kitchen surfaces clean and dry, cover food, and keep flies and cockroaches away.
• Stock for power cuts: shelf-stable foods, not relying on the refrigerator; see kitchen safety for older adults.
• Keep eating well: protein and fluids help immunity; see how much protein do older adults need.

Mosquito control

• Remove standing water weekly: coolers, pots, tyres, buckets, flower vase trays, plant saucers, rooftop containers. Cover water tanks. Dengue mosquitoes breed in clean standing water, and bite in daylight.
• Screens and nets: fit window and door screens; use bed nets, especially for bedridden people.
• Repellents and coils: use skin repellents only as the product label directs and as the pharmacist advises; electric vaporisers and coils may irritate lungs, so use in ventilated rooms and not near people with asthma or COPD.
• Dress: long sleeves and trousers in light colours at dawn and dusk.
• Report fogging or drain problems to your local municipal office; see garden, balcony and terrace safety.

Damp, mould and breathing

• Dry the house: open windows when it is not raining, run fans, use a dehumidifier if available, and wipe condensation.
• Fix leaks and damp walls; clean visible mould with appropriate care, keeping the older person away during cleaning; see pest, damp and mould at home.
• Dry laundry completely before wearing; damp clothes and bedding promote fungus. Use sunny hours or a well-ventilated space.
• Air quality: an air purifier with a suitable filter can help people with allergy and lung disease; see air purifier buying guide and indoor air quality for older lungs.
• Pillows and bedding: wash and sun-dry regularly; see pillow hygiene and allergies.
• Shoes, bags and cupboards: keep dry; check for mould.
• Lung disease: continue prescribed inhalers; know your action plan; see COPD action plan and asthma in older adults.

Skin and feet

• Keep feet dry: dry well between the toes after every wash or wet walk; change wet socks and shoes promptly.
• Avoid walking barefoot in dirty water. After wading through water, wash feet and legs with clean water and soap, dry, and check for cuts.
• Wear appropriate footwear: closed, dry, non-slip shoes or sandals with grip; see choosing shoes for older feet.
• Check skin folds, groin, under the breasts and between toes for redness, itch or peeling; tell the doctor rather than applying creams on your own.
• Wounds: clean, cover and watch for redness, swelling, pus or fever; diabetes slows healing; see wound care at home for older adults.
• Bedridden people: keep skin and sheets dry; see preventing bedsores at home.
• Incontinence: change promptly to prevent skin breakdown in humid weather; see incontinence-associated dermatitis.

Preventing slips and falls

• Non-slip mats inside and outside bathrooms and at entrances; see non-slip bath mats guide and anti-slip tape and coatings.
• Wipe wet floors, use doormats to dry shoes, and keep a towel at the door.
• Grab bars and good lighting in bathroom and passage; see grab bar buying guide and lighting and contrast at home.
• Stairs and balconies can be slippery; see stairs, steps and thresholds.
• Outdoors: avoid going out in heavy rain or on flooded roads; use a stick with a rubber tip and an umbrella; see walking stick rubber tips.
• Electric safety: keep plugs, extension boards and appliances away from water, and do not touch switches with wet hands; fix damp wiring.

Exercise and routine

Continue regular activity indoors; see exercise in summer and monsoon indoors. Keep medicine and doctor appointments, and refill supplies before heavy rains or floods.

Vaccination

Ask the doctor about influenza, pneumococcal and other vaccines suited to your parent, ideally before the monsoon; see vaccines for older adults in India: a practical schedule.

What to keep ready

• A thermometer, blood pressure monitor and, if advised, an oximeter; see digital thermometers: choosing and using them for older people and pulse oximeters: how they work and how to use one.
• Oral rehydration salts and clean drinking water.
• A week or more of regular medicines, in a dry place, and a current medicine list.
• A torch, battery fan, charged phone and power bank.
• Emergency numbers and a plan for evacuation if flooding; see emergency contact card and medical summary and emergency bag for a hospital visit.

Warning signs

Call the doctor the same day for: - Fever, especially with body pain, headache, rash, pain behind the eyes, nausea or vomiting, or chills and shivering; do not wait for it to pass. Do not give anti-inflammatory painkillers or other blood-thinning pain relievers for fever unless the doctor advises, as they can worsen bleeding in dengue. - Loose motions lasting more than a day, or with blood, severe pain or vomiting. - Yellow eyes or dark urine. - Cough, wheeze or breathlessness that is worse than usual. - Red, swollen, painful or oozing skin or wounds. - Reduced urine, dry mouth, dizziness. - New confusion or unusual sleepiness.

Call 112 or go to hospital at once for: - Severe breathlessness, blue lips, chest pain. - Confusion, drowsiness, fits or fainting. - Bleeding from gums or nose, vomiting blood, black stools, severe abdominal pain or persistent vomiting with fever (possible dengue warning signs, particularly days three to seven of illness). - Very little or no urine, cold clammy skin, a very weak pulse. - Fever with stiff neck or severe headache. - Severe diarrhoea with dehydration. - Fever and muscle pain after wading in floodwater, with red eyes or jaundice (possible leptospirosis).

When to ask a professional

Ask the doctor about vaccines, chronic condition plans and what to do if fever starts. Ask a pharmacist about repellents and medicine storage. Ask your local health office about fogging and drains. Seek urgent help for warning signs; call 112.