Robin Schiltz, C.D.S.
Much like walk-in tubs, hot tubs can be a great source of relaxation for senior citizens. They provide relief from the aches and pains of arthritis and can help people loosen stiff joints for greater mobility. It’s no secret that many people are sold on their therapeutic benefits.
But, are hot tubs safe for elderly? Hot tubs pose health risks for the elderly because they can breed infection-causing bacteria. They also are dangerous for seniors with high (or low) blood pressure, diabetes, or heart conditions. Elders with chronic lung problems or who take certain medications should also avoid using hot tubs.
When you see hot tubs at home shows or in ads, they always seem so innocent and user-friendly. Who doesn’t love a long, hot soak?
But for senior citizens, hot tubs can pose safety and health risks that range from seemingly innocent dizzy spells all the way up to downright deadly conditions.
Can Hot Tubs Make You Sick?
Hot tubs can quite literally make you sick. This is especially true if you are a senior citizen with health concerns or someone who has a compromised immune system.
Bacteria thrive in warm, moist environments, which means that hot tubs are perfect breeding grounds for them. In addition, parasites can also live in the warm water.
“Skin infections like “hot tub rash” are a common RWI {recreational water illness} spread through hot tubs and spas. Respiratory illnesses are also associated with the use of improperly maintained hot tubs.”
Centers for Disease Control and Prevention
In 2018, the Centers for Disease Control and Prevention (CDC) released its report on pathogenic outbreaks that came from infected recreational water.
These are things such as the water in swimming pools, hot tubs, and in those fun, interactive fountains that kids play in at parks.
The CDC noted that, “During 2000–2014, public health officials from 46 states and Puerto Rico reported 493 outbreaks associated with treated recreational water. These outbreaks resulted in at least 27,219 cases and eight deaths.”
Bacteria like Escherichia coli (abbreviated as E. coli) and parasites such as Cryptosporidium (Crypto for short) and Giardia can thrive in hot tubs. In addition, several other disease-causing germs also can, as well.
In fact, despite being treated with chlorine at the CDC’s recommended levels, both Crypto and Giardia can stay alive in the warm water for several days.
Illnesses that the elderly could get from a hot tub include:
- Both coli and Crypto cause diarrhea.
- E. coli is also responsible for respiratory illnesses like pneumonia, and urinary tract infections.
- Crypto and Giardia can cause stomach cramps, vomiting and nausea, dehydration, and fever.
Elderly people and those who have weakened immune systems (such as someone who is getting chemotherapy) are most likely to get sick from the germs in a hot tub. Some of the illnesses they could pick up can be deadly (example: pneumonia).
How About Legionnaires Disease and Hot Tubs?
Legionella bacteria (causes the pneumonia found in Legionnaires disease) and hot tubs go hand in hand with each other.
This is because Legionella thrives in hot tubs and other warm water environments, just like E. coli and other bacteria do.
Legionella is naturally found in water, especially warm water. Hot tubs (or spas) that are not cleaned and disinfected enough can become contaminated with Legionella. A person can get infected with Legionella when they breathe in steam or mist from a contaminated hot tub.”
Centers for Disease Control and Prevention
The CDC reports that certain groups of people are more susceptible to getting Legionnaire’s disease. Among them are:
- Those over age 50
- Smokers
- Those with a weakened immune system
- People who have a chronic lung disease
Sadly, these criteria fit many seniors.
Because it is difficult to keep the disinfectant levels high enough in a hot tub to kill bacteria, hot tubs are not safe for elderly people to use.
Seniors really should get cleared by their physician before they get into or purchase a hot tub.
Can You Get in a Hot Tub With a Heart Condition?
Seniors who have heart conditions should be very careful using hot tubs and realistically should probably avoid them altogether. Likewise, those with breathing problems.
Here’s why hot tubs (and saunas) are unsafe if you have a heart condition – soaking in hot water causes blood vessels to expand.
This is called vasodilation and it is known to affect heart conditions because it causes variations in blood pressure.
Normally we sweat when we get overheated. Evaporation of the sweat cools down our body temperature, but sitting in a hot tub surrounded by hot water doesn’t allow for this cooling to take place.
The body tries to compensate by dilating the blood vessels. This routes blood away from the body’s core and out to the skin in an attempt to cool down.
The result is an elevated pulse and heart rate in order to offset the corresponding drop in blood pressure. Among other things, this could cause fainting or lightheadedness.
William Kormos, MD, Editor In Chief of Harvard Men’s Health Watch, also recommends that people, “avoid moving immediately from the hot tub to cold water, since this could trigger a sudden spike in blood pressure”.
Hot Tub Dangers – High Blood Pressure
Along with worrying about using a hot tub with a heart condition, seniors often wonder is it safe to use a hot tub with high blood pressure histories. The short answer is “no”.
The longer answer tells you why: as mentioned in the section about heart conditions, high temperatures cause vasodilation, which is expansion of the blood vessels.
This expansion can cause fluctuations in blood pressure, resulting in dizziness or loss of consciousness (fainting).
Cardiologists worry that someone who has high blood pressure may experience:
- inadequate blood flow to the heart
- abnormal heart rate
- nausea or dizziness
- possible heart attack
That said, a study by T. Shin, M. Wilson, and T. Wilson of the Departments of Medicine and Pharmacology and the Cardiovascular Risk Factor Reduction Unit, University of Saskatchewan, Saskatoon, Canada, reported that, “Immersion in a hot tub for 10 minutes lowers blood pressure in subjects with treated hypertension, but no more than in normotensive control subjects. Spending 10 minutes in a hot tub should be safe for most treated hypertensive patients.”
To minimize their risk, seniors with high blood pressure or a heart condition should get in and out of a hot tub slowly to give their bodies time to adjust to the change in temperature.
Also, as the researchers noted, they should limit their soaking time to no more than 10 minutes.
Hot Tubs Safety Tips for Seniors
- First, check with your doctor to be sure it is safe to use a hot tub. They are not safe for those who have diabetes, a heart condition, lymphedema, blood pressure problems, or circulatory problems.
- Always
use a safety handrail (like the one pictured on the right) to enter or exit a hot tub. They can stabilize someone who becomes dizzy or lightheaded and are good for those who need help pulling themselves out of the hot tub. Note: If you get a handrail that can swivel so the user can grab it more easily, be sure it has a locking feature to keep it in place.
- Seniors who are taking certain medications must check with their doctor before using a hot tub. These include beta blockers (which lower heart rate), diuretics, tranquilizers, anticoagulants, or antihistamines. This is because the heat and length of soaking time can amplify the effects of a medication.
- Start off using a hot tub slowly. Don’t sit in one for more than 10 – 15 minutes at the beginning and never for more than thirty minutes, which can cause heat-related illnesses like dehydration, nausea, and fainting.
- People with fragile skin can be burned by the high temperatures of hot tub water, so always check the heat of the water before getting in. Elders who have fragile skin should start with a temperature of about 100 degrees Fahrenheit (37 Celsius). They should avoid soaking in water that is hotter than 102-104 degrees Fahrenheit (39-40 Celsius).
- Never use a hot tub alone. Senior citizen or not, always have someone with you when you use a hot tub.
