Fevers in the Elderly

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Specializes in Emergency/Trauma.

I have a quick question about fevers in the elderly. When I was in EMT training, we were told that the elderly don't always run fevers even with an acute infection because of the age-related changes in temperature control.

Now, when I was studying for my last test in Physical Assessment, my textbook said the same thing, that the elderly don't always run a fever because of the age-related cahnges in temp control.

Then, I went to take my test and I answered my test question according to the book. I got it wrong. I politely brought my book to the professor and showed her the sentance in the book that completely contradicted the "correct" test answer. She was real nice about it, but told me that she was right, the elderly run fevers MORE often than younger people do. However because their baseline temp is lower, the fevers are harder to detect.

Does somebody with experience have any input on this? Thanks!

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Specializes in Education, FP, LNC, Forensics, ED, OB.
I have a quick question about fevers in the elderly. When I was in EMT training, we were told that the elderly don't always run fevers even with an acute infection because of the age-related changes in temperature control.

Now, when I was studying for my last test in Physical Assessment, my textbook said the same thing, that the elderly don't always run a fever because of the age-related cahnges in temp control.

Then, I went to take my test and I answered my test question according to the book. I got it wrong. I politely brought my book to the professor and showed her the sentance in the book that completely contradicted the "correct" test answer. She was real nice about it, but told me that she was right, the elderly run fevers MORE often than younger people do. However because their baseline temp is lower, the fevers are harder to detect.

Does somebody with experience have any input on this? Thanks!

Hello, EMT/Nurse,:balloons:

I think, IMHO, this instructor is incorrect in her rationale. True, the body temp of the elderly are often subnormal. Now what is normal? This is know as 98.6. So, if the elderly individual has a "normal for them" body temp of 96 and their temp is 98, then they are febrile, but, because "normal" body temp is 98.6, then the individual is not febrile. Kinda confusing. That is why we cannot factor these things individually. There is a standard, in this case ..... a standard "normal" body temp.

So, yes, I can see her point, but, the elderly do not often times exhibit elevated temps due to the rationale your book reflects.

If I were the instructor, I would throw that question out .....again, IMHO.

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Specializes in Gerontological, cardiac, med-surg, peds.
Hello, EMT/Nurse,:balloons:

I think, IMHO, this instructor is incorrect in her rationale. True, the body temp of the elderly are often subnormal. Now what is normal? This is know as 98.6. So, if the elderly individual has a "normal for them" body temp of 96 and their temp is 98, then they are febrile, but, because "normal" body temp is 98.6, then the individual is not febrile. Kinda confusing. That is why we cannot factor these things individually. There is a standard, in this case ..... a standard "normal" body temp.

So, yes, I can see her point, but, the elderly do not often times exhibit elevated temps due to the rationale your book reflects.

If I were the instructor, I would throw that question out .....again, IMHO.

Great answer. ITA. At the very least, the wording on the question needs to be changed (i.e., substitute "elevated temperature" or "above normal temperature" for "fever" - this would be much less confusing and fairer to the students).

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:yeahthat:

The elderly don't always exhibit the clasic s/s of infection. Temp might not be elevated, but when it it..you know something is definatly up. We figure out each residents normal/ baseline temp. Not everyone's is 98.6 Normally anything over 100.5 we treat/ call md.

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Specializes in Emergency/Trauma.

Thanks everyone for the input! I'm not going to make a big deal out of it with the instructor, but it did seem odd to have her contradicting the book. Thanks again!

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