• Use heated blankets as needed. Keeping the immobile elderly patient warm when out

of bed is also a subject that needs addressing.

RACHEL FRANCIS Hill, New Hampshire

In working some 20 years in long-term care, I know that keeping residents comfortable at night is an ongoing challenge.

Here are a few ideas that may help: Bath blankets between resident and sheet Jogging suits to sleep in Flannel hospital gowns Kneehigh socks (not too tight) The "old" nightcap works well Allowing a favorite quilt or blanket from home Leg warmers Allowing socks to be left on Thermal blankets between sheet/bedspread

If a client's feet and head are warm, they tend to be comfortable. Just remembering what you do when you are cold will help you come up with many ideas.

Don't forget that warm hug before bed.

FLOREEN PENZKOVER, RN, DON Rice Lake Convalescent Center

Rice Lake, Wisconsin

In response to the letter from Pamela Rowe requesting information on keeping patients warm, I would suggest that she consider "sandwiching" one thermal blanket be- tween two sheets. This seems to work to keep the patient warm as would a comforter, without the added weight of extra blankets.

Barbara Walker RN, BS Lewisburg, West Virginia

In response to Pamela M. Rowe's letter, although I have not encountered this as a clinical issue with older adults, I am certain it exists in nursing home settings, as

well as in the home setting. As adults age, they seem to learn to accept and adjust to certain discomforts, maybe dismissing the discomfort as being part of normal aging or simply uncorrectable. I can only hypothesize that feel- ing cold while lying in bed probably holds the potential of influencing sleep, urinary/elimination patterns, sensory perception, integumentary integrity, as well as the per- ceptions of comfort and well-being of the older adult. I know I am unable to get to sleep if I feel cold under the sheets.

My solution was the purchase of a down comforter. Af- ter many years of trying to rationalize the cost, I decided to take the leap and purchased a king-size goose down comforter for $200. Even though the temperature of my hands and legs is cooler than the rest of my body, enough heat seems to be trapped within the down to generate some heat, enough heat to warm me. Down is neither heavy nor cumbersome, and thus, does not inhibit mobil- ity nor weigh on toes, knees, shoulders, or arms. Also, those older adults who desire a cooler room temperature can still remain comfortably warm under the covers.

The cost of a down comforter may be too high to be purchased for a unit; nevertheless, families can be en- couraged to purchase one as a gift for the patient. On sale, a twin-size down comforter ranges between $75 and $150.

If Rowe is interested in formally studying the effects of down on the body temperature in older adults, I would appreciate her contacting me. The scientific investigation of this problem has direct implications for the quality of life of older adults. I believe that some "undercover work" would prove interesting and valuable.

CORA D. ZEMBRZUSKI, RN, MSN Assistant Professor, Gerontological Nursing

Wilcox College Middletown. Connecticut

Because I have had this same problem (being cold and on an onocology unit), I empathize with the problem. Sweat suits, preferably a size larger than the patient nor- mally would wear, provide a very satisfactory solution. This works equally well for men and women.

Winnie Robb, LPTN Long-Term Care Ombudsman Supervisor

Beaver, Oklahoma

A g re e or d i sagree w i th a n ar t i c l e or ed i tor ia l? H a v e a n u r s i n g tip o1"

ins igh t to share?

Write to P r i s c i l l a E b e r s o l e , E d i t o r ,

GERIATRIC NURSING, 2 7 9 0 R o l l i n g w o o d

Dr. , San B r u n o , CA 9 4 0 6 6 .

Letters Geriatric Nursing Volume 14, Number 4 181