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A trend toward more hot and humid summers in the United States raises concern for the health of our elderly population. Older adults are more vulnerable to heat illness than younger people because of dysfunctional thermoregulatory mechanisms, chronic dehydration, medications, and diseases involving the systems that regulate body temperature. Heat exhaustion, if untreated, will lead to heat stroke, which is fatal if body temperature is not quickly lowered, and research shows that survivors may suffer long-term disabilities. Prevention requires strong knowledge and application of measures necessary to keep elders healthy in extreme heat. Should illness occur, careful monitoring and assessment will ensure early detection and prompt treatment. This article provides information for caregivers that will enable them to protect their patients from heat illness. It also discusses age-related changes in the thermoregulatory system's response to heat, risk factors, assessment criteria, preventive measures, and first aid for victims of heat exhaustion and heat stroke.