The challenge of maintaining

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The challenge of maintaining skin integrity on
the older person - an achievable goal
Rosie Callaghan Tissue Viability Nurse for
Nursing Homes Worcestershire Primary Care
Trust rosiecallaghan_at_nhs.net 07717543046
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skin
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layers
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Changes in ageing skin
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Results in

• Are more likely to suffer pressure and thermal
  damage to the skin due to diminished sensation
• Risk hyper/hypothermia due to decreased
  subcutaneous tissue
• Have fewer sweat glands and therefore produce
  less sweat which hinders thermoregulation and
  increases the risk of hyperthermia

• Slower to exhibit a sensitization response
  redness heat discomfort due to reduction in
  langerhans cells this can result in overuse of
  topical medications and more severe allergic
  reactions
• Risk of overdose of transdermal medications poor
  absorption can prompt them to reapply too often
• Much higher incidence of shear and tear injuries
  due to compromised skin adhesion and less
  flexible collagen

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Pigment changes

• There is an increase in brown spots which
  resemble freckles.
• senile purpura are more often associated with
  the arms.

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Extrinsic Factors

• Smoking
• Environmental pollutants
• Ultra violet light
• Decreased mobility
• Drug induced disorders
• Chronic illness

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• Correct manual handling techniques
• good nutrition and hydration
• Good skin care including emollients and use of
  non perfumed soap
• The removal of potential hazards

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references

• Benbow M (2009) skin tears British journal of
  Community Nursing 23 (1) 14-18
• Bianchi J, Cameron J (2008) Assessment of skin
  integrity in the elderly British journal of
  Community Nursing 13 (3) s23-32
• Davies A Management of dry skin conditions in
  older people British journal of Community Nursing
  13(6) 250-257
• Finch M (2003) Assessment of skin in older people
  Nursing Older People 15 (2) 29-30
• Hodgkinson B, Nay R, Wilson J (2006) A systematic
  review of topical skin care in aged facilities
  Journal of Clinical Nursing 16 129-136
• Lawton S addressing the skin care needs of the
  older person British journal of Community Nursing
  12(5) 203-210 British journal of Community
  Nursing 13 (7) 302-308
• Nazarko L Understanding and treating a common
  dermal problem pruritus
• Timmons J (2006) skin function and wound healing
  physiology Wound Essentials 1 8-17

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Web sites

• www,skincarecampaign.org
• www.bdng.org.uk
• www.britishskinfoundation.org.uk
• http//www.woundcare.com/
• http//www.smtl.co.uk/World-Wide Wounds/
• http//www.ewma.org/
• www.cochrane.org
• www.dressings.org