Experienced caregivers offer their best suggestions for maintaining skin integrity and health. Eating a diet full of beneficial vitamins and minerals will not only benefit your skin, but also your overall wellness. If you lose sensation due to damaged skin, you could be at a higher risk of injury or danger. | Aging is associated with structural and functional changes of the skin that result in increased vulnerability. People have the right to get care from those they love and trust — people who bring them comfort & joy. Imbalanced nutritional state - Nutrition has a direct impact on skin health. These macronutrients play a critical role in skin health. Skin becomes thinner and naturally dryer, making it much easier to damage and dry out. Lack of moisture - Lack of adequate moisture in the skin could cause it to become dry, flaky, and itchy, and overall skin health could suffer. Assist with skincare routine - Help your loved one or friend stick to their skincare routine. The changes that can occur to skin as it ages can affect its integrity, making it more vulnerable to damage and at a higher risk of developing pressure injuries and skin tears. Older adults are at a higher riskbecause of the skin aging process. There are a plethora of skin moisturizers out in the wild and they are not the same. It receives one third of the body’s blood circulation. What you should specifically do will vary depending on the current skin health of the person you’re caring for. For seniors that you might be caring for, one of the biggest complications arising from loss of skin health is the greater risk of pressure wounds. ●       Apply a natural dermatologist recommended moisturizer regularly, especially if you have dry skin, ●       Avoid showers in water that is too hot to prevent dry and cracked skin, ●       If you have vulnerable areas in your skin, be sure to apply ointments and dressings regularly. Dry Skin and Itching. Here are some of the possible conditions that can arise as a result of pressure ulcers. That could mean helping them do some stretches on the bed, or it could be that you drive them to the park for a walk or jog. And the best way to prevent pressure wounds is to maintain optimal skin health and integrity. We will also cover what you can do as a care provider to help your senior family member or client to maintain skin integrity, as well as to help in the skin healing process if necessary. 3. Cellulitis - Cellulitis is an infection that affects the skin, and the soft tissue connected to the skin. Many people don’t think of their skin as a protective organ. GOAL: Monitor the condition of skin and risk factors to ensure skin integrity Potential Interventions: Inspect skin daily with cares (done by nursing assistants) Inspect skin weekly by licensed nurse Risk assessment per protocols Documentation of skin integrity concerns (i.e., pressure ulcer) at least weekly In this article, we will cover the topic of skin integrity when it comes to older adults. The twenty-first century clinician has several online, evidence-based tools to assist with optimal treatment plans. Inflammatory skin disorders are manifestations—for the most part— of the immune response, which wanes with age. Even if these products are used, the skin must still be cleaned each time after passing urine or stool. You might take the approach of helping them maintain good skin health, or in some cases, you might have to aid the healing process if their skin is already damaged. Call us now on 718.989.9768 to learn more about the Consumer Directed Personal Assistance Program (CDPAP). FreedomCare does not provide medical services. Regardless of whether you have damaged skin or not, you should maintain a proper skincare routine to promote skin integrity. Previous pressure injuries or skin tears Symptoms may be redness, swelling, and pain. When it comes to skin integrity,there are several things you can do to promote skin health and support the healing process. Movement promotes better circulation, which will help maintain skin integrity. ●       Category 2 pressure ulcer - A blister or an open wound on the skin. To learn more about our home care services, Sores are most easily seen on the outside surface of the forearms, but they can occur anywhere on the body. diet full of beneficial vitamins and minerals. Changes to the skin include its mechanical properties, geometry, physiology and repair, and transport and thermal properties. 1. In these situations, it might be best to assist them periodically and help them shift positions to avoid too much pressure on one part of the skin. Changes occur in the epidermis, dermis and hypodermis leading to thin, dry and sagging skin, while loss of structure and integrity diminishes the skin’s ability to protect the body and detect changes in … The databases Medline, EMBASE, CINAHL (1990–2012), Scopus, SCI (February 2013) and reference lists were searched. Regular inspection - Frequently inspect your senior relative’s skin for any warning signs of pressure wounds. As we just explained in detail in the previous section, pressure ulcers can develop into a serious medical condition. We have strict non-discrimination and privacy policies. If you’re not already familiar, CDPAP is a program through the New York State Medicaid that allows Medicaid beneficiaries to hire friends and family members (with specific exceptions) as care providers. Thin skin on the arms and legs is often quite normal for elderly people. Below, we will discuss in detail what you can do as a caregiver to help maintain skin integrity to reduce the risk of pressure wounds, and to improve your senior client’s overall quality of life. Sensory information - The skin provides necessary sensory input about any potential dangers in the environment. The first thing you should do for your skin health is to consult with a dermatologist. But protection is one of the most important functions of your skin. We will discuss what is skin integrity, the complications that can arise from losing it, and the various causes and risk factors for loss of skin health with aging. Also, apply the right moisturizers and dressings to any wound on the skin to support the healing process. Skin conditions among older adults are common, so identifying and protecting high-risk skin areas and maintaining skin integrity is important (Hahnel et al., 2017; Kottner & … Another one of the biggest contributors to poor skin integrity is sun exposure. But skin integrity is important for reasons beyond preventing bedsores, like the following: Protection - The skin is the largest organ and the outermost layer of the body, and it is responsible for protecting you from various factors like temperature changes, environmental chemicals, and more. If you have a skin injury or have been exposed to environmental factors such as radiation, you may be at risk for impaired skin integrity. 2 Clinicians need to focus on the assessment and management of the elderly with or at risk for impaired skin integrity. Extremes of age - After a certain age, skin moisture levels decrease, causing dry and flaky skin, as well as a higher risk of skin damage. Also, garlic and ginger are great additions to any healthy diet. Encourage and facilitate a healthy diet - We’ve discussed the importance of nutrition when it comes to skin health. To keep it simple, just try to eat a mix of leafy greens like spinach, cruciferous vegetables like broccoli, roots like carrots, and fruits like berries. That means you can get CDPAP wherever you are in New York. A provider can recommend barrier creams to help protect the skin. 30 NO. Try some of the tips mentioned in this article to prevent conditions like pressure wounds, and to help your senior family members enjoy their golden years with healthy and vibrant skin. As we age, it is inevitable that we will all lose some of our youthful skin due to various factors like exposure to the sun, pollution, and other factors like stress and gravity. Research has shown that a moist environment promotes better healing when compared to a dry environment. GENERAL PURPOSE: To provide an overview of the assessment and management of risk factors for falls in older adults. Wound healing may be up to 4 times slower. Nutritional factors that can help maintain skin integrity: Stay hydrated. With aging, there are a variety of factors that can contribute to poor skin integrity. If the pressure sores progress beyond stage 1, one may experience the following symptoms. Long-term steroid use - Research has shown links between chronic steroid use and a higher risk of loss of skin integrity. Dry skin is itchy and this can lead to scratching and skin breakdown. We will discuss below how to include nutrients in the diet to promote healthy skin in older adults. At no cost, we can connect you with a network of providers covered by Medicaid or Medicare. With age, it becomes more important to take care of … A skin integrity issue might mean the skin is damaged, vulnerable to injury or unable to heal normally. Pressure ulcers can be caused by skin changes, loss of the fat layer, reduced activity, poor nutrition, and illnesses. In addition, older people in hospital are likely to spend more than 23 hours per day either in bed or sitting 2. health disciplines (eg, the physician, physical therapist, and dietitian) to plan and provide preventive treatment measures for the elderly person with potential for impaired skin integrity: pressure ulcers. Make sure you are getting enough Vitamin A, C, E, K and minerals zinc, iron and copper. ●       Category 4 pressure ulcer - A very deep wound that might potentially reach the bones and muscles in the affected area. This is often referred to as the loss of skin integrity. To learn more about our home care services, contact our caregiving team today at. Here are a few common skin conditions elderly people experience. Common Skin Conditions in the Elderly Wrinkles re the most visible sign of aging skin. Immobility - Patients who suffer from mobility issues, whether due to a disability, obesity, or another underlying condition, are more likely to experience pressure wounds. Pressure wounds usually develop over time, but in some cases it can show up in a matter of hours. If you’re caring for a senior that has an underlying condition that might make it difficult for them to change positions in bed frequently, then they could be at an added risk for pressure wounds. Discuss risk factors that may cause skin breakdown. The UV light from sunlight damages elastin, which is the elastic tissue that is responsible for the plump look in youthful skin. find a caregiver near you. 118-35 Queens Blvd, Suite 414, Forest Hills, NY 11375, 749 E 135th St., Suite 105, The Bronx, NY 10454, 300 Cadman Plaza West, One Pierrepont Plaza, Suite 12093,Brooklyn, NY 11201, 300 International Drive, Suite 149, Williamsville, NY 14221, 20 Miller St. Suite 200, Plattsburgh, NY 12901, 510 Clinton Square, Suite 538, Rochester, NY 14604, 4583 North St, Suite 2,  Jamesville, NY 13078, 747 Third Ave, 29th Floor, New York, NY 10017, 445 Broad Hollow Road, Suite 25 Melville, New York 11747, 73 Market Street, Suite 350, Yonkers, NY 10710, 150 Motor Parkway, Suite 414, Hauppauge, NY 11788, 418 Broadway, 2nd Floor, Albany, NY 12207, 115 Broadway, Suite #3, Newburgh NY 12550, 3900 W. Alameda Ave, Suite # 1200, Burbank, CA 91505, Now offering InstaPay4Care — Clock out &, To see if you are eligible, fill out this form. If your care patient has had mechanical trauma to their skin, consult with a dermatologist to ensure proper and quick healing. Mechanical trauma - Mechanical trauma refers to events like skin tears and deep scratches. Self-image and mental health - The skin is directly tied to one’s appearance and therefore can affect self-image. When you don’t properly maintain your skin integrity, it can result in numerous circumstances. Maintaining skin integrity equals maintaining skin health, and this includes people of any age. Consult a medical professional to determine your best course of action if you experience or are currently experiencing any of the following. Or perhaps you can join exercise classes aimed at older adults at your local senior center. It could be something as simple as going for a walk around the neighborhood. Regular shifting will help avoid too much pressure on any one part of the skin. Geriatric skin care requires knowledge of the anatomy and physiology of the skin, physiological changes that occur with aging skin that play a significant role in common geriatric skin conditions, skin assessment … Skin integrity relates to skin health. Depending on your level of mobility, try to get as much exercise or movement as possible. Do you have a question or do you just want to speak with us? Apply moisturizers, ointments, and dressings as needed and recommended by the dermatologist. Most bedsores heal with treatment, but in some severe cases, there might not be a complete recovery. Cancer - If the wound doesn’t heal for a long time, it can develop into a type of cancer known as squamous cell carcinoma. If left untreated, the skin overlying edema can become stretched, increasing the risk of damage. When this does happen, it takes much longer to heal. Seniors have thinner, more delicate skin, and incontinence and a sedentary lifestyle can easily lead to skin breakdown. Pressure wounds can happen to anyone, but older adults who spend prolonged periods sitting in a wheelchair or lying in bed can be more vulnerable. CLINICAL SCENARIO An 86-year-old female patient, Mrs B., returns for a follow-up visit at the wound clinic. Itchy and painful skin can be very uncomfortable, and it could have a significant impact on one’s quality of life. Impaired sensation - Impaired sensation in the skin can cause your care patient to ignore skin discomfort or prolonged pressure, making them more vulnerable to the condition progressing further without treatment. If an older adult has visibly damaged skin, he or she might be less willing to socialize with friends or take part in community activities. A skin integrity issue might mean the skin is damaged, vulnerable to injury or unable to heal normally. Aging skin is more sensitive and susceptible to a lot of skin diseases and conditions. The best way to help your care patient prevent damage due to sun exposure is to make sure they apply sunscreen before they go outside on a sunny day. Some age-related skin changes can be reduced – limit sun exposure, don’t smoke, avoid harsh skin irritants and moisturise regularly. Maintaining skin integrity helps ensure that the skin can perform its protective function optimally. Specifically, vitamin K, C, A, and E are great for skin health, along with minerals like zinc, iron, and copper. 2017 Jan;30(1):40-46. ●       Pain or itchiness - There are many conditions that can cause the skin to get painful and itchy, including pressure sores. Assist with movement - Help your relative get as much exercise as possible. Edema - Edema is a condition that causes swelling due to too much fluid trapped in one part of the body, usually in the extremities like hands, feet, arms, ankles, etc. The aim of this systematic review is to synthesize empirical evidence about the efficacy and effectiveness of basic skin care interventions for maintaining skin integrity in the aged. The bony areas of the body, such as shoulder blades, hip bones, ankles, etc., are typically at a higher risk of pressure wounds. Obesity - Obesity is associated with a higher risk of other risk factors of skin health such as lack of mobility, poor circulation, immune deficit, and impaired nutrition, all of which could cause skin health issues. Let’s take a closer look at some common conditions, the principles of skincare in the elderly, and how to maintain skin integrity in the elderly. Signs of healthy ageing skin include thinning, sagging, wrinkling and the appearance of age spots, broken blood vessels and areas of dryness. Understanding best practices in addressing skin integrity issues can promote positive outcomes with the elderly. Every person is unique, and so is their skin. As skin ages, the junction between the epidermis and dermis thins a… Hyperthermia or hypothermia - Both hypothermia and hypothermia can leave your skin more vulnerable and susceptible to damage. ●       Warm, spongy, or hard skin patches - Watch out for these symptoms, especially if there is no explanation for them. Ideally, if there is a pressure wound forming, you can identify it early in the progression and get it treated so it never reaches the later stages. Quality of life - Unhealthy skin can become dry and flaky, and it can cause pain and itchiness. Skin integrity refers to the health of your skin. It could also be due to a medical procedure like a surgical incision. However, if you have paper-thin skin that cracks or splits very often, you may want to talk to your doctor to make sure that your nutrient intake is adequate. But be sure to only use sunscreens that are either approved or recommended by their dermatologist to avoid any unwanted skin reactions. But for the elderly, especially ones who fall in the risk categories mentioned in this article, the loss of skin health can cause serious conditions like pressure ulcers. Their skin can be extremely fragile, but there are a few things you can do to help maintain good skin integrity and prevent skin breakdown. Complications as a result of pressure wounds, depending on the severity and the patient’s overall health, can range from relatively mild to, in some rare cases, life-threatening. Despite positive characteristics, the skin is always susceptible to and at risk of injury and breakdown. A dermatologist can evaluate the condition of your skin, the risk of severe infections like pressure wounds, and recommend a treatment or maintenance plan accordingly. Mechanical factors - Mechanical stress on the skin, such as excess friction, pressure, and shear, might contribute to skin integrity issues. In addition, the prevalence of polypharmacy in the aged population substantially increases the risk of cutaneous drug reactions, which can profoundly complicate accurate diagnosis of dermatologic disorders. Identify common skin problems of the elderly or ill. 4. A skin integrity problem might indicate the skin is damaged, exposed to injury or inefficient to repair and recover normally. https://www.freedomcareny.com/posts/skin-integrity-in-older-adults Your skin acts as a barrier and protects you from a variety of things like trauma, changes in outside temperature, and environmental chemicals, to name a few. ●       Exposure to pollution and harmful chemicals. KEYWORDS: falls risk, older adults, skin integrity, chronic wounds ADV SKIN WOUND CARE 2017;30:40–6. In general, keep an eye out for the following symptoms and warning signs for pressure wounds. The point is to get as much movement as your health and fitness level allows. To learn more about our home care services, contact our caregiving team today at (877) 268-3277 or This is because their immobility might cause them to spend prolonged periods in one position, resulting in too much pressure on certain joints and the skin in that area. Encourage your relative to stick to healthy food options to promote skin integrity. High risk patients require skin inspection at least once per shift in addition to admission to a ward or transfer to another facility. To learn more about our home care services, Chemical skin irritants (i.e, adhesives, soaps, formaldehyde, hair dyes), Mechanical factors (e.g., pressure, shear, friction), Mechanical trauma (e.g., scratches, skin tear, surgical incision), Eat a balanced diet that includes protein, healthy fats, vitamins (A, C, E, and K), and minerals (zinc, iron, and copper), Shower and/or bathe with warm water as needed (hot water and frequent bathing increases dry skin and skin irritation) and use mild soaps without perfumes or dyes, Apply non-greasy lotion on your body after a bath or shower, Check your skin regularly for changes and report them to your medical professional, Use sunblock with SPF 15 or higher in addition to wearing hats and light clothing during summer months and use a humidifier during the winter months, If an individual is bedridden, turn and reposition them every two hours to prevent pressure on the body’s bony areas, Diabetics should especially uphold good foot skincare to limit cracking, which could lead to infections. More than 70% of the older population has skin conditions. But it is especially critical for older adults who might be experiencing dry, flaky, or itchy skin. She has had venous ulcers for the past JANUARY 2017 e C LI N I CAL MANAG E M E NTxtra ADVANCES IN SKIN & WOUND CARE & VOL. Pressure wounds, also known as bedsores or pressure ulcers, are injuries to the skin and the underlying tissue that occur as a result of the skin being under pressure for too long. The skin is the largest organ of our body, covering 18 square feet and weighing approximately 12 pounds. The age-related reduction in oil and sweat gland function (which helps to keep the skin soft and hydrated) is the main cause of dry skin. Author information: (1)Catherine Cheung, MD, FRCPC • Geriatrician • Women's College Hospital • Toronto, Ontario, Canada. Impaired circulation - Optimal circulation delivers nutrients to the skin that keep it healthy and nourished. Here are some things you can do on a regular basis. The aging process, both for the skin and in general, varies from person to person, and it can depend on the following factors, among others. Include healthy fats in your diet. 1 Thus, it is not surprising that most of these dermatoses are less common in older adults. Skin hygiene is essential for skin health and important in promoting personal wellbeing. Shower or bathe using warm water as needed. Eat a balance diet that includes protein. To maintain skin integrity, it’s important for older adults to take a few steps. If you lose skin integrity, that might mean that you’re more susceptible to damaged skin that is unable to heal after trauma or injury. How to Care for Dry Skin in the Elderly. 6. But unfortunately, those with impaired sensations due to nerve damage often don’t notice the symptoms. Make sure to include plenty of high quality proteins and healthy fats in your diet. Gerontological nurses must continue the development and refinement of … They follow chronic sun exposure and form when the skin loses its flexibility. But as we age, we start losing skin integrity due to a wide variety of factors, as we will discuss below. When you don’t properly maintain your skin integrity, it can result in numerous circumstances. What you eat on a regular basis might be one of the single biggest factors to influence your health, and that includes skin health. Shift positions - If your relative or friend suffers from mobility issues and they spend a lot of time in bed or a wheelchair, you can help them shift positions periodically. Here are some of the things that older adults and their caregivers can do to maintain and promote skin integrity. If you’re caring for a senior who falls into one or more of the following risk categories, be sure to pay extra attention to their skin health and regularly check for pressure wounds. Explain how improving communication can prevent impaired skin integrity. FreedomCare proudly services all 62 counties of New York. As people age, skin changes and becomes thinner, drier, and more fragile. A pressure wound (also called a pressure sore, bed sore or pressure ulcer) is an injury to the skin and surrounding tissue. Although reversing the lost skin integrity with aging is very impossible, it is fairly possible and doable to implement some of the actions down below to keep skin hydrated and dewy. contact our caregiving team today online or call us at Skin is the largest organ covering the entire outside of the body. Let’s take a closer look at skincare tips for seniors. For right now I will put emphasis on the elderly and the immobile. According to the Mayo Clinic, more than half of adults over age 40 have dry skin. Along with a healthy diet, you can make sure that your family member stays adequately hydrated. 2 These changes can make skin more susceptible to injury and infections. 9. Identify the different types of skin breakdown. Maintaining skin integrity is a vital aspect of the healthy aging process. Older Adults, Falls, and Skin Integrity. For older people with dry skin it is particularly important to achieve a balance between cleanliness and overwashing, which may damage the barrier function (Voegeli, 2008a). The goal should be to always avoid pressure ulcers, and in the event they do develop, to identify and treat them immediately. Request PDF | Maintaining Skin Integrity in the Aged: A Systematic Review. With advancing age, these functions are increasingly impaired. In severe cases, the bone infection can affect the cartilage and even impact the function of limbs and joints.