skin integrity in the elderly

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. But protection is one of the most important functions of your skin. Assist with movement - Help your relative get as much exercise as possible. High risk patients require skin inspection at least once per shift in addition to admission to a ward or transfer to another facility. Mechanical factors - Mechanical stress on the skin, such as excess friction, pressure, and shear, might contribute to skin integrity issues. Exposure to radiation - If the person you’re caring for has gone through radiation therapy, they could be at a higher risk of skin infection and damage. Many older people suffer from dry spots on their skin, often on … Here are some risk factors for impaired skin integrity. 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. It could also be due to a medical procedure like a surgical incision. But it is especially critical for older adults who might be experiencing dry, flaky, or itchy skin. diet full of beneficial vitamins and minerals. As you can see, bedsores or pressure ulcers can potentially have some severe consequences, especially in those with underlying conditions and suppressed immunity. Explain how improving communication can prevent impaired skin integrity. Skin becomes thinner and naturally dryer, making it much easier to damage and dry out. Also, apply the right moisturizers and dressings to any wound on the skin to support the healing process. 30 NO. Older adults are at a higher riskbecause of the skin aging process. Otherwise, you could simply do some stretchings in your home. Maintaining skin integrity helps ensure that the skin can perform its protective function optimally. Make sure you are getting enough Vitamin A, C, E, K and minerals zinc, iron and copper. Understanding best practices in addressing skin integrity issues can promote positive outcomes with the elderly. To maintain skin integrity, it’s important for older adults to take a few steps. There are a plethora of skin moisturizers out in the wild and they are not the same. Along with a healthy diet, you can make sure that your family member stays adequately hydrated. Long-term steroid use - Research has shown links between chronic steroid use and a higher risk of loss of skin integrity. Shower or bathe using warm water as needed. If you have an elderly family member or relative that needs care, you can provide caregiving services and get compensated through Medicaid. Self-image and mental health - The skin is directly tied to one’s appearance and therefore can affect self-image. Skin integrity refers to the health of your skin. When this does happen, it takes much longer to heal. The skin is the largest organ of our body, covering 18 square feet and weighing approximately 12 pounds. 6. 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. Fecal or urinary incontinence - Prolonged fecal or urinary incontinence can impact skin integrity, also known as incontinence-associated dermatitis (IAD). Changes to the skin include its mechanical properties, geometry, physiology and repair, and transport and thermal properties. Here are some of the early symptoms of pressure wounds, also known as stage 1 pressure ulcers. The first thing you should do for your skin health is to consult with a dermatologist. 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. Discuss risk factors that may cause skin breakdown. A skin integrity problem might indicate the skin is damaged, exposed to injury or inefficient to repair and recover normally. Consult a medical professional to determine your best course of action if you experience or are currently experiencing any of the following. As a caregiver, you can play a critical role in helping your patient or family member promote skin integrity. With advancing age, these functions are increasingly impaired. The point is to get as much movement as your health and fitness level allows. How to Care for Dry Skin in the Elderly. 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. KEYWORDS: falls risk, older adults, skin integrity, chronic wounds ADV SKIN WOUND CARE 2017;30:40–6. Infections of the bones and joints - As we mentioned above, if pressure wounds progress beyond the early stages, it can reach and infect the bones and joints surrounding the affected area. Also, garlic and ginger are great additions to any healthy diet. According to the Mayo Clinic, more than half of adults over age 40 have dry skin. Skin integrity relates to skin health. As we just explained in detail in the previous section, pressure ulcers can develop into a serious medical condition. Maintaining skin integrity equals maintaining skin health, and this includes people of any age. 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. 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. Itchy and painful skin can be very uncomfortable, and it could have a significant impact on one’s quality of life. In addition, older people in hospital are likely to spend more than 23 hours per day either in bed or sitting 2. But as we age, we start losing skin integrity due to a wide variety of factors, as we will discuss below. When in proper health, the skin performs various vital functions. In general, keep an eye out for the following symptoms and warning signs for pressure wounds. Skin integrity refers to skin health. Thin skin on the arms and legs is often quite normal for elderly people. 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. Seniors have thinner, more delicate skin, and incontinence and a sedentary lifestyle can easily lead to skin breakdown. 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. 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. At no cost, we can connect you with a network of providers covered by Medicaid or Medicare. Regardless of whether you have damaged skin or not, you should maintain a proper skincare routine to promote skin integrity. Make sure to include plenty of high quality proteins and healthy fats in your diet. 1 Thus, it is not surprising that most of these dermatoses are less common in older adults. Lack of certain nutrients can make the skin more prone to breakouts, dryness, and damage. Hydration is also vital in the wound healing process. This results in adverse skin conditions. A skin integrity issue might mean the skin is damaged, vulnerable to injury or unable to heal normally. 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. ●       Discolored skin - Red patches (on pale skin) or purple or blue patches (on darker skin) can be an early symptom of pressure wounds. If you’re caring for an older adult who falls under one or more of the higher risk categories listed below, you should check and inquire about their skin health regularly. Mechanical trauma - Mechanical trauma refers to events like skin tears and deep scratches. The key marker of quality care is the maintenance of skin integrity and prevention of pressure ulcers. Sores are most easily seen on the outside surface of the forearms, but they can occur anywhere on the body. Every person is unique, and so is their skin. Signs of healthy ageing skin include thinning, sagging, wrinkling and the appearance of age spots, broken blood vessels and areas of dryness. 2 Clinicians need to focus on the assessment and management of the elderly with or at risk for impaired skin integrity. Older Adults, Falls, and Skin Integrity. 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. These macronutrients play a critical role in skin health. 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. People have the right to get care from those they love and trust — people who bring them comfort & joy. 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. 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). It helps maintain optimal core temperature in your body, helps absorb and process vitamin D from the sun, keeps you hydrated by supporting electrolyte balance, among many others. Let’s take a look at a few of the things you might do as a CDPAP aide. https://www.freedomcareny.com/posts/skin-integrity-in-older-adults Sensory information - The skin provides necessary sensory input about any potential dangers in the environment. But be sure to only use sunscreens that are either approved or recommended by their dermatologist to avoid any unwanted skin reactions. Regular shifting will help avoid too much pressure on any one part of the skin. ●       Exposure to pollution and harmful chemicals. Intact skin is the first line of defense against infections, the environment, and trauma. 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. When it comes to skin integrity,there are several things you can do to promote skin health and 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 & … ●       Category 3 pressure ulcer - A deeper wound that might reach the layers beneath the outer skin. contact our caregiving team today online or call us at Skin integrity in the elderly is compromised, and safety concerns are increased with the long-term use of any medication prescribed. What you should specifically do will vary depending on the current skin health of the person you’re caring for. ●       Warm, spongy, or hard skin patches - Watch out for these symptoms, especially if there is no explanation for them. CLINICAL SCENARIO An 86-year-old female patient, Mrs B., returns for a follow-up visit at the wound clinic. Too much sun exposure can also lead to certain types of skin cancer. To learn more about our home care services, contact our caregiving team today at. Even if these products are used, the skin must still be cleaned each time after passing urine or stool. Aging skin repairs itself more slowly than younger skin. (877) 268-3277. 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. 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. Chemical skin irritants - Some people have skin that is sensitive to specific chemicals like certain detergents, soaps, dyes, adhesives, etc. The databases Medline, EMBASE, CINAHL (1990–2012), Scopus, SCI (February 2013) and reference lists were searched. Dry Skin and Itching. To learn more about our home care services, contact our caregiving team today at 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. It receives one third of the body’s blood circulation. Here are a few common skin conditions elderly people experience. We have strict non-discrimination and privacy policies. A skin integrity issue might mean the skin is damaged, vulnerable to injury or unable to heal normally. Identify the different types of skin breakdown. 3. means any injuries to the skin may be slow to heal and regulation of body temperature is not as effective. 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. 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. The goal should be to always avoid pressure ulcers, and in the event they do develop, to identify and treat them immediately. Call us now on 718.989.9768 to learn more about the Consumer Directed Personal Assistance Program (CDPAP). When you don’t properly maintain your skin integrity, it can result in numerous circumstances. 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. 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 … This is true especially as you get older. Some age-related skin changes can be reduced – limit sun exposure, don’t smoke, avoid harsh skin irritants and moisturise regularly. When you don’t properly maintain your skin integrity, it can result in numerous circumstances. Adv Skin Wound Care. If circulation is impaired due to cardiovascular issues or lack of mobility, then skin health might suffer as a result. Here are some things you can do on a regular basis. Eat a balance diet that includes protein. 9. Dry, flaky skin (xerosis) is the most common skin problem among the elderly. Assist with skincare routine - Help your loved one or friend stick to their skincare routine. Cellulitis - Cellulitis is an infection that affects the skin, and the soft tissue connected to the skin. Encourage your relative to stick to healthy food options to promote skin integrity. The first thing you need to do is educate yourself about senior skin care. Inflammatory skin disorders are manifestations—for the most part— of the immune response, which wanes with age. 5. More than 70% of the older population has skin conditions. Dry skin is itchy and this can lead to scratching and skin breakdown. Unfortunately, as we age, our skin health gradually starts to deteriorate due to several reasons, and it becomes less effective in its protective role. Aging skin is more sensitive and susceptible to a lot of skin diseases and conditions. With age, it becomes more important to take care of … Eating a diet full of beneficial vitamins and minerals will not only benefit your skin, but also your overall wellness. In severe cases, the bone infection can affect the cartilage and even impact the function of limbs and joints. Some skin care products, often in the form of a spray or a towelette, create a clear, protective film over the skin. Even if you can’t find anything, ask them and check if there is any discomfort or other symptoms. As people age, skin changes and becomes thinner, drier, and more fragile. find a caregiver near you. The bony areas of the body, such as shoulder blades, hip bones, ankles, etc., are typically at a higher risk of pressure wounds. This is often referred to as the loss of skin integrity. 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 Maintaining skin integrity is a vital aspect of the healthy aging process. Most bedsores heal with treatment, but in some severe cases, there might not be a complete recovery. Apply moisturizers, ointments, and dressings as needed and recommended by the dermatologist. 2017 Jan;30(1):40-46. But unfortunately, those with impaired sensations due to nerve damage often don’t notice the symptoms. However, because epidermal integrity also decreases with age, the prevalence of eczematous inflammatory dermatoses is higher among persons older than 60 years. If they become isolated, it could also affect their mental health. 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. 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 … Imbalanced nutritional state - Nutrition has a direct impact on skin health. To learn more about our home care services, Movement promotes better circulation, which will help maintain skin integrity. Immobility - Patients who suffer from mobility issues, whether due to a disability, obesity, or another underlying condition, are more likely to experience pressure wounds. Many people don’t think of their skin as a protective organ. But some older adults might be at a higher risk of skin damage depending on various risk factors. Let’s take a closer look at skincare tips for seniors. 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. For right now I will put emphasis on the elderly and the immobile. Impaired circulation - Optimal circulation delivers nutrients to the skin that keep it healthy and nourished. We’ve covered some of the contributing factors for poor skin integrity as we age. Describe several ways to prevent skin breakdown. Symptoms may be redness, swelling, and pain. The UV light from sunlight damages elastin, which is the elastic tissue that is responsible for the plump look in youthful skin. Skin hygiene is essential for skin health and important in promoting personal wellbeing. | Aging is associated with structural and functional changes of the skin that result in increased vulnerability. That means you can get CDPAP wherever you are in New York. Luckily, there are steps you can take, such as enjoying a nutritious diet or practicing good hygiene, and risk factors you can monitor to keep your skin feeling healthy. 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. To maintain proper hydration, drink plenty of water, and eat a lot of fruits and vegetables to get minerals like potassium, sodium, and magnesium. Moisture - The skin plays a vital role in maintaining optimal moisture levels within the body to keep you adequately hydrated. 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. Quality of life - Unhealthy skin can become dry and flaky, and it can cause pain and itchiness. 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. 1. If your care patient has had mechanical trauma to their skin, consult with a dermatologist to ensure proper and quick healing. 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. If left untreated, the skin overlying edema can become stretched, increasing the risk of damage. 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. Research has shown that a moist environment promotes better healing when compared to a dry environment. In this article, we will cover the topic of skin integrity when it comes to older adults. 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. What you eat on a regular basis might be one of the single biggest factors to influence your health, and that includes skin health. 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. Skin integrity assessment is an essential part of nursing care and should be conducted on admission and at least daily depending on the individual’s circumstances. Here are a few common skin conditions elderly people experience. For more information, check out our guides on how CDPAP works, and how you can become a caregiver. Pressure ulcers can be caused by skin changes, loss of the fat layer, reduced activity, poor nutrition, and illnesses. Keeping the skin moisturized is important for skin health regardless of age. Do you have a question or do you just want to speak with us? Cancer - If the wound doesn’t heal for a long time, it can develop into a type of cancer known as squamous cell carcinoma. Another one of the biggest contributors to poor skin integrity is sun exposure. 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. Also, try to eat a wide variety of fresh fruits and vegetables to include a range of micronutrients. Previous pressure injuries or skin tears Have a question or concern — or just want to learn more? Ensuring skin integrity in the elderly requires a team approach and includes the individual, caregivers, and clinicians. The twenty-first century clinician has several online, evidence-based tools to assist with optimal treatment plans. 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. Nutritional factors that can help maintain skin integrity: Stay hydrated. Not to mention, skin plays a vital role in one’s appearance, which may impact your self-image and quality of life. Pressure wounds usually form over bony parts of the body, such as: When elastin breaks down, the skin can become saggy, wrinkled, and blotched. Specifically, vitamin K, C, A, and E are great for skin health, along with minerals like zinc, iron, and copper. All office visits are by appointment only. Request PDF | Maintaining Skin Integrity in the Aged: A Systematic Review. Or Enroll Now! It might also be a good idea to schedule a visit with a dermatologist to get a skin health evaluation. 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. Or perhaps you can join exercise classes aimed at older adults at your local senior center. Experienced caregivers offer their best suggestions for maintaining skin integrity and health. Despite positive characteristics, the skin is always susceptible to and at risk of injury and breakdown. 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. Older people are at risk of skin damage, as changes that can occur to skin as it ages can affect its integrity, making it more vulnerable to damage, and to the development of a pressure injury or skin tears 1. Skin is the largest organ covering the entire outside of the body. ●       Category 2 pressure ulcer - A blister or an open wound on the skin. Regular inspection - Frequently inspect your senior relative’s skin for any warning signs of pressure wounds. Encourage and facilitate a healthy diet - We’ve discussed the importance of nutrition when it comes to skin health. A pressure wound (also called a pressure sore, bed sore or pressure ulcer) is an injury to the skin and surrounding tissue. 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. 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. Apply Some Moisturizers. 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. Sepsis - Also in severe and rare cases, a pressure wound might lead to sepsis. ●       Pain or itchiness - There are many conditions that can cause the skin to get painful and itchy, including pressure sores. Older adults with lower skin integrity might be more susceptible to a reaction after exposure to chemicals.. Dermatitis, pruritus, or itching -  If the senior person you’re caring for has a history of itchy skin, dermatitis, or pruritis, they might be at a higher risk of age-related skin issues. Cheung C(1). With aging, there are a variety of factors that can contribute to poor skin integrity. Wound healing may be up to 4 times slower. 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. If the skin becomes injured or broken, it is generally very resilient and has an amazing ability to self-repair and heal. Hyperthermia or hypothermia - Both hypothermia and hypothermia can leave your skin more vulnerable and susceptible to damage. 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.