As we get older, our skin gets thinner and drier, so it is easier to damage. The chance of skin damage is higher for people who can't move much, or who spend most of their time in bed or in a wheelchair. The skin can develop rashes and sores, especially pressure injuries. These injuries are caused by constant pressure, which can limit the blood supply to the skin.
Skin also can be damaged by sweat, feces, or urine, making pressure injuries more likely and harder to heal.
You can help protect the skin of the person you're caring for by checking it every day and by being careful when cleaning it.
How do you watch for problems?
Thin skin in older adults
- As people age, their skin becomes thinner.
Rash areas on the upper body
- Rashes can develop in folds of skin on the torso, and in the creases of the armpits, elbows, and groin.
Rash areas on the lower body
- Rashes can develop in the areas around the knees, ankles, and toes.
Rashes in the groin and anal areas
- Rashes can develop in the groin and anal areas.
How can you help prevent pressure injuries?
Relieving and spreading out pressure is the most important part of both preventing and treating pressure injuries. Putting pressure on one spot for long periods of time damages the skin and underlying tissues. Pressure can be relieved and spread in several ways. Often a combination of these is best.
- Change position often.
- In a bed, change position every 2 hours. Learn how to move yourself so that you avoid folding and twisting your skin.
- In a wheelchair or other type of chair, shift your weight every 15 minutes.
- Try not to slide or slump across sheets in a chair or bed. Recliner chairs are likely to allow slipping, so don't sleep in a recliner. Try to keep the head of a bed, a recliner chair, or a reclining wheelchair raised no more than 30 degrees.
- Take good care of your skin.
- Bathe as often as needed to be clean and comfortable. Use gentle soap, and use warm (not hot) water. Be careful not to scrub the skin too hard.
- If you have problems with bowel or bladder control, clean your skin right away if it gets soiled or wet. Use a protective barrier cream, lotion, or ointment to protect your skin from wetness. Use pads or briefs that absorb moisture and pull it away from your skin.
- If you have dry skin, use moisturizing cream or lotion to keep your skin from drying out and cracking.
- Check your skin every day for signs of pressure injuries. Pay special attention to bony areas such as the hips, elbows, knees, and heels. Also watch for pressure from sources such as:
- Body parts or skin folds, especially if you're overweight.
- Chair arms, parts of wheelchairs, braces, or other places where you rest your elbows or other body parts.
- Medical equipment such as oxygen masks or oxygen tubing.
- Make healthy choices.
- Eat healthy foods with enough protein, and get plenty of fluids. That can help damaged skin heal and help new skin grow.
- Stay at a healthy weight. Both weight gain and weight loss can make pressure injuries more likely. Weight changes can also cause problems with support equipment that no longer fits.
- Don't smoke. Smoking dries the skin and reduces blood supply to the skin.
- Talk to your doctor about pressure-relieving cushions and pads.
- Use special support surfaces. There are mattresses, bed covers, and chair cushions designed to help reduce and spread pressure.
- Ask your doctor which cushions and pads might help you. Some products, such as doughnut-type devices, may actually cause pressure injuries or make them worse.
If you or someone you care for is not able to move much, it's important to prevent pressure injuries and to check the skin every day. If you think that a pressure injury is forming, take steps to treat it. Talk to your doctor or nurse about what more you can do.
What can you do to keep skin healthy?
Keeping the person's skin clean and moisturized can help keep their skin healthy.
- Help them bathe as often as needed to be clean and comfortable. When helping someone bathe:
- Use gentle soap.
- Use warm (not hot) water.
- Wash gently with a washcloth.
- Pat the skin dry rather than rubbing. You also can offer the person a terry cloth robe. Terry cloth is a type of fabric often used for towels. It can help gently dry the skin.
- Use moisturizing creams or lotions to keep the skin soft. If the skin is very dry, use a protective barrier cream, lotion, or ointment. These include over-the-counter lotions such as CeraVe. Some lotions are available by prescription.
- Don't put moisturizers in creases and folds, such as those under the breasts and in the groin or on the stomach. These areas are already moist. More moisture can lead to rashes and infections.
- A humidifier may help prevent dry skin. Make sure to clean the humidifier as directed. This can prevent mold, fungus, or bacteria from forming in the machine.
- Good nutrition and plenty of fluids can also help the skin stay healthy and heal if it's damaged. Provide a healthy diet, with lots of protein and fruits and vegetables. Offer the person plenty of water.
- When washing clothing and sheets, use mild detergents. Don't use fabric softeners. And try to have the person wear clothing made with soft fabrics, such as cotton (rather than wool).
Where can you learn more?
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