rosie_callaghan

January 28, 2018 | Author: Anonymous | Category: Science, Health Science, Immunology
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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 [email protected] 07717543046

skin

layers

Thermoregulation

Excretory Function

sensation metabolism

Protection

Non-verbal communication

Changes in ageing skin Pigmentation

Texture

Thickness

Ageing

Turgor

Moisture

Reduced number of sweat glands Lac of tensile strength in healed wounds

Reduction in the number of langerhans cells

Poor nutrition and hydration

Poorer absorption through the skin

Presence of Chronic conditions

Reduced vitamin D synthesis's

Use of multiple medication

Poor oxygenation

Impaired function of respiratory and immune systems

Reduction in ability to detect pressure

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

Reduced vascularisation

Prone to oedema around wounds

Bruise easier

Decreased sensation

Not notice discomfort from Remaining in one position

Bony areas have less subcutaneous cushioning

Higher incidence of ischemia

Thinner skin

Reduced sebum production

Less effective barrier

Fewer langerhans cells

Dry, itchy skin

Fewer mast cells

infection

Puritis, dermatitis, venous leg ulcer

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

Extrinsic Factors • • • • • •

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

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

references • • •

• • •

• •

Benbow M (2009) skin tears British journal of Community Nursing 23 (1) 1418 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

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

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