Skin Care Basics for Caregivers

One of the caregiver’s most important responsibilities is keeping the patient’s skin intact and healthy. For patients who are ill or elderly, proper skin care is essential to prevent serious complications.

The skin is the largest organ of the human body. Let’s look at what it does:

1. It is the physical barrier that protects the rest of the body.

2. It is normally dry, salty, and acidic, which keeps bacteria from growing.

3. It is flexible, moving with the body. Oil glands help keep it lubricated.

As long as the skin is intact and moisturized, it prevents micro-organisms from entering, as well as protects against toxins and chemicals that might be absorbed.

As people age, the skin becomes thin and dry. Small cracks and tears can easily occur, allowing bacteria and other contaminants to invade. Lack of mobility can also cause the skin to break down, leading to pressure sores. Every caregiver must be diligent in helping to maintain skin integrity. Start by keeping your nails short and trimmed, to avoid accidental scratches. Don’t wear jewelry, rings, or watches that might injure the patient’s skin.

Each encounter with the patient is an opportunity to evaluate the skin’s condition:

• Baths are the best time to observe the skin. Check for areas of redness, blisters, small cuts, or dry patches. Be sure to note and report anything new or unusual.

• If the patient is incontinent, excellent perineal care must be given with each episode. The entire area is cleaned, front to back, including all skin folds and the inside of the thighs. Dry the skin well before applying any barrier creams.

• Patients who have difficulty moving, are bed-bound, or spend long periods in a wheelchair, should be repositioned at least every two hours. During the position change, check the lower back, tailbone, and buttocks for red areas. If present, reposition and check the area in 15 minutes. If it has not disappeared, notify the supervisor or provider. Never massage a reddened area.

• Always keep skin dry by using disposable bed pads. If the patient uses disposable underwear, monitor for leakage or incontinence. Patients who perspire will need clothing changes.

• Watch for signs of scratching, which can indicate dry skin. More common in the winter than summer, dry skin often occurs on the hands, arms, shins, and abdomen.

• After bathing or cleaning, dry the skin before applying moisturizer. Adjust the moisturizer to the weather: heavier creams in winter, lighter lotions in summer. Do not apply lotion between the toes; it can promote fungal growth.

• Nutrition and hydration are important for healthy skin. A balanced diet, including high-quality protein, is required to repair and maintain skin. Many ill or elderly patients do not experience thirst, so encourage fluid intake throughout the day.

As you become familiar with your patient, checking skin condition becomes a natural part of the day. You’ll notice changes and be able to act quickly to prevent unnecessary infections or discomfort.