Skin/Promoting Healthy Skin

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Skin is the largest organ of the body. Skin is the first line of defense a client has to heat, cold, and infection. Age and chronic illness can lead to:

skin becoming thinner and drier – tearing easier and not healing as easily;
the loss of the layer of fat just below the skin, decreasing the ability to stay warm;
sweat glands losing the ability to cool the body;
the loss of the ability to feel pain, heat, or light touch.

Promoting Healthy Skin

There are five ways to help keep skin healthy.

ONE: Keep skin clean.

Keep skin, nails, hair, and beards clean.
Set up a routine bathing schedule.
When bathing, use warm, not hot water and mild soaps. Monitor water temperature to avoid scalding and burns for any client.
Take extra care to make sure skin folds are clean and dry. Skin folds hold bacteria, yeast, dirt, and dead skin cells.
In-between baths, clean the skin as soon as you see or smell something on it.

TWO: Keep skin dry.

Use pads or briefs that absorb urine and keep moisture away from the skin for clients with incontinence. Use a cream or ointment as further protection for the skin. Provide frequent toileting and perineal care, and change incontinence products as soon as they become soiled.
Avoid using “blue pads” or disposable waterproof underpads that can hold moisture on the skin. A waterproof cloth pad that can be laundered and reused is a good alternative.

THREE: Use moisturizing creams and lotions.*

Gently apply lotion to dry skin regularly.

FOUR: Encourage good nutrition.

Diet contributes a great deal to healthy skin. Encourage a client to eat a healthy, well-balanced diet and to drink plenty of fluids (unless on a fluid restriction). See Module 9 on page 173 for more information.

FIVE: Encourage mobility.

Encourage a client to stay as mobile as possible.
Encourage activities or exercise that helps increase circulation.
For clients who are unable to move about on their own, reposition frequently to minimize pressure on any part of the body. You may need to use pillows to decrease pressure.

*Some Tasks are Not Permitted

A Home Care Aide can:

apply non-prescribed ointments, barrier creams, or lotions (e.g. dandruff shampoo or body lotion to prevent drying of skin); and
apply or change a Band-Aid in response to a first-aid situation.

A caregiver can NOT:

change sterile dressings; or
apply a prescribed lotion or ointment used to treat a condition (unless under Nurse Delegation or Self-Directed Care).

See Module 11 on page 227 for more information about Nurse Delegation and Self-Directed Care