Skin Care

Skin care is very important as more time is spent in bed lying or sitting in one position quickly leads to breakdown of the skin.

This can cause discomfort and pain.

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Stages of skin breakdown

Stage 1: Persistent redness
Stage 2: Loss of outer skin, wound is red, ulcerated
Stage 3: Full thickness loss of skin, deep ulcer
Stage 4: Deep ulcer with visible muscle and even bone

 

Special type of ulcer at the very end of life is a 'Kennedy' ulcer or 'terminal ulcer'. Starts off as looking like a bruise near or on the tailbone and quickly (within hours) becomes an ulcer

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What you can do

  • Try and inspect high risk areas: tail bone, hips, and heels
  • If possible, try and reposition (even a little bit) every 2 hours
  • Do not delay or avoid repositioning because of pain with movement
  • If complaining of pain, use available pain medications provided in comfort pack
  • Use pillows, wedges to help
  • Keep skin dry. If uses diapers/depends, make sure changed quickly
  • Ask Hospice Team every time they visit to inspect for skin issues
  • Make sure hospice provides necessary creams, dressings, and other skin care products

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What the Hospice will do

  • It is the responsibility of the Hospice Team to monitor for any skin issues
  • The Hospice Team should be inspecting for skin breakdown on every visit
  • The Hospice Team should and can provide any supplies needed for skin care related to inability to change ones position in a bed, chair, or wheelchair

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