Skin Care

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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