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									        Skin care




      Avoiding the rays
      Summer adds a layer of complexity to skin care. To be safe, caregivers should
      adhere to the basics: hydration, sunscreen and staying in during peak sun hours

      By Julie E. Williamson
      Properly caring for residents’ skin
      is a year-round requirement, but
      for many providers it becomes
      an especially tough challenge in
      summer months. The blazing sun
      and high temperatures can pose
      an even greater threat than usual
      to fragile, aging skin.
         Just a few moments in direct
      sunlight can lead to a host of
      problems: sunburn, discomfort
      and the potential for subsequent
      skin breakdown. Higher tempera-
      tures (coupled with either exces-
      sive humidity or the dryness of arid
      climates) also can wreak havoc on
      skin integrity, experts warn.
         “Aging skin is thinner, sensi-
      tive and more prone to damage,
      so good skin care is always impor-
      tant,” notes Eric Goldman, M.D.,
      a Matrix Medical Network physi-
      cian who works at Sarah Neuman




                                                                                                                                                                Photo: iStockphoto
      Center for Healthcare and Reha-
      bilitation in Mamaroneck, NY.
      “But as more people venture out-
      doors to enjoy the better weather,
      there are [additional] factors that       “Skin care should be individu-    Nursing home residents should be able to spend time outside during the warm
      need to be considered.”                alized, based on the resident’s      summer months. But they need protection to avoid skin breakdown.
         Fortunately, keeping residents’     medical history (taking into con-
      skin healthy and intact doesn’t        sideration medication use, skin      and nutritional status, including      to the subscore of moisture on the
      require a tremendous amount of         cancer history other dermato-        conditions such as dehydration.        Braden Scale, says Cindy Sylvia,
      effort. With proper assessments,       logic conditions, such as eczema        A lthough ski lled nursing          MSC, MA, RN, CWOCN, edu-
      the right treatments and a healthy     or psoriasis),” says Sharon Brang-   residents might be less likely to      cational development program
      dose of staff education, provid-       man, M.D., president-elect of the    regularly venture outdoors, their      manager for Gaymar Industries.
      ers can feel secure when their         American Geriatrics Society in       caregivers cannot afford to become        It’s important to note that
      residents head outdoors to take        New York.                            lax when it comes to summertime        humidity—when coupled with
      in some fresh summer air.                                                   skin care regimens.                    high temperatures—can increase
         Experts generally agree that        Never ease up                           “In our setting, we are very pro-   perspiration and raise the risk of
      many of the basic rules followed       Preventive skin and risk assess-     active,” notes Darien Tully, RN,       problems such as fungal infection
      in cooler weather months will          ment protocols also should be        charge nurse at Lima Estates, an       and skin degradation.
      still apply.                           followed faithfully, using tools     ACTS retirement community in              “We need to do our best to
         Among the most important?           such as the Braden Scale or Nor-     Media, PA. “Every resident gets a      keep skin dry and be on alert for
      Keep skin care tailored to each        ton Scale. Risk assessments should   [thorough, full-body skin assess-      moisture-induced infections,”
      resident, as opposed to following      take into consideration mobility,    ment] once a week.”                    Goldman reasons, adding that
      a one-size-fits-all formula.           incontinence, sensory deficiency,       Clinical practice should relate     moisture is commonly trapped in

      40 www.mcknights.com • July 2009




LTC Feature.indd 40                                                                                                                               6/25/09 12:54:20 PM
      skin folds of the abdomen, breasts     exposure time and rate of perspi-              should be applied year-round                 prefers a sunscreen with at least
      and groin areas of the body.           ration. Family members, who are                when res
								
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