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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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