We should screen all patients over 65 years of age for pressure injury and skin tear risk as soon as possible after admission to hospital (within 8 hours) and following any change in health status.
Older people are at risk of skin damage, as changes that can occur to skin as it ages can affect its integrity, making it more vulnerable to damage, and to the development of a pressure injury or skin tears1. In addition, older people in hospital are likely to spend more than 23 hours per day either in bed or sitting2.
As skin ages it:
- becomes thinner and less elastic
- loses moisture and can become dry and more vulnerable to splitting and cracking
- develops folds and wrinkles
- loses its cushioning layer of subcutaneous fat
- has decreased sensory perception and is less likely to be able to detect temperature changes or pain
- has decreased temperature control and therefore an older person is less able to regulate their body temperature
- is more easily injured (prone to tearing and bruising)
- is slower to heal3,4,5.
1. Best Practice Statement, Care of the Older Person's Skin, 2012, Wounds UK: London.
2. Brown, C.J., et al., The underrecognized epidemic of low mobility during hospitalization of older adults. J Am Geriatr Soc, 2009. 57(9): p. 1660-5.
3. MacNeal, R., Effects of aging on the skin, in The Merck manual home health handbook for patients and caregivers, R. Porter, Editor 2006.
4. Carville, K., Wound care manual. 5th edition ed2005, Osborne Park: Silver Chain Foundation.
5. Edwards, H., et al., Champions for Skin Integrity: CSI Guide and Resource Pack, 2013, Brisbane University of Technology.