It is a fact and does not need any further explanation that the skin of the older people is much more vulnerable to injuries, cuts, and tears. It is, for this reason, it is required to take extra care for the skin of such a patient during home care. It is only a professional home care agency that will ensure the skin is well protected and injuries, infections, and other issues are prevented.
They will make sure that the following processes are followed while taking care of the skin of aging patients.
- Avoid adhesives: Since the skin of the older patients is extremely ‘fragile,’ adhesives should be avoided at all costs on it, especially during dressing. It is for this reason that the home caregiver will use skin sealants to the skin under the tapes. This will reduce the chances of skin damage while removing the tape. In addition to that using adhesive removers is also recommended as that will facilitate tape removal when counter pressure is applied to the skin in the opposition while rolling off the tape slowly. If you have to use this tape on the skin then you should do so as minimally as possible. Silicone, paper, and cloth hypoallergenic tapes are often used because these are gentler on the skin and facilitates removal as compared to other tapes.
- Fingernails: The home caregiver will also assess the length of fingernails as well as the toenails from time to time to determine the need for trimming it or filing it. Long fingernails of the patient, the family member, and even the caregiver may cause damage to the skin of the older adults. Short nails of the patients will also prevent damages from scratching and accidental pinches. Many caregivers even discourage wearing artificial nails. They themselves do not wear it either as these can harbor bacteria and other harmful organisms that can cause infection if it is passed onto open skin.
- Treatment: the home caregiver will also develop the best treatment process for the skin to prevent skin tears. This ideally is their primary focus and that is why they take evidence-based wound care principles when any skin tear develops. It is the same principles that are used while treating for other wounds. Ideally, they should have a carefully designed wound treatment plan to prevent injuries. In addition to that, they should also consider the ways in which they can provide the best nutritional support, facilitate pain management, treat the local wound conditions, and make the optimal dressing selection. In order to provide the best treatment for the skin, they must perform a wound assessment essentially before dressing or dealing with it on an older patient.
In addition to that, the home caregiver should also document all findings regarding the local wound conditions to ensure that the best home care jobs near me are provided to the patients. This documentation should include elements like the location, size, exudate, flap status, and pain of the wound as well as the skin tear category.
Creating a multifactorial care process
In order to create a proper treatment plan that will be easy, most effective and prevent any further injuries to the skin, the home care agency should develop a multifactorial plan very carefully and precisely. The most common and important elements to include in this plan are:
- Cleansing the wound is the first important thing to include in the care plan to remove the surface bacteria or the necrotic debris. This will prepare the wound for the dressing. For cleaning noncytotoxic solutions can be used such as normal saline water or nonionic surfactant cleansers. Safe pressure should be maintained which should be less than 10 to 15 pounds per square inch or PSI. Sometimes, a 35-mL piston syringe and a 19-gauge angio-catheter may also be used. If there is no debris on the wound then it should be cleansed gently at lower pressures which should be less than 8 PSI to protect the granulating tissue using the same cleansers as before. Nowadays, most of the cleansers for skin come in specially designed spray bottles. This ensures that it is delivered with the appropriate force and pressure to clean the wounds. Tepid showers may also be suggested to rinse and cleanse the wound as well. However, wiping or rubbing over the wound is strictly forbidden as that can disrupt the fragile tissues.
- The next important step includes the dressing of the wound so as to cover it up to protect it from further injuries and infection. This also helps in healing the skin tear fast. Ideally, there are several dressing options to choose from but such selection should be based on the needs of the wound care, the products available, the care process followed by the home healthcare agency as well as their clinical expertise. It also depends on the degree of damage caused to the skin from the tear. Ideally, the dressings done on the skin tears must absorb the exudate or drainage from the wound, maintain a moist environment around the wound, stay in the place for several days but not more than seven days and in the end allow for pain-free removal. Typically, moist wound dressing remains the most popular choice as this has a high level of evidence that it effectively supports the use of skin tears and at the same time provides an environment that supports healing with faster growth of the cells and tissues around the wound.
Lastly, the home caregiver should focus on a few specific aspects to choose the right kind of dressing for older patients. Ideally, the dressing should maintain constant moisture balance, protect the wound, suit the local environment, control infection, and most importantly optimize caregiver time.
Therefore, to sum up it can be said that skin tears should be treated in a professional and systematic way so that it does not clot and addresses the characteristics of the wound. The primary focus of the caregiver should be on the closure of the skin tear.
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