Important Considerations in the Older Adult

Presented by: Mary E. Barna DPM, PA-C

Important Considerations in the Older Adult

Now to

Early Intervention

of

Pressure Ulcers

Core Principles

Changes In The Skin That Occur With Normal Aging

• Structural changes – Skin dryness, roughness, wrinkling, and laxity increase; skin elasticity decreases.

• Functional Changes - Skin barrier function, mechanical protection, sensory perception, wound healing, immunologic responsiveness, thermoregulation, and vitamin D production decline.

Changes in Wound Care with Increased Age

Skin Diseases That Cause Itchiness in Older Adults

Cutaneous Disease Examples Treatments

Inflammatory *Contact Dermatitis *Discontinue Psoriasis Causative agent *Topical steroids

Neurodermatitis *Lichen simplex *Many Treatments,chronicus including addressing

underlying psychologicalfactors

Papulonodular *Lichen planus *Topical steroids*Other treatments

Vesiculobullous *Bullous pemphigoid *Topical steroids*Other treatments

Skin Diseases That Cause Itchiness in Older Adults (Continued)

Cutaneous Disease Examples Treatments

Infection/Infestation *Candida *Topical therapies may *Folliculitis be adequate

*Scabies

Drug reactions *Discontinue causative agent

Urticaria *Discontinue causative agent

Other *Diabetic *Treat underlyingdermopathy condition

Changes that contribute to Xerosis in Older Adults

Epidermal *Stratum corneum intercellular lipids

*Slower turnover of cells

*Natural moisturizing factor in stratum corneum cells

Changes that contribute to Xerosis in Older Adults

Dermal *Number and function of sebaceous glands

*Number and function of sweat glands

*Number of blood

vessels

*Water movement from dermis to epidermis

Keys for Treating Dry Skin in the Older Adult

• Humidifier with relative humidity setting of 45% - 60%

• Room temperature should be as low as is comfortable

• Bathe with warm (not hot) water for 10 minutes daily

• No bath oils (risk of slipping in the tub)• Avoid harsh soaps and drying agents (such

as powders)• Use moisturizers twice a day (once after the

bath while the skin is still damp and again before bed.