Chapter 1: Personal hygiene
Rubbing lotion and massaging it into her hands and feet seemed to be one of the few things she enjoyed when she was so sick, and I felt more connected to her knowing I could do this small comforting gesture for her.
Anyone who remains lying or sitting in one position for more than a couple of hours is at risk for skin breakdown. This can lead to pressure sores, also known as pressure ulcers or bedsores. These skin problems can be painful and decrease a person’s quality of life.
If the person who is ill cannot change position in bed or is limited to sitting in a chair, they need to be helped to change position every hour or two. Good skin care, repositioning, and pressure reduction are all necessary to prevent skin problems and to keep small problems from getting worse. Click the tabs below for helpful tips and guidelines.
Look at the person’s skin daily. Tell the healthcare team about any changes you notice, such as red areas. These are the first signs of skin breakdown and will lead to sores if left untreated.
Clean skin daily.
If the person who is ill uses an adult incontinence brief, clean the skin under the brief each time it is changed. Protect skin with a moisture barrier cream. These products often contain zinc or silicone.
Use mild cleansing products and avoid using hot water to clean the skin.
Use moisturizers for dry skin.
Check to make sure clothing and bed linens are clean, dry, and free of wrinkles. Wrinkles increase friction and may lead to skin discomfort or pain.
Relieve any constant pressure on areas at greatest risk for skin breakdown. These include the site of existing pressure sores, the site of previously healed sores, scars, and bony areas.
If the person who is ill is in bed, remind or help them change position every two hours.
If the person who is ill is in a chair or wheelchair, remind or help them change position every hour. If possible, help the person stand briefly, or alternate between sitting and lying. It is best if the person avoids sitting for long periods.
Use pillows between legs, under arms, or elsewhere. This separates bony areas, prevents direct skin-on-skin contact, and may make swollen legs and ankles feel better.
Have the person who is ill avoid lying directly on the side, that is, with the front of the body facing sideways, at right angles to the mattress. A better position is to lie slightly sideways, using supporting pillows to help the front of the body tilt about thirty degrees to the mattress.
Avoid using air rings or other donut-shaped cushioning devices.
Ask your local home care or palliative care program if they have a loan program for pressure-reducing mattresses.
Watch the video for a demonstration and tips on caring for the skin.