Chapter 1: Personal hygiene
Skin care
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.
As a person’s illness progresses, their risk for skin breakdown can increase. Remaining in the same position for long periods of time can lead to pressure sores, also known as pressure ulcers or bedsores. These skin problems can be painful, can lead to infection, and decrease a person’s quality of life.
How often a person needs to change position will depend on the person’s pressure injury risk, their mattress, and their comfort. Talk with the person who is ill and their healthcare provider about how often the person should change position.
If the person who is ill cannot change position in bed or is limited to sitting in a chair, they will need help to change position. 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 can lead to sores if left untreated.
Clean skin daily.
If the person who is ill uses an adult incontinence brief, clean and check 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.
Ask your local home care or palliative care program if they have pressure-reducing specialty mattresses to lend.
Gently remind or help the person to change position throughout the day. If they sit in a chair, help them to stand briefly or alternate between sitting and lying down.
Ensure the person avoids lying directly on their side; this position puts pressure on the bony prominences (hip bones, heels, shoulders, elbows). A better position is for the person to lean slightly back or forward using pillows for support.
Use pillows between legs, under arms, or elsewhere. Pillows can separate bony areas and prevent direct skin-on-skin contact, and they may make swollen legs and ankles feel better.
Avoid using air rings or other donut-shaped cushioning devices.
Use care when moving the person in bed. A
slider or slide sheet
These help people with movement and transfers and are designed to reduce handling injuries and skin abrasions. These products are very slippery and should be used only after instruction from a healthcare provider.
, or a
turning sheet
Turning sheets are small sheets that run from the person’s head to buttocks. Any sheet can be made into a turning sheet by folding it in half and laying it over a full sheet. The small sheet or pad allows two people to grab the corners to lift or move the person on the bed.
helps to prevent skin shearing (skin tearing). You can check with the person’s home care coordinator or healthcare provider for information on where to purchase a slide sheet or for alternative suggestions.
Watch the video for a demonstration and tips on caring for the skin.
