The old lady is lying in bed with a diaper and nylon pantyhose. She scratches herself, the itching is unbearable. The 85-year-old can hardly move anymore. And she is not an isolated case. The situation in nursing homes is often difficult for patients and caregivers alike. “There is hardly any time for proper skin care, physical touch or conversation,” says Dr. Wolfgang Lensing from Hanover. Attention that old people and their skin lack.
The skin in old age is different
“Itching is often the most agonizing problem for people in nursing homes,” explains the experienced dermatologist. The skin of older people differs significantly from young skin. The moisture and fat content decreases, the skin dries out and begins to itch. Artificial fiber clothing and washing with liquid soaps further stress the skin. It becomes increasingly susceptible to infections. Dr. Lensing: “Bacteria or scabies mites can hardly penetrate healthy, well-oiled skin, but they have an easy time with aging skin.”
What are the problems that occur?
As we age, skin layers become thinner and more sensitive. Taking medications such as heart medication or sedatives promote excessive sweating or itching. As a result of lack of exercise, eczema forms in body folds, thromboses or even open sores, so-called ulcers, on the legs. Pressure sores (decubiti) are also a common problem in elderly patients who can no longer turn and twist themselves, or in whom the nerves no longer transmit information from the skin, so that those affected do not realize that they should turn. “The elderly pose the greatest medical challenge; they require the most comprehensive medical care and should not be relegated to minimal care,” Dr. Lensing said. Why does a patient stop turning and lie sore? First, underlying internal diseases must be clarified. Nursing errors are not always the cause of ulcers. Reasons can also be, for example, a dementia syndrome, iron deficiency anemia or kidney failure, such as when patients do not drink enough. Often, only a blood test reveals the true reason.
What should family members do?
“As soon as changes are seen on the skin, relatives should call in a specialist,” advises Dr. Lensing. Some homes already have a trusted dermatologist for all nursing home residents. A good regulation, since house calls are paid quasi hardly more. Therefore one should inquire first with the care personnel whether a dermatologist is responsible for the home. The medical association also provides information on which dermatologist in the vicinity makes house calls in nursing homes. Often, however, the rubbing and scratching of the skin is also a reaction of the person to the impending “loss of self” due to lack of physical contact and social references. The tip from the dermatologist: Don’t give away skin care products at Christmas! “Care is not shower gel and perfume, but conversation and loving touch.”
Allergies – also among nursing staff – on the rise
For caregivers, too, the many different care products they have to come into contact with in the course of a day – thanks to well-intentioned gifts – mean a burden. Allergies among caregivers are increasing significantly as a result and can force them to quit their jobs.
