Taking care of the skin is central to the health, comfort and wellbeing of people with Alzheimer's. By the late stage of the disease they are totally reliant on your attention. I want to give you some nursing care tips about basic skin hygiene and how diet, bed care, toileting routines and movement can all help improve the quality of their lives, and by implication, yours too.
Basic Skin Carygiene Routines
Skin care routines will be dictated to an extent by individual circumstances. These include;
- Their overall health.
- Co-existing diseases, for example heart, liver, respiratory, kidney disease.
- Skin conditions such as eczema, psoriasis.
- Urinary and/or fecal incontinence.
- Environmental conditions such as heat and cold.
The bed-bound or people with severely restricted movement should be washed twice a day. Wash the whole body and face in the morning. In the evening (before sleep) wash hands and face, underarms and groin area. If it is very hot wash their back too. More frequent washing is required if the person with Alzheimer's is incontinent.
Diet and Nutrition Affects Skin Health
Keeping skin as healthy as possible involves providing a balanced diet with sufficient calories, dietary fiber, vitamins and fluids. This can be difficult because of poor appetite and feeding problems such as swallowing difficulties. Weight loss is common, as is fragile skin that will be prone to damage. You may need to liquefy food and/or give them food supplement drinks. You may also need to consult a dietician for ideas on an appropriate diet. If food and fluid intake becomes too limited then you will need to discuss tube feeding with their doctor.
Comfort Feeding Provides Great Alternative to Feeding Tube
Feeding Tube and People with Dementia
Skin Care and Incontinence in Severe Late Stage Alzheimer's
Loss of continence, urinary and fecal, becomes an inevitable part of severe, late stage Alzheimer's. You will have to purchase appropriate materials and equipment such as mattress protectors, flannel coated rubber pads, nappies and baby wipes. You may need to consider catheterization at some point. A qualified health worker or doctor will advise you on the appropriate time when this may be required and what the side effects may be.
Caregiving Skills for Fecal Incontinence
Avoiding Pressure Ulcers/Sores in Late Stage Alzheimer's
Skin care and frequent changes of position will help prevent pressure ulcers.
Pressure ulcers occur when you stay in one position too long. The blood supply to the area becomes depleted and the skin eventually breaks down especially if the skin is unclean and nutrition is poor. The areas particularly at risk are the elbows, heels, ankles, buttocks, shoulders, and the back of the head. A doctor should be consulted if the skin breaks down.
More on Physical Care in Late Stage Alzheimer's Disease