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Skin tears - elderly people with damage to fragile skin
Posted: Thu Jul 10, 2008 7:20 am
My fathers skin tears very easily, and he gets large open raw sore areas, which I have to attempt to heal. I have tried putting gel on them as advised by my chemist, then covering them with so-called "non-stick" dressings, which actually do stick, meaning that to remove them I have to bathe them before they will come off.
I have searched google but can find no really useful information on how to care for these wounds properly. I originally tries getting dad to use a gentle moisturiser to keep his skin mor supple, but he is intensely suspicious of substances and not one for using such things as even bathing is an issue.
Has anyone got any hints? (Incidentally, his skin tears even from his legs moving about in bed sometimes.)[/i]
Not sure how this will
Posted: Thu Jul 10, 2008 2:06 pm
Not sure how this will translate in Oz, but I`ll give it a try.
I use "Epaderm Emollient" on the legs at night. This washes off like soap in the morning and has left the skin moisturised. "Aqueous Cream" which is a lighter moistureiser during the day and for any bits which have broken out "Enhanced healing dressings" from Superdrug work a treat. They are like melolin but can be left on for longer and are waterproof. "Tegaderm" is like surgical cling film and it is fine for covering openings and for anything deeper that that "Allevyn" dressings under the tegaderm of "Allevyn" adhesive dressings although I found them to peel the skin they are attached to. For deep wounds "Intrasite gel" is wonderful, covered by allevyn and tegaderm.
All these should be available from your doctor although some can be purchases online. As these are all medical things and not "Women`s smelly moisture stuff".(to quote the menfolk I look after) they should be acceptable to your dad.
Best of luck
Fragile elderly skin
Posted: Tue Jul 15, 2008 10:28 pm
All Meg's tips are good, but you could try asking his GP to review his medication - my husband had awful sores, bruises and flaky patches, all much better since the Salbutemol inhaler was replaced. I think steroids can be a problem. Good luck with this as getting meds right can be a long process - don't know what your Dad's condition is, but in our case (COPD) the physiotherapist is much more 'holistic' than the GP and prepare to discuss things like skin condition in depth.
Thank you for your replies!
Posted: Tue Jul 15, 2008 10:47 pm
Thank you for your replies! Dad is 95, and has always neglected his skin,never bathed much even before he got old. He outright refuses to apply any sort of cream to his skin, he says it wouldn't work and is suspicious of all medications although he religiously takes those prescribed by his doctors. Anything else he suspects of causing all sorts of side effects.
His skin is paper thin and this is manily due to age, although if he had taken better care of it, it wouldn't be so bad.
I have found some dressings(all expensive of course)that are designed to draw out infection and promote healing, and you can leave them on for a week. So I'm giving them a try. I have no medical assistance inthis whatsoever, Dads GP only calls once a month and then can't get out the door fast enough.
Posted: Thu Jul 17, 2008 8:29 am
Do you have health visitors / district nurses in Australia? They are visiting us twice a week to change dressings on my husband's pressure sore. Won't help if you don't, but just a thought. Lack of interest in personal hygiene, skincare etc seems quite normal - my dad (died at 89) would only ever have a bath once a week, and even then he complained that this was a waste as when he was a boy one lot of bathwater did for himself and his three brothers...
I could have help, we
Posted: Sun Jul 27, 2008 9:08 am
I could have help, we have the Blue Nurses here who could come and change his dressings, but he refuses to have them.They only charge $5AUD per visit - virtually a donation only - but he won't have it!! He would prefer to let me suffer. He doesn't worry about it, he's happy to moulder away in be all day, but I am responsible and very scared of not doing the right thing.
Believe me I do understand
Posted: Sun Jul 27, 2008 11:13 am
Believe me I do understand and recognise the problem - it's maybe easier with my husband as I can persuade him that he's undergoing the washing, denture cleaning etc for my benefit. Left to himself he wouldn't bother even if he had the strength. I too hate the idea that anybody might be judging the standard of care I give by his cleanliness or lack of it -worse, he doesn't eat, and is undoubtedly malnourished no matter how hard I try. Re. visiting nurses - my husband is always very willing and even charming with them and will submit to all sorts of things - could you get them across the threshold despite what your dad says and see what his reaction is?
Well, I did initially get
Posted: Sun Jul 27, 2008 12:13 pm
Well, I did initially get one of the Blue Nursing staff to come and speak to dad about his general health and needs, but dad just said he was fine, could feed and toilet himself, his daughter was there, and being dad, got talking about totally unrelated topics so that the whole visit was unproductive. The nurse said there was nothing they could do for him and she couldn't see any reason for them to call again. She was not able to really discuss the issues she wanted to discuss so what was the point. He always says he doesn't want strangers coming in.
I asked him if we could show the worst wound to his doctor, who comes once a month, but it would mean I would have to remove the dressing, and leave it uncovered until the doctor arrived, which could be any time from 11am to 3pm. With the wound uncovered dad would nt be able to get into bed, as I couldn't have anything touching it.It would be very awkward. Dressings stick to the wound and I have to bathe them off, so it would have to be removed beforehand in preparation. So probably the doctor won't get to see it.
I just feel dad is so completely unco-operative and I am trying to sort things out without any real idea of what I'm doing or if I'm making things worse.
If I were you I
Posted: Sun Jul 27, 2008 4:27 pm
If I were you I would show the GP and if he has to wait until the wound is ready for his inspection then, so be it. At least he would see for himself what you are up against and will probably know the best dressings for your dad to have, and prescribe them for him. We have special nurses here (usually attached to the hospitals) called "Tissue viability nurses". If you have something similar in OZ then they would be the best people to see your dads wounds.
Meg - I have once
Posted: Mon Aug 04, 2008 8:30 am
Meg - I have once been to Thurso would you believe, a long time ago, I thought it was lovely if a bit cool(I live in Australia).
I showed his wounds to the doctor who in his usual fashion was completely disintrested and said just keep it clean and replace the dressings.
I seem to have it under control lately, found some good dressings to put on it and realy that's the best I can do. He damages his skin in his sleep, I think his legs get violent.Tried puting a pillow between them but he found it uncomfortable.
It's a hard fact of life here that there are not enough doctors to go around and many of them are apathetic; any other assistance is nearly non-existent. I have mentioned to my local Carers Association that instead of all the "self empowering" group meetings they have, it would be nice if they provided someone with geriatric care assistance who you could ring and talk to if you had a problem.