1. Important Considerations in the Older Adult Presented by: Mary E. Barna DPM, PA-C

2. Important Considerations in the Older Adult Now to Early Intervention of Pressure Ulcers

3. Core Principles

4. Changes In The Skin That Occur With Normal Aging Structural changes – Skin dryness, roughness, wrinkling, and laxity increase; skin elasticity decreases. Functional Changes - Skin barrier function, mechanical protection, sensory perception, wound healing, immunologic responsiveness, thermoregulation, and vitamin D production decline.

5. Changes in Wound Care with Increased Age

6. Skin Diseases That Cause Itchiness in Older Adults Cutaneous Disease Examples Treatments Inflammatory *Contact Dermatitis*Discontinue Psoriasis Causative agent *Topical steroids Neurodermatitis*Lichen simplex*Many Treatments, chronicusincluding addressing underlying psychological factors Papulonodular*Lichen planus*Topical steroids *Other treatments Vesiculobullous*Bullous pemphigoid*Topical steroids *Other treatments

7. Skin Diseases That Cause Itchiness in Older Adults (Continued) Cutaneous Disease Examples Treatments Infection/Infestation *Candida*Topical therapies may *Folliculitis be adequate *Scabies Drug reactions *Discontinue causative agent Urticaria*Discontinue causative agent Other*Diabetic*Treat underlying dermopathycondition

8. Changes that contribute to Xerosis in Older Adults Epidermal*Stratum corneum intercellular lipids *Slower turnover of cells *Natural moisturizing factor in stratum corneum cells

9. Changes that contribute to Xerosis in Older Adults Dermal*Number and function of sebaceous glands *Number and function of sweat glands *Number of blood vessels *Water movement from dermis to epidermis

10. Keys for Treating Dry Skin in the Older Adult Humidifier with relative humidity setting of 45% - 60% Room temperature should be as low as is comfortable Bathe with warm (not hot) water for 10 minutes daily No bath oils (risk of slipping in the tub) Avoid harsh soaps and drying agents (such as powders) Use moisturizers twice a day (once after the bath while the skin is still damp and again before bed.