Chapter 17: Care of Aging Skin and Mucous Membranes

Physiologic changes, such as the thinning of the epidermis, decreased subcutaneous fat, and reduced sebaceous secretions, contribute significantly to common issues like chronic dry skin (xerostomia), bruising from fragile capillaries, and a higher risk of traumatic injuries, including skin tears and pressure injuries. Comprehensive assessment protocols involve systematic head-to-toe inspection, monitoring for color variations (e.g., erythema, pallor), and evaluating contributing risk factors like immobility, malnutrition, and moisture using formal assessment tools such as the Braden or Norton scales. Interventions focus heavily on prevention, requiring meticulous moisture management for incontinent patients, frequent repositioning (ideally using the 30-degree lateral position to minimize shearing forces), the application of appropriate emollients and barrier ointments, and ensuring adequate caloric and fluid intake to support tissue repair. The chapter also addresses age-related alterations in hair and nails, emphasizing the need for specialized foot care, particularly for those with impaired peripheral circulation or diabetes, to prevent severe infections. Furthermore, oral health is examined as a critical indicator of overall wellness, detailing challenges like periodontal disease, dental caries, dry mouth (xerostomia), and the detection of potentially precancerous lesions such as leukoplakia. Nurses must facilitate consistent and thorough oral hygiene, including the proper cleaning of dentures, to maintain comfort, enhance appetite, and reduce the risk of systemic complications, such as aspiration pneumonia.