Our youth-obsessed culture distorts attitudes to ageing skin
Nurses can help to promote a more positive approach to skincare in older people
Nurses can help to promote a more positive approach to skincare in older people
Age spots, dry and thinning skin, itching, more frequent bruising, skin tags, wrinkles – these are just some of the skin changes that we experience as we age.
Sadly, due to a culture obsessed with youth and beauty, older people may not only find such alterations dispiriting but also the object of ageist attitudes.
Close-up on older skin
- Personally and professionally, avoid perpetuating the myth that older skin is unattractive
- Try to avoid medicalising older people’s skin
- Take every opportunity to advise older people on how to keep their skin healthy, for physical and psychosocial well-being
- Tailor health promotion strategies to meet the needs of older people
- Consider lifestyle when discussing skincare regimes
- Suggest the use of products that are easily available and have empirical evidence to support their use
- Enable people to select products they find acceptable and cost-effective
- Provide written instructions for such products if needed
Reframing the way we think
Unfortunately, there has also been a tendency among nurses and other health professionals to medicalise skincare for older people, seeing it as an issue to be treated or managed rather than part of the natural ageing process. It is time to move away from this one-dimensional approach.
We need to reframe the way we think to meet the contemporary needs of older people.
Not enough attention is paid to maintaining the skin of older people, although keeping skin healthy is essential not just for physical but also psychosocial health and well-being.
If skin integrity is compromised – if it’s damaged, vulnerable to injury or unable to heal normally – as well as being uncomfortable and potentially painful it can cause skin breakdown, which can have significant personal, social and financial consequences.
Concerns about appearance
Older people, particularly women, are often concerned about the appearance of their skin and are well aware that its texture, tone and appearance gives an immediate impression.
Generally, older people are under-represented in most types of media coverage. When they do feature, they are often represented as frail and dependent. Meanwhile, considerable media space is devoted to anti-ageing skincare products. In Western society in particular, vast sums of money are spent on them, and studies have shown that older people feel increasingly compelled to use them. There has been a dramatic rise in cosmetics aimed specifically at mature skin, despite the scant empirical evidence about their effectiveness.
All of these pressures created by our youth-obsessed culture make for a challenging environment for nurses and other health professionals. A 2013 study on nurses' attitudes towards older people found that some had ageist attitudes but many others wished to counter ageist stereotypes.
Conditions such as xerosis (dry skin), fissures (breaks or tears) and pruritus (itching) are common but are often left untreated as they are considered minor complaints.
Benefits of prevention
However, if untreated these conditions can have serious repercussions. Xerosis, for example, can become highly uncomfortable and also increase the risk of other problems such as pruritus (also potentially socially embarrassing), infection, skin tears and pressure ulcers.
Much more attention needs to be paid to preventive care before such conditions become chronic and people become patients.
Preventive measures, through skincare and the use of widely available emollients, can be highly cost-effective, help stop or reduce negative feelings about personal appearance, and greatly reduce physical and mental suffering.
Health and hygiene
We also need far more research into skin problems within the ‘well’ older population. This would enable us to understand skincare needs and the prevalence of early signs of problems, so more effective preventive strategies can be developed.
It’s essential we move away from an emphasis on disease management towards promoting healthy skincare and hygiene so that conditions are prevented in the first place. We all grow older, and with an ageing population attitudes need to change.
It is time to promote a more positive attitude towards older people, and nurses are in a prime position to contribute to the concept of healthy ageing.
Dawne Garrett is RCN professional lead for older people and dementia care
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