By Paula Erwin-Toth MSN, RN, CWOCN, CNS

Winter weather is upon us and that brings a whole host of challenges. Our skin is more liable to experiencedryness, cracking and breakdown. Everyone, especially older adults, are more vulnerable to falls due to slippery steps and walkways. Shoveling heavy, wet snow has been associated with increased risk of heart attacks. Just heading to the mailbox, grocery store or the doctor's office can spell disaster. All of these situations can combine for a 'perfect storm' for risk of skin breakdown at home and all healthcare settings.

So what can we do to help our patients avoid the potentially hazardous impact of the winter months? First, review safety precautions with your patients and their families. Do not forget to review them with your own family - or review them yourself, for that matter.

Central heat results in dry air; use of steam humidifiers can be healthful, but caution must be exercised to avoid leaving a pot unattended and causing a fire. Many people use space heaters to provide extra (or even basic) heat. Make sure they are being used safely. Injuries and fires due to improper use of these devices are both tragic and preventable. Setting timers to remind users to turn off the stove or heater is a great way to remind people to shut off devices. Keeping pets, children, clothing and drapes away from heaters can save lives.

How do you keep your skin moist? The best way to get the most benefit from a moisturizer is to apply while your skin is still damp. It usually is not necessary to take a bath or shower every day, especially older adults. As one older lady cleverly put it, as long as you clean the 'pits and bits' you are good to go. Provide your older patients with bathing tips, especially during the cold, dry months, to help them preserve their already vulnerable skin. Commercially available bathing cloths are a great way to cleanse and stay moisturized between baths or showers. When bathing or showering, avoid using hot water and drying soaps and select products that retain moisture. Always be sure to use a non-slip bath mat to avoid falls.

People tend to be more sedentary during the winter months. This can be especially problematic for people with venous insufficiency. Therapeutic compression, elevation of the legs above the level of the heart and moderate exercise are usually key components in preventing venous ulcers. These actions may fall by the wayside once winter hibernation sets in. Suggest mall walking to your at-risk patients - it is a great way to get out, walk and socialize.

All of us may be tempted to eat more and less healthful food during the dark winter months. Cravings for 'comfort foods' are not unusual when the days shorten and the temperature plummets. This can be especially problematic for people living with diabetes mellitus. There are great recipes for people with diabetes that are healthy and will still warm the tummy. Encourage diabetics to try modified versions of their old favorites.

Winter can be a time of joyous celebration - just make sure it is safe for one and all. Talk to your patients about ways of keeping safe and healthy these dry, cold, potentially slippery and more sedentary months ahead of us!

About The Author
Paula Erwin-Toth has over 30 years of experience in wound, ostomy and continence care. She is a well-known author, lecturer and patient advocate who is dedicated to improving the care of people with wounds, ostomies and incontinence in the US and abroad.