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Skin and pressure area care for patients at the end of life
  1. Jane McManus, Deputy Ward Manager
  1. Rugby Ward, St Christopher’s Hospice, London. Email: j.mcmanus{at}


Dying patients are at increased risk of skin breakdown. Skin breakdown in the dying patient may be an inevitable outcome of dysfunction of organs and blood circulation associated with the dying process. This article aims to explain the function and structure of the skin, highlighting factors affecting that structure and function, particularly in relation to the dying patient. Guidelines are offered to assist the healthcare worker to manage skin care for dying patients more effectively, taking into account the inevitability of skin failure that may be a feature of dying. The guidelines, developed by St Christopher’s Hospice, London, are based on clinical research findings and the experience of end-of-life care. They are designed to assist the healthcare worker to assess and cleanse the dying patient’s skin and position the patient to reduce the detrimental effects that may be caused by sustained skin compression. Conflicts of interest: none.

  • Assessment
  • Cleansing
  • Pressure area care
  • Skin care

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