Skin, Nails and Hair
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Skin
Skin can be very delicate and needs to be treated gently otherwise it can tear. When drying skin use an absorbent towel (not a threadbare one) and dab rather than rub.
Moisturising forms of handwash and shower gel are useful. If applying moisturising cream avoid applying it between the toes, unless advised otherwise by a health professional, as it will stay damp and could lead to fungal infection.
How to help with washing
When cleaning between toes, a folded sheet of disposable paper kitchen towel can be used like floss - held taught between your hands and working it in from between the tips of the toes whilst gently moving it up and down. Use a new sheet to dry.
When a person needs help washing it can be embarrassing for them, so try to let them do as much of it as they can, with prompting where necessary (this also helps keep up their skills). Whilst they're distracted washing their top half you could do their bottom half where they can't reach.
Pressure sores
Pressure sores can be extremely painful, and whilst there may be a visible redness, they can be painful without anything at all to see (and don't let anyone tell you otherwise). They arise when the blood circulation to the area is reduced, usually as a result of lack of movement so that the person's own weight presses on the same area for a prolonged period.
We naturally adjust our position periodically to avoid the problem, but with age the need to move may not be felt as greatly or reduced mobility may prevent this. The situation is made much worse if the skin is wet, for example through incontinence, which also reduces the strength of the skin and makes it more likely to tear. Dehydration through not drinking enough, and poor nutrition, also make things worse. Sores can potentially develop into ulcers, with broken skin and damaged tissue underneath. See our advice on how to prevent pressure sores.
Diabetics
Diabetic people have less feeling in their skin and may not be aware of a skin problem starting, particularly in their feet and extremities. Added to this, people with dementia may find it difficult to express where something feels wrong. It's important to check their skin periodically for signs of any problems, so these don't develop into something more serious.
Nails
Older people's fingernails and toenails can become brittle and break up rather than cut cleanly. They may also be nervous about having someone cut their nails, disliking the feeling of clippers flattening the nail or fearing their skin might be cut too. There's an excellent solution to both these problems at once, and that is to soak the nails in water before cutting them - see below.
Soaking nails before cutting
Soaking in water prevents the nails being brittle, and also softens them so that the clippers can flatten them more easily and without the skin underneath feeling pulled. There's also an element of feeling pampered and relaxed - the difference it makes to someone who's nervous is quite unbelievable.
Just a couple of minutes in water is enough. The temperature of the water doesn't affect how it works, but should be just so it's comfortable - so it feels slightly warm but not hot and not cold. Dry the fingers before cutting the nails, so they aren't slippery.
Nail softener cream
There are also toenail softener creams available (including one from our favourite supplier of wide slippers, the Cosyfeet website), although we haven't found them necessary. Always read the small print with any application for toe nails - for example some fungal treatments may not be suitable for people with some medical conditions.
Clippers and scissors and how to cut nails
We suggest using nail clippers for fingernails and for toenails except the big toe, for which we suggest straight, not curved, nail scissors. Clippers and scissors shouldn't be shared between people (at least without thoroughly disinfecting), as this could spread fungal infections.
When cutting nails, don't round off the cut so much in the corners that the nail risks growing into the skin, but equally don't leave a large protrusion that could catch on something.
Visiting podiatrists
For toenails, see our note on podiatrists (or chiropodists to use an older term) - including ones that visit you in your own home.
Do make sure that someone is cutting both toenails and fingernails, otherwise these can slip through the net.
Hair
A modern 'tangle free' / 'detangler' hairbrush is useful, with a rounded blob on the end of each bristle to prevent damage to the scalp.
Don't share hairbrushes, combs or hats between people as this can spread scalp infections.
For haircuts, if your loved one becomes anxious about scissors near their head (which is understandable if they've forgotten that it's routine and normal), or is surprised by their hair being wetted, then make sure you or the hairdresser explains what it is they're going to do and why, before each stage. If they're nervous about being cut then reassure them that the hairdresser's hand is between the scissors and their head, so the scissors won't touch their head.
Mobile hairdressers
If travelling out to a hairdresser is difficult, there are hairdressers who can visit your home. 'Mobile hairdressers' don't have a salon and can be cheaper because they don't have to pay the cost of running one, whilst some salons that specialise in older clients also have days they visit. Make sure you get a reputable person, and consider being there, or having a carer or trustworthy neighbour there, at the same time.
Shaving
An electric shaver is obviously much safer than a razor. Note that if changing to a rotary shaver a little skin reddening may occur until the skin gets used to it.
Older ladies are also likely to benefit from a few whiskers being removed periodically, and especially before photographs. To avoid any embarrassment you can always say it's just in case there are any little whiskers, rather than indicating that there are any.
Ears and Nose
Don't forget to trim ear and nose hairs if they're ungainly, using the person's own mini-trimmer (not a shared one, and never by plucking). Try to keep cut hairs from getting into the ears, or from tickling the nose.
Earwax
Keep an eye on excessive earwax buildup, and consult a nurse or doctor for advice on treatment if necessary. Never try to clean out earwax from anywhere near the small opening with a cotton bud or other tool - doctors have an amusing way of putting it: "Don't put anything smaller than your own elbow into your ear". Unfortunately, pointy tools are sold online, but they shouldn't be. High street chemists have a range of ear drops for helping dry wax come out, but we do recommend consulting a nurse, doctor or qualified pharmacist before using them.