Home Health Aide Training Part 9: Assisting with Special Skin Care and Dressing Change

by admin on July 3, 2019

One of the important skills that any home health aide must have is the ability to help with special skin care as well as dressing change (i.e. changing bandages). This is because you will often be working with patients who have severe injuries which require your constant diligence to ensure that they will not become infected or get worse. Here’s what you need to know:

What Normal Skin Does

In a person with healthy skin, the skin performs a large number of important functions. It keeps the inside of the body healthy and free of infection by creating a protective outer layer over the inside of the body. It also helps to keep moisture in and keep the body cool during the summer heat by allowing sweat to come out form the glands of the body.

Problems with Skin

There are a large number of potential problems that your patients may face as a result of their skin being damaged in some way. These can range from simple infections to severe problems, including cancer and other kinds of deadly diseases.

Skin Tears

The most common skin problem is tears in the skin. This includes any kind of bruise where the skin is damaged in some way. This can be as simple as a small cut or scrape or it can be a major wound which exposed vital parts of the anatomy.

Moisture Issues

Another common problem that many of your patients may face when dealing with skin problems is a problem of moisture. Normal skin maintains a healthy amount of moisture while at the same not drowning the body in liquids. However, on some of your patients, you may find that they are dealing with cracked or dry skin which can cause lesions and other kinds of discomfort.

Circulatory Problems

Damaged skin can also lead to problems with blood circulation in some patients. That’s because skin actually conducts a significant amount blood all around the body and damaged skin will curtail this circulation.

Caring for Skin

Dealing with skin problems in your home health care patients may require a variety of measures, including dressing and redressing wounds as well as more basic therapy.


Believe it or not, a massage is not just a way to enjoy yourself and relieve stress. A massage can also help tremendously with skin care, ensuring that skin is protected and worked correctly so that it can continue to grow and protect the body. Areas which are particularly sensitive and useful for the purposes of offering your patients a massage include:
  • Coccyx
  • Heals
  • Sacrum
  • Ischial tuberosities
  • Back of skull
  • Elbows

Back Rub

Similar to offering a massage, a back rub can also be quite healthy for your patients with skin problems because it can help to massage the skin in a particularly tender part of the body.


In many cases, patients with cracked or dry skin will require special care whereby you introduce moisturizers to their bodies so as to help guarantee that the skin will retain its natural color and glow. This is especially important when dealing with diabetic home health care patients as they often lose a certain amount of circulation in the feet, which can cause severe damage to that part of the body.

Common Signs of Skin Damage

Some common signs of possible skin damage (other than the very obvious cracked skin and or tears in the skin) include signs of redness in the skin, warmth of particular parts of the body as compared to other areas or the formation of a rash. Itching may also be a sign that there is skin irritation. In all cases, these symptoms should be recorded and reported to the attending physician.

Changing a Dressing

Another issue which many home health care aides must deal with which is related to skin care is the changing of dressings. These can include everything from a simple Band-Aid to major wound dressings which must be kept clean in order to prevent infection. The procedure for performing such dressing changes are as follows:
  1. Explain to your client what you will be doing.
  2. Wash your hands with antibacterial soap to reduce the chance of germ transmission.
  3. Assemble any equipment needed for the dressing change. For example, if you require bandages cut to specific lengths, this should be done before you begin changing the dressing.
  4. Make sure that your client is comfortable and ready.
  5. Ensure that there is enough light to allow you to see well in the area where you will be working.
  6. Place a biohazard bag nearby to collect the old dressing materials
  7. Put on a pair of latex gloves.
  8. Remove the clothing covering the area of the dressing if needed.
  9. Remove the old dressing and clean the wound as needed.
  10. Apply the new dressing to the wound.
  11. Tape the new dressing in place and assist the client in putting his or her clothes back on.
  12. Put away unused supplies and clean up the area, being careful to remove used dressings.

Precautions for Changing Dressings

When changing dressings for your home health care patients, it’s important to realize that these are areas where opportunistic infections can easily enter into the body’s blood stream. Therefore, there are a number of precautions which should be taken in order to minimize the possibility:

Be Sure to Keep the Area Clean

In addition to the precautions mentioned above, it’s a good idea to clean the area where you will be working on changing the patient’s dressings. This means removing dirt and, if working on the bed, ensuring that clean sheets are used.

Avoid Aggravating the Injury

Do not probe the injury when changing dressings as this can cause more problems. Simply record what you see in front of you and report this information to the doctor.

Be Prepared to Call for Help

If, in the process of changing dressings you find that the wound has grown significantly worse, or you find that the wound is beginning to bleed profusely, be prepared to contact emergency services and or the patients’ attending doctor to help them ensure that they will not suffer further problems due to their injury.

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