How to manage incontinence-associated dermatitis in older adults

As humans age, their skin becomes more susceptible to breakdown due to the effects of the ageing process. An older adult has thinner, more fragile skin, and the risk of skin damage occurring due to external factors, such as moisture or pressure, is increased in this section of the population. The author (2018) acknowledged that the role of skin (the body's largest organ) is one of a functional barrier, providing protection from the outside world, and damage to this barrier increases the risk of infection (Beeckman, 2016). All skin damage requires timely and appropriate diagnosis, management and intervention.

Moisture-associated skin damage (MASD) is an overarching term used to capture all skin damage occurring due to moisture. MASD significantly affects the skin, decreasing its ability to act as a functional barrier. It can present as persistent redness or broken skin. Additionally, it can both increase the risk of pressure ulcers and occur alongside pressure ulcers (Beeckman et al, 2009). Under the umbrella term of MASD, sit four sub-categories, further identifying the cause of moisture damage. Incontinence-associated dermatitis (IAD) is one of these four categories. IAD occurs due to excessive moisture (from urine and/or faeces) and poses the greatest risk to the sacrum, buttocks and groin areas (Beeckman, 2017). NHS England (2015) estimated that around 14 million adults suffer from incontinence.