Skin failure is a recognised end of life concept
(Langemo and Brown, 2006; Sibbald et al, 2009).
The condition of the skin and underlying tissue
can be an early sign of pressure damage (NPUAP
et al, 2014). In the individual receiving palliative
care, skin changes may indicate early or progressive
pressure damage, but may also indicate endstage
skin failure and reduction in skin and tissue
perfusion as vital organ function is preserved. In
skin failure, there is both a general and local
reduction in vascularity eventually leading to
ischaemia and tissue death. This can manifest as
pressure damage in the tissues in the presence of
pressure and/or shear. The pressure ulcer guideline
notes that preventive skin care and maintenance
of skin integrity are essential if pressure
ulcers are to be prevented (NPUAP et al, 2014).