However, the overall deteriorating health status of the individual receiving palliative care underpins the ongoing influence of each of the risk factors discussed above, and should be considered significant to this population. Skin assessment and care 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).