Individualized turning plans should be developed to align with the older person’s care needs. Turning an older person q2h is often considered the gold standard implemented in many areas of health care to aid in the avoidance of skin breakdown and pressure injuries. However, there is little evidence to support this particular frequency of repositioning. In some cases, it is far too frequent; in others, it is not frequent enough. For older persons at low risk for skin breakdown, this practice may severely impact their quality of life due to sleep deprivation and disruption, leading to delirium, depression and other psychiatric impairments. Excessive repositioning of an older adult may also result in shearing forces that can lead to pressure injuries. Conversely, q2h turning may be inadequate for persons at higher risk for skin breakdown, including those with decreased tissue tolerance and limited mobility. To facilitate an appropriate turning schedule for older adults of all risk levels, it is crucial to use a validated tool to assess each client’s risk for skin breakdown and develop an individualized turning plan.
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