Changes to skin integrity and damage to the skin can occur at the end of life (EOL), despite appropriate interventions that meet or exceed standards of care. It can also be difficult to determine which wounds can be prevented and which ones are unavoidable (Sibbald et al, 2010; Beldon 2011). It is therefore the role of the nurse and carer to consistently deliver the best end-of-life (EOL) care, support palliation of symptoms, and maintain optimal skin integrity. Best practice for EOL skin care is about maintaining skin integrity for as long as is possible, followed by a goal of a dignified death (Kennedy, 2016) in line with patient/family wishes. This article discusses factors associated with maintaining skin integrity, and how skin damage can be prevented and a skincare regimen managed in EOL patients.