Background To provide equitable care for people approaching death it is important that we understand how to provide the best skin care for people with darker skin tones. Healthcare professionals, carers, and people important to the dying person need help to recognise normal skin type, rashes, signs of acute inflammation, pressure damage, and changes at the end of life in patients with darker skin tones.

Aims To see what information exists documenting changes in darker skin tones that is relevant to people approaching death to update resources to ensure the information, support and services we provide are fully inclusive.

Methods Online databases were searched for articles published in the last five years describing skin changes in people of darker skin tones relevant to end-of-life care, including skin appearance at the end of life, development of pressure damage, sepsis, signs of infection, erythema and cyanosis. We consulted healthcare professionals, looked for existing guidance available on skin changes in people with darker skin and we consulted the Ubele Initiative.

Results Preliminary searches found few articles covered descriptions of skin changes at the end of life and contained outdated terms. No studies described the appearance of skin in people with darker skin at the end of life. Information about skin changes relevant to end of life care in people with darker skin found in resources from Wounds UK, National Wound Care Strategy, Mind the Gap and UK Sepsis Trust was used to update resources and website information which were reviewed by experts by experience and professionals.

Conclusion There is a significant lack of robust evidence, information, and guidance on changes of skin tone in people with darker skin at the end of life. There is a need for co-produced, evidence-informed practical guidance for healthcare professionals and informal carers supporting people at the end of life.