Feet often take a beating in American culture. Many Americans spend years working each day standing on their feet, or cramming toes into uncomfortable shoes for work. While some do indulge in getting regular pedicures, which remove dead skin and calluses, clip and shape toenails properly, and provide a deep clean, it can be difficult to do so from a financial standpoint. As we age and skin loses its thickness and elasticity, it can become even harder to avoid blisters, foot infections, and other uncomfortable foot conditions. Foot health can also be affected by a loss of mobility (particularly when a person cannot bend or perform fine motor movements any more). Lower visibility caused by poor eyesight can affect how well a person takes care of his or her feet also.
Keeping elders' feet healthy can be a daunting task for caregivers. Many people feel embarrassed if they cannot cut their own toenails or check their own feet for cracks and may resist caregivers' efforts to do so. Still more people do not like touching other people's feet, whether or not they are clean, so the caregiver may have some resistance too. Some caregivers might not understand the basics of foot care.
If it falls to you to care for the feet of an elderly person, keep in mind a few simple guidelines to make your foot health efforts more effective.
The first thing to look for in the feet of an older person is signs of infection. Discolored nails, blisters, cracked skin, bleeding sores or wounds--all of these can show that an infection is present or soon to occur without proper care. A doctor must diagnose such problems, but noticing them quickly and scheduling an appointment can prevent a foot health crisis. Keeping skin and nails clean and moisturized will largely prevent problems, but keep an eye out for changes and report them to the doctor immediately.
Toenails should be kept fairly short. The longer they are, the more you risk them breaking, snagging on clothing, or scratching skin open accidentally. Using nail clippers, clip them down carefully and then file them to a smooth curve using a nail file. This takes some time, but is worth doing every few weeks (or more frequently, depending on how fast the nails grow). The shorter and smoother the nails, the less likely they are to cause problems. Look for ingrown nails or hangnails. You may need to call in an expert to treat them properly.
Regularly--whenever the natural growth calls for it--toenails should be clipped and filed, and skin should be moisturized. Dry areas of skin should be treated immediately, since skin can crack and become painful, as well as open to infection. Finding proper moisturizers can be difficult; you may find success with pure coconut oil or a shea-butter-based lotion. Avoid lotions with scents and fragrances, as they may actually dry skin out more, or cause an allergic reaction on sensitive skin.
Seniors who need circulation support may also enjoy a warm foot bath, either in a special small tub or in their own bath. The warmth helps blood flow and can relieve tired, achy feet. Adding a dash of aroma-therapeutic oil or Epsom salt can help increase relaxation.
You should also sanitize any equipment you use to care for a senior's feet. Nail clippers, typically made of metal, can be boiled or soaked in rubbing alcohol. Nail files should be used only by one person and discarded every few uses to prevent spread of a fungus or infection. Wash your hands before and after caring for a senior's feet, just in case you carry away any germs on your hands.
Shoes and socks should fit snugly, but not too tightly. Have feet measured before buying shoes, and make sure the shoes are closed but do not cut off circulation. Improper shoe and sock sizes can cause falls, discomfort, or even ingrown nails, if feet are pushed into an unnatural position. Always have the senior try on shoes before buying!
Make sure that footwear, including socks, are dry, clean, and comfortable. Many seniors find that the high-heeled or dress shoes of the past are suddenly very painful, or cause them to not be able to walk well. Finding shoes with appropriate arch support and sturdy closing methods (so as to avoid untied shoelaces, for example, which can cause falls) will increase walking comfort. There are both expensive and inexpensive options for this, but having a few options available is best. Socks should be washed after each wear and immediately stored in a clean, dry place, which can help avoid foot infections or fungus growth.
It is always a good idea to have someone review your work and recommend improvements. While a commercial nail salon may offer some expertise and can even provide some foot care for the elderly, a podiatrist will provide the most accurate information. Some podiatrists and even primary care physicians will do some foot care in their offices, but that may come with a hefty price tag--more than what you would pay at a nail salon, and more than what you pay at home (free!). Occasional visits to a podiatrist for a checkup on foot health is a great idea, and these visits can be even more helpful if you are able to go in with a senior in your care to discuss any changes in routine or foot health needs.
Overall, like many aspects of senior caregiving, foot health care is mostly about prevention and response. Preventing ways for infection or injury to arrive and responding if they do will yield the best results for a senior in your care, and a podiatrist will always add valuable input to your process.
Advanced Foot & Ankle Care Centers. Elderly Foot Care. Available at http://www.afacc.net/foot-problems/treatment/geriatric-foot-care/. Retrieved May 20, 2016.
National Institute on Aging. Foot Care. Available at https://www.nia.nih.gov/health/publication/foot-care. Retrieved May 20, 2016.
NHS Choices. Foot care for older people. (September 21, 2015) Available at http://www.nhs.uk/Livewell/Staywellover50/Pages/Foot%20care.aspx. Retrieved May 20, 2016.
Soliman, Alison. (December 9, 2014). Foot assessment and care for older people. Nursing Times. Available at http://www.nursingtimes.net/roles/older-people-nurses/foot-assessment-and-care-for-older-people/5077564.fullarticle. Retrieved May 20, 2016.