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Foot Care for the Elderly: 10 Tips for Healthier Feet

Bunion deformityLike other parts of our aging bodies, feet not only suffer from normal wear and tear but injure more easily and heal more slowly. As a caregiver of an elderly person, or even as we ourselves age, being aware of how to keep feet healthy can prolong mobility and prevent or relieve pain. Here are 10 Tips that can help:

  1. Wash and dry feet thoroughly: It may be difficult for an elderly person to thoroughly wash and dry their feet. Keeping feet clean and dry can prevent or help to improve a number of irritating skin conditions. Help your patient or loved one as needed, and while doing so, check for foot problems that might not be evident without close examination.
  2. Have a professional regularly trim toenails: Usually, Medicare will pay to have a podiatrist trim toenails every nine weeks. Cutting your own toenails or even having a family member cut them heightens the risk of small cuts that may become infected. This can be of special concern in diabetics, who tend to have poor circulation in their feet. Toenails that are too long or too short can affect the fit and comfort of shoes. Improper cutting of nails can also result in ingrown toenails.
  3. See a Dr. for ingrown toenails:If nails aren’t trimmed properly, an ingrown toenail might be the result, especially on the big toe. Pain will often alert the patient that a toenail is ingrown, but sometimes lack of feeling in the feet will require that it be discovered by examination. When a piece of the nail breaks the skin, infection can also be a risk. A doctor can remove the part of the nail that is cutting into the skin, allowing the area to heal. Ingrown toenails can often be avoided by cutting the toenail straight across and level with the top of the toe.
  4. Wear shoes that fit and give arch support: Many elderly people, especially those with painful conditions like bunions, hammer toe, or arthritis, are tempted to wear easy-to-slip-on bedroom slippers. Although they are comfortable, they can cause foot problems and even falls. My 96-year-old father could not be dissuaded from wearing his furry slippers until he developed a painful crack in one heal. To our surprise, the podiatrist prescribed that he wear shoes! He explained that Dad’s dry feet not only needed lubrication, but something to support his heels and arches, in order to keep the skin from splitting. We found Dad a pair of soft leather shoes with non-slip, thick soles. They open and close with a Velcro strap. Presto! No more crack, and Dad also walks with more confidence and is able take the shoes off and put them on himself. If you have painful bunions, arthritic or hammer toes, corns or calluses, you should wear shoes that are wider and softer in the ball of the foot. Proper arch support is also important for preventing leg pain and posture issues. Orthotic devices might be called for to help a variety of problems. 
  5. Prevent dry skin by using healing lotion frequently: It may be difficult for a person who needs home care to remember to use lotion or to apply it properly. Making mild soap and all-over body lubrication part of a shower or bath routine is something very therapeutic and pleasurable that a caregiver can do. Dry skin can be itchy and, as noted in #4, cause cracks, especially in hands and feet. Leaving a tube of a thick body lotion on a night stand can be another reminder to apply lotion or cream to the feet before bed or a nap.
  6. Treat fungal infections of the skin and nails quickly: If you think you or your loved one might have a fungal or bacterial condition on one or both feet, and it doesn’t get better within 2 weeks, you should talk to a doctor. If not treated in time or properly, it might be difficult to cure. To prevent infections, keep the feet, especially the area between the toes, clean and dry. Changing shoes and socks often and dusting feet with powder will help. Symptoms include dry skin that doesn’t respond to non-medicated lotion, redness, blisters, itching and peeling.Toenail fungus can be especially difficult to treat. Men are more likely to get it than women. Your age, if you have diabetes or a weak immune system, if you smoke or if you have family members who have it, you are also at higher risk. Symptoms include a change in nail color or the thickness of the nail. An excellent article on “How to Handle Nail Fungus” can be found here: http://www.webmd.com/skin-problems-and-treatments/ss/slideshow-toenail-fungus.
  7. Prevent and treat heel pressure sores with a device that “floats” the heel: Pressure sores are injuries to skin and underlying tissue resulting from prolonged pressure on the skin. See our blog on Sept. 1, 2014. Pressure sores most often develop on skin that covers bony areas of the body, such as the heels. At first, the skin is not broken, but it appears red and doesn’t briefly lighten when touched. The site will probably be tender or painful. People most at risk of pressure sores are those with a medical condition that limits their ability to change positions, requires them to use a wheelchair or confines them to a bed for a long time. If you notice early signs or symptoms of a pressure sore on the foot, change the position to relieve the pressure on the area. Simple devices such as a circle of foam around the ankle or a foam pad under the leg that prevents the foot from touching the bed can give quick relief and prevent the sore from getting worse. If you don’t see improvement in 24 to 48 hours, contact your doctor.
  8. Put your feet up to prevent swelling and increase circulation: Actually, elevating your feet is just one way to keep blood circulating there, thus increasing the chances of healthier feet. Others not already mentioned include stretching and moving around—if you are able to, not sitting for too long without getting up, walking as much as you can, keep your feet warm, not crossing your legs, taking a warm foot bath and asking your caregiver for a gentle foot massage.
  9. See a Dr. for Warts: Wartsare skin growths caused by viruses. They are sometimes painful and, if untreated, may spread. Since over-the-counter preparations rarely cure warts and can be dangerous to the elderly, see your doctor. (The same advice applies to treating corns and calluses.) A doctor can apply medicines, burn or freeze the wart off, or take the wart off with surgery. In normal people, half of all common warts, on average, spontaneously go away within about 18 months, but it could also take years for them to heal themselves and more serious conditions, even cancer, could develop.
  10. Have your feet examined often for signs of disease in other parts of your body: Problems with our feet can be the first sign of more serious medical conditions such arthritis, diabetes, and nerve and circulatory disorders. If you are aware that you have any of those conditions, you are probably already aware of how they can affect your feet. Caregivers should examine feet frequently, and a patient’s PCP or Podiatrist should also make careful foot examinations a part of their regular routine. If warning signs are noted, then appropriate action should be taken.
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