Let’s compare the human foot to the tire on a car. After many years and hundreds of thousand gyrations, the tire begins to wear down. It becomes thin and the tread is not as sure as it was when factory new. After many years and hundreds of thousands of steps, the human foot begins to show its age. (On average, a person may take as many as five thousand steps in one day.) Of course, the biggest difference between a foot and a tire is you can’t change a foot. You get one pair for life and that’s it.
As people are living longer these days, that means even more wear and tear on the feet. The old-timer napping at the VA home marched off to war on his feet. The armchair coach ran touchdowns once upon a time on his feet. The frail old lady knitting on her porch used to chase after wayward toddlers on her feet. Or maybe she walked a beat, ambulated patients or hurried to board meetings in heels.
These feet danced at weddings and maybe even led someone down the aisle. Now, that person and their feet have earned their rest. Because an elderly person is less active, they may not pay as much attention to their feet as they used to. However, they need to pay attention to their feet more than ever now. If you are over a certain age or are the primary caretaker of an elderly person, you may want to keep reading.
Feet Problems in the Elderly
The foot problems start earlier than you think it would. After age 45, one in four adults experiences foot pain. In older adults, foot pain is associated with a sixty-two percent increased risk of recurring falls. Muscles and tendons overall lose elasticity with age. That contributes greatly to foot pain. Generally, there are six factors that contribute to foot pain in senior citizens.
- Putting on weight This is more than just some middle-age spread we’re talking about. Obesity is bad for the body overall but especially the feet. There is only so much of a load those twenty-six bones and thirty-three joints and more than one hundred and twenty muscles, ligaments, tendons, and nerves can take. Not only is it hard to lose weight after a certain age, but foot pain can also make it difficult to stay active, leading to a vicious cycle.
- Losing weight While getting too fat can be a problem, so can getting too thin. The heels and balls of our feet need a bit of fat to act as shock absorbers. Some people may find this padding atrophies with age. Cortisone injections and overwork can exacerbate the problem. This can lead to bruised bones, stress fractures, and balance problems.
- Compromised blood flow Some elderly people may have health problems such as blood clots, diabetes or peripheral neuropathy. While smoking has become less popular with young people these days, (Cigs are out, vapes are in.) plenty of older people are still hooked and maybe for life. All of this can lead to bad circulation. This can make it hard for wounds, sores, and tissues to heal properly.
- Persistent foot ailments Common ailments such as hammertoes, bunions, corns, calluses, and fungal infections can happen to anyone of any age. They just seem to get worse with age. This is especially true for anything affecting the joints or tendons. When the person’s mobility is compromised, trying to fix these ailments can get a little harder.
- The wrong shoes If an elderly person finds that their shoes are too tight, it may mean their feet have swollen a bit with age. It could be time to start getting shoes half a size up or bigger. Soles should not be slippery. Ladies, you’re not on the catwalk.
- Simple neglect Your feet need to be washed and dried every day. Moisturizer will keep them from cracking. They also need to be checked over to make sure there is nothing out of the ordinary. If the person does not have the flexibility to look at the sole of their foot, they should use a mirror or get someone to look at it for them.
Other problems the elderly may experience regarding their feet include dry skin, flat feet, thicker toenails, and arthritis. Lesions such as seborrheic keratosis make wearing shoes irritating. The Achilles tendon can shorten with age and lose elasticity. Chronic illness can make the problem just that much worse. The odds of getting a fungal infection raise with age as well. So, how do we treat or better yet prevent these ailments?
Geriatric Foot Care
If you are taking care of an older person, remember that they may not have very good eyesight and their feet may be a bit numb from poor circulation. Do a daily foot inspection when you help them change socks. (Said socks should be soft and not too tight.) A podiatrist can show you what to look for, but what you should be looking for is anything out of the ordinary.
Toenails should be short and even. Cut them straight across. Corns and calluses should not be cut with a razor or other sharp tool but filed down with a pumice stone after a soak. Skin creams, Epsom salts, and moisturizers can keep the skin supple. If the elderly person you’re caring for is a bit testy about having their feet handled, a little lavender oil might help them relax.
And here is what the owner of those feet can do. You should not walk around barefoot, even inside your home. If you are diabetic, keep your blood sugar under control. Remember that some remedies for corns and calluses are so much snake oil. Talk it over with your health care provider. Do some exercises to keep your feet healthy. If you have poor circulation, do not cross your legs or use heating pads.
Tight shoes are not good for you and neither are tight socks. Improve your circulation by doing a little walking or stretching, as much as is comfortable for you. Set an alarm to remind you to do foot exercises if it helps. Even wiggling the toes little help. If you think your feet are becoming less sensitive to temperature, start using your hand to test your bathwater.
Many common foot ailments can be debilitating for seniors. There are more than three hundred different kinds of foot ailments. Here are the most common ailments and how to prevent them.
- Athlete’s Foot Despite the name, it can affect anyone whose feet are in warm, dark, moist areas. Keep the feet clean and dry. Powders and sprays help.
- Dry Skin This is a minor ailment, but a very uncomfortable one. Petroleum jelly and moisturizers with lanolin, ceramides and hyaluronic acid can fix it up.
- Corns and Calluses Always wear properly fitting shoes. Remove them with a pumice stone or callus file.
- Heel Spurs This is caused by being overweight, wearing shoes that aren’t supportive, standing too long or being a rich boy trying to get out of service. Heel pads and heel cups can help.
- Hammertoes This is caused by not giving the toes room to move and causing the knuckle to swell. Wear comfortable socks and shoes.
- Ingrown Toenails Trim nails straight across, keeping them even with the toe. Trim them regularly. Do not try to rip a nail off. If it looks infected, see a doctor particularly if you are diabetic.
Foot pain is not only painful by itself; it can lead to other problems. Someone who can’t walk properly because of foot pain is more likely to fall and hurt themselves. Reduced mobility means a loss of personal independence. Not getting enough exercise can lead to more health problems. The result can be hospitalization or even amputation. Feet need to be taken care of so they can stay where they belong and do what they were meant to do.
Toenail Care for Seniors
If you do not have chronic foot trouble, seeing a podiatrist once a year may be enough. If you have chronic foot troubles you may want to consider the services of a visiting foot care nurse to help you with everyday grooming and inspection of the feet. This can be beneficial if you are having problems performing routine self-care of your feet.
The act of bending and twisting to touch one’s feet can become more difficult with age. If you are seriously considering hiring a visiting foot nurse or other health care provider to help with foot care you should first see to it that the person is certified and appropriately licensed in your state to provide this kind of care. Medicare may cover this service.
Here is how a pedicure for a senior citizen may typically go so you will know what to expect. The patient’s feet will be first soaked no more than five minutes in lukewarm water with a pH-balanced hydrating foot soak. A salt or acid-based product is not recommended. A warm, moist towel compress may be substituted. The feet will be cleaned gently and thoroughly with a hydrating, urea-based callus softener.
The toenails next will be tended to. The person should be gentle about this and use the straight and even cut mentioned earlier. A fine grit file or buffer will be used with a lateral motion on the surface of the toenails near the cuticle area instead of trying to push them back. Calluses will be gently smoothed down.
The moisturizer and massage come next. There will be no deep pressure and it will only go as high up as the knee. The caregiver will then give the patient recommendations and suggestions to keep their feet healthy between visits. Another appointment will be booked and it will be time to go. Feel free to ask questions during the procedure or speak up if something feels uncomfortable. Ideally, this pedicure should not only be painless but soothing.
If you are caring for a senior citizen’s feet yourself, you may not have any fancy chemicals or know how to do therapeutic massage, but you may not need them. Really all you need for at-home foot care is an ottoman, cotton socks, mild soap, lotion, and nail clippers. Sometimes all that is really necessary is just a little tender care. First, inspect the feet for any irregularities. Remember that even a bloodless crack can get easily infected.
The feet should be washed with mild soap and dried thoroughly. The toenails then should be carefully cut as described. Lotion can be worked into the skin and then dressed in cotton socks. Lotion can be used on the top and bottom of the foot but not between the toes. Do not use talcum powder as this can block the pores and cause friction. The senior should be reminded to sit with the feet raised on an ottoman to improve circulation.
Cleanliness is key. If you hire someone to take care of a senior’s feet make sure they work clean. If you do it yourself, you should also work clean. Any equipment that is used to care for a senior’s feet must be sterilized. Nail clippers, which are usually made of metal, should only be used by one person and moreover either boiled or soaked in rubbing alcohol each time before being used.
Nail files are also a personal care item. That means it should only be used by just one person and disposed of every few uses in order to prevent any spread of a fungus or infection. Hands should be washed before and after caring for a senior’s feet to prevent the spreading of infectious germs.
You can do foot care at home, but it’s always a good idea to have an expert look over your work and make suggestions. The people at a commercial nail salon may not charge as much as a clinical foot care provider, but remember that you usually get what you pay for.
Many pedicurists may even have to legally turn a client away if they clearly have an infection of some kind. In any case, an expert may be able to give you good advice and recommend products that will make caring for your feet a little easier.
Signs and Symptoms to Look For
If you inspect your feet regularly, you’ll know what’s normal and what’s not. Unusual swellings and discolorations can tell you something is wrong. Brittle nails, dry skin, and loss of leg hair are all signs that something is not right. Ask the senior if they experience any cramping, numbness and/or tingling in the feet.
Cuts, cracks, calluses, blisters, pressure sores and spots where splinters or other foreign objects have been removed should show signs of healing within a day or so. If even a minor wound is not healing, a doctor must look into it. This is especially true for diabetic patients. Diabetic patients, as well as those with poor circulation and/or numbness, may benefit from visiting a podiatrist several times a year.
If the feet smell bad, do not mistake that for normal foot odor. As with fish, feet have a bad reputation for being smelly. The truth is, fish should smell like the water they came from and feet should smell like clean skin. Bad smells are a telltale sign that something is not healthy. If feet smell bad even after cleaning there could be a bacterial infection. Antibacterial foot sprays can be helpful.
There are many reasons a senior citizen may be unable to care for their own feet. It may be hard for them to reach their feet on their own. Arthritis can make it difficult to handle clippers safely. Some elderly patients have conditions that make them dizzy if they try to bend. Weak vision may make it difficult to cut nails straight or look for any blemishes that need treatment.
At an age where they need foot care the most, they are least capable of handling it themselves. An elderly patient with dementia or who is just plain cantankerous may see some improvement in their disposition and mental stability if they regularly get tended to by a friendly and attentive foot care provider. It may seem a small thing to take care of a senior citizen’s feet, but it really means a great deal.