Foot Care for Seniors
How can seniors take care of their feet?
Foot problems are especially common in older people, for a variety of reasons. Feet lose cushioning as they age, and the skin and nails can grow dry and brittle. Many seniors have poor circulation, and this can slow the healing of foot sores.
Finding comfortable shoes that fit is the best thing you can do for your feet. It's especially important to avoid tight or high-heeled shoes that put undue pressure on the foot. The constant rubbing and pinching from this "fashionable" footwear are a major cause of corns, calluses, and bunions. (Not surprisingly, these conditions occur four times as often in women as in men.) Keep in mind that feet can become wider in your later years, so you should always have them measured before buying new shoes.
Another way to protect your feet is to keep your blood flowing freely. If you usually spend much of the day in a chair, you can improve your circulation by stretching, walking, and other exercises. Avoid wearing tight socks or sitting too long with your legs crossed. And here's yet another reason to avoid tobacco: Smoking narrows the arteries and can hamper blood flow.
You can also avoid problems such as foot odor by alternating what shoes you wear each day, and by washing your feet every day and drying them carefully. (Drying between your toes and elsewhere will also help you ward off irritating problems like athlete's foot.)
What are the foot problems seniors commonly face?
Here are a few typical hazards, all of which can be prevented and treated.
Athlete's foot. You don't need to be an athlete to develop this fungal infection. The fungus thrives in warm, dark, moist areas, which makes the foot an inviting target. If you notice redness, blisters, peeling, and itching (especially between the toes), quickly blast the fungus with an athlete's foot powder or spray. You can prevent athlete's foot by keeping your feet clean and dry and, whenever possible, going barefoot or wearing open-toe sandals. Just keep in mind that going barefoot can be risky if you have diabetes or other circulation problems (see below).
Dry skin. You can reduce the burning and itching of dry skin with moisturizers, preferably the kind with petroleum jelly or lanolin.
Corns and calluses. As mentioned, wearing properly fitting shoes is the best way to prevent these painful sores. If they do arise, you can pare them down by gently rubbing them with a pumice stone or callus file. You can protect them from further irritation with nonmedicated pads or moleskin. The medicated corn-removing solutions sold in drugstores may be tempting, but use extreme caution: They can eat away at healthy skin and cause even more pain. These products are particularly dangerous for people with diabetes (see below) or other circulation problems. If you have one of these conditions, call a doctor at the first sign of a corn or callus.
Heel spurs. If you put too much pressure on your feet -- by being overweight, standing too long, or wearing shoes that don't give proper support -- calcium deposits can form on your heel and cause considerable pain. You can give your feet a break with heel pads, heel cups, or other forms of support. If a bone spur continues to cause you pain, see a doctor.
Hammertoes. When a toe doesn't have room to move, the knuckle can swell and draw the toe back. Hammertoes are especially troublesome for seniors because they can affect balance and increase the risk of falls. The remedy is simple: Wear shoes and socks that give your toes ample space.
Ingrown toenails. This painful nuisance occurs when a sharp piece of nail pierces the skin. Instead of trying to pull the nail off, carefully trim it straight across, keeping it even with the top of the toe. Regular trimming will also help prevent future problems. If you have an ingrown toenail that looks red and infected, you should see a doctor, particularly if you have diabetes.
How should people with diabetes care for their feet?
If you have diabetes, seemingly minor-league foot problems can pose serious threats to your health. The disease often damages the blood vessels that feed the feet, which means small wounds will heal slowly and can even develop gangrene. In many cases, what started out as a simple corn or blister becomes a life-threatening infection that forces amputation of the foot or leg. To complicate things further, diabetes can also deaden the nerves in the feet, making it easy to overlook minor wounds as they fester and worsen.
For these reasons, people with diabetes have to be extra vigilant about foot care, especially if they've had the disease for several years. Here are some tips for maintaining healthy feet:
Take care of your diabetes. Keep your blood glucose in your target range with the help of your health care team.
Keep your feet clean. Wash them every day in warm water and dry them carefully. You can use a moisturizer to keep the skin from drying out, but don't put it between your toes. Wear soft, absorbent, clean socks made of natural fibers such as cotton, and change them often.
Check your feet every day. Call your doctor promptly if you find a corn or callus or if you have a cut, scrape, blister, or bruise that doesn't start to heal within one day. Never use over-the-counter solutions to remove corns.
Always wear socks and shoes while walking around -- going barefoot invites minor injuries that may not heal properly -- and wear socks at night if your feet get cold. In addition, make sure the inner lining of your shoes is smooth, and carefully trim your toenails each week.
Keep the blood flowing. When your feet get tired, sit down and put them up for a while. Wiggle your toes and ankles for a few minutes, two or three times every day. Don't cross your legs for long periods, and above all, don't smoke.
American Diabetes Association http://www.diabetes.org/
National Institute on Aging. Foot Care. July 2010. http://www.nia.nih.gov/HealthInformation/Publications/footcare.htm
Erika Dillman. The Little Foot Care Book. Warner Books: 2000, 228 pp.
American Diabetes Association. Foot Care. http://www.diabetes.org/type-2-diabetes/foot-care.jsp
Beuscher TL. Community outreach--foot care for the elderly: a winning proposition. Home Health Nurse. 1998 Jan;16(1):37-44.