Older Feet Need Special Care
An engineering team hardly could have come up with a structure more complicated than the human foot. Our bodies have 206 bones—and 52 of those bones are in our feet! The job our feet do is complicated, as well. They support our body weight, which adds up to tons of pressure every day as we move around. They push us forward, act as shock absorbers, and even provide our brains with information about the position of our bodies, which is so necessary for good balance.
With all this complexity, it’s no surprise that things can go wrong. Under normal circumstances, we pay little attention to our feet. But when something’s amiss, our feet often will protest, and even the smallest blister can slow us down. Foot problems raise the risk of weight gain, heart problems and disability. They make it hard to exercise and even to drive.
The American Geriatrics Society says one-third of people older than 65 have problems with their feet. Podiatrists see more older patients than any other age group. Normal changes of aging are partly to blame: the fatty cushion of padding in our feet thins; the arches flatten; joints grow stiffer; the skin is drier; and toenails become more brittle. Our feet even change shape, growing flatter and longer. We might go up a shoe size or two.
Common health conditions also affect our feet. These include osteoporosis, obesity, arthritis, circulation problems and most notably, diabetes.
Here are common foot problems seniors might experience:
A bunion is a deformity at the big toe joint. It occurs when the toe slants outward at an angle and becomes swollen or tender. About one-third of older adults will have a bunion. Bunions are treated with special shoe inserts and sometimes surgery.
Hammertoes happen when shortened tendons pull the toe into an upside-down V shape, affecting walking and balance. Wearing the right shoes helps, and surgery may be recommended.
Corns and calluses are thick layers of dead skin caused by friction and rubbing from shoes. Our body creates them to protect delicate skin, but the pressure on sensitive nerves can be painful. Well-fitted shoes can help. It’s best to consult a doctor before using over-the-counter remedies.
Athlete’s foot, toenail fungus and other infections can flourish within the warm, moist environment of our shoes. The doctor may recommend medications, medical procedures, and improved hygiene.
Ingrown toenails happen when nails are cut incorrectly, allowing the corners or sides to dig painfully into the skin. Correct nail care can prevent them.
Several types of arthritis can limit motion in the feet, as well as cause discomfort. One type, gout, can be extremely painful. Treatment might include medications and diet changes.
Other common foot problems include warts and other growths, cracked heels, injuries such as sprains and broken bones, and heel pain from bone spurs or an inflamed ligament called plantar fasciitis.
Diabetic foot problems can be serious.
Many people with diabetes have nerve damage in their feet. The resulting numbness prevents them from noticing early signs of a foot injury or infection, putting them at risk for a serious, stubborn foot ulcer that could eventually lead to amputation. People with diabetes should have regular medical foot care, report any sores or changes right away, and follow the doctor’s recommendations closely.
Seven steps to better foot care for older adults
1. Inspect feet regularly. Look for cuts, redness, swelling, blisters, sores, and any changes to nails or skin.
2. Apply lotion to the feet as recommended to prevent cracks and calluses (but not between the toes—that could lead to infection).
3. Consult a podiatrist. Doctors of podiatric medicine (DPMs) are physicians and surgeons who offer a wide variety of treatments for the foot, ankle and related structures of the leg.
4. Trim toenails straight across and smooth edges with an emery board. If toenails are thick or you have a fungal infection or diabetes, it’s best to have the podiatrist trim your nails.
5. Wear properly fitted shoes. Podiatrists tell us that while few people are born with foot problems, they’re plenty common in later life—and shoes are a frequent culprit. Have shoes professionally fitted.
6. Always wear clean, dry socks. Ask your doctor if natural fibers or fabrics that wick moisture might be the best choice for you. Padded socks also may be recommended.
7. Exercise your feet. Stretches and resistance activities can make feet stronger and more flexible. But talk to your doctor first.
Ask for a hand with foot care.
As we grow older, it can be much harder to follow the above tips. Inspecting the feet, trimming the nails, keeping feet clean, or even keeping a fresh supply of clean socks can be difficult when a senior has vision loss, reduced flexibility, dementia or other health problems. Foot health can become an “out of sight, out of mind” matter, quickly leading to problems.
Professional in-home caregivers assist with many aspects of hygiene, including foot care. Older adults often need assistance to inspect their feet, keep their feet clean, and put on shoes and socks properly. Professional caregivers provide transportation to the podiatrist and other medical appointments. They provide companionship and supervision during exercise. And they help with all-around wellness for clients with diabetes. When it comes to foot health, professional in-home caregivers are an essential part of the team.