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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.

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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.

Did you know that by age 50 the average adult has walked 75,000 miles? And with life expectancy going up each year, that is many more miles that we should expect to walk. No foot pain is “normal,” even as we age. Many of our older loved ones may chalk up foot pain to the aging process and ignore it. Worse yet, they often cut back on activities to try to prevent pain, causing other health risks. Our feet often provide early indications of conditions such as diabetes, arthritis, or circulatory disease. All pain should be referred to a professional health provider.

According to the US National Center for Health Statistics, impairment of the lower extremities is a leading cause of activity limitation in older people. The NCHS also reports that one-fourth of all nursing home patients cannot walk at all, while another one-sixth can walk only with assistance. Poor foot care can contribute to these statistics. However, there are solutions.

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. A professional health care provider 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.

Blisters, cuts or scratches can lead to infection if ignored. Thinner, aging skin can make it easier to bump or bruise our feet, allowing for the entry of bacteria.

Diabetic foot problems can be serious as 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.

The most important solution is daily foot care.

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.Applying lotion. This is 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. Cut 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 a professional trim. 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. Determine whether 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.

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 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.

Elements of Senior Footwear. A properly fitted shoe should have the following characteristics:

1.Shoes need to fit correctly. If the shoes are too big, the senior's foot will slip and slide within the shoe and can contribute to a fall or loss of balance. Shoes that are too tight cause foot pain which makes it difficult for the elderly person to walk and focus on each step. An easy comfortable measure is a thumb’s width between the end of the shoe and the longest toe. 2.Room to pinch some material at the sides or top of the shoe for width 3.A shape that matches the shape of and conforms to the foot (no human has a foot shaped like the point that many dress shoes have). Flip flops and unsupported sandals can lead to falls. 4.A firm closed heel (press on both sides of the heel area to ensure that the heel is stiff and won’t collapse.). Wearing a high heel is bad for posture, balance and negatively affects gait. Low heel only is recommended as it provides greater stability. 5.Heavy shoes are a problem for weak seniors. They may have trouble lifting their feet up so they tend to shuffle when they walk which can cause falling. 6.A firm sole (try to twist the shoe from side to side…it shouldn’t twist in the middle) that is slip- resistant provides better stability. Choose shoes that have a good tread and get rid of shoes that have worn out tread.

Modern Day Home Health caregivers are screened, supervised and trained to meet all the care needs of clients and support for families. Ask for a home care plan consultation:

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