Adventures in Eldercare (February 2011)
Foot problems in the elderly population are a common and serious health condition, fortunately if caught early most problems can be successfully dealt with. This is the time of year that cold winds and cold homes keep elders feet tucked away in woollen socks and slippers for the vast majority of the day and night. If you are not actually with the elder at bath time you may not have a chance to visually inspect the feet over the winter. This task cannot be left to the family doctor; chances are this type of inspection will not be performed on routine office visits unless the elder complains of pain. This is an unreliable indicator because of decreased nerve sensitivity in the very old. The elder is often the last one to notice a foot problem.
Start with a thorough visual inspection. Warm up the room a bit so everyone is comfortable. Carefully remove the slippers. Inspect for abnormal wear and tear. Soles should be non-slip and in good condition. The slipper should be fully closed in at the toes and the heel. The toe cover will prevent toe injuries and the heel cup will help prevent sliding out of the slipper. Any wear and tear indicates it is time for new slippers. Particularly watch for holes worn through the sides of the slipper as this will indicate pressure from swelling joints as happens with a bunion and severe arthritis.
While removing the sock take note of any sticking to the skin, this may indicate an oozing sore of some type. Visually inspect all aspects of the bare foot. Check the bottom and between the toes. Feel how warm or cold the feet are and note any sensitivity that the elder may complain about during your inspection. Note any overly strong odour. Check the nail beds for swelling or infection.
A trip to the doctor or nurse is warranted if you observe any of the following; any part of your leg or foot is blue or black, extreme sensitivity to cold or heat or touch, an open sore that does not heal or is infected, any unusual numbness, tingling or cramping.
This simple and quick examination should be done regularly. Healthy feet and quality of life go hand in hand. Healthy feet allow elders to stay active. Strength is lost when feet are too sore to walk, leading to increased risk of falls. Walking will help prevent blood clots and keep muscles and bones strong. Feet that are healthy and pain free help the elder to keep their balance. Good balance prevents falls, a major cause of injury and hospitalization. As well, keeping an eye on the feet can provide early warning signals for health concerns such as diabetes, arthritis, poor blood circulation and nerve damage. Thank you Chris (Grandma’s House) for the topic suggestion.
Dr. Bruce Veltri operates Victoria Eldercare, a non-medical home care agency matching exceptional care-givers with elderly seniors to help them maintain independence and remain safely in their own home. Victoria Eldercare can be contacted by phone, 519-429-2644 or the web-site, www.victoriaeldercare.com.