Wednesday, December 2, 2009

Old feet have special needs

Update: 12/18/2011:  another entry old caring for old feet
Update: 3/20/2011:  Please look at the comment section for some specific ideas on caring for old feet.

Original entry Oct 2009:
As a great display of respect and humbleness Christ washed the feet of his disciples.  There's a good reason why it was considered such a respectful act - feet were GROSE.  Feet are still grose but in Christ's time, it was even worse. Ancient people had less access to water and soap, shoes were basically sandals, and who knows what they walked in given that transportation was done with animals not gas-powered vehicles.   Last night I helped mom with a difficult task  - I washed her feet and cut her toe nails.   For elderly people cutting toe nails is often physically impossible and it's hard to find a foot doctor willing to do it. Our Elders are too stiff to bend down that far or pull their legs up that close.  Toe nails are often thick and really, really tough to cut.   Foot doctors, or podiatrists, used to cut toe nails but due to cuts in payments by medicare, medicaide and private insurance they say they make no money on the procedure.   

I've done this for my Mom for a long time and I'm the only one she really trusts to do a gentle job.  To start, I soak Mom's feet in warm water with epsome salts -  no soap or lotion added because that can cause dryness if I don't rinse it off well.   Epsome salt also has mild antibacterial qualities. The water can't be too warm and what's warm to me is hot to her.   Once her feet have soaked for about 10 minutes, I leave one foot soaking while I sit on a small stool and gently work on her feet.   I ease a wash cloth between her toes and delicately move it back and forth like floss to clean between her toes.  This is especially important because you don't want to leave this area damp and you want to remove all the dead skin or lint from sock and slippers.   To clip her toenails I use both flat and rounded clippers, it depends on the nail. I also use files to smooth the nails on top and picks to remove anything between the sides of the toe nails and her flesh.

Let's face it - feet are smelly and ugly but this is a necessary task for the health and well being of our Elders.   We need to be open about these basic elements of hygiene - toes, hands, skin, bottoms, ears and heads.  I'll bring these out of the bathroom so to speak and discuss each in detail here.  Though often overlooked, these are important to the well being and good care of our Elders.   It makes them feel better and what makes them feel better enhances their quality of life. 


2 comments:

  1. Old feet are also delicate because of old skin - it's thinner, blood flow may restricted by all sorts of conditions; old skin doesn't heal as quickly. Years of walking can flatten arches causing pain. Years of wearing shoes, especially if they don't fit well, mean thick callouses, bunions and even deformed toes or joints.

    If you're caring for an old person at home, the wisest thing might be to take them to a foot doctor to see what problems they detect and ask for their advice on how to care for the elders feet. Be prepared to pay for this consultation since medicare no longer pays podiatrists (foot doctors) to cut toe nails. Ask the foot doc if they know a good pedicurist who specializes in old feet. Since I first wrote this entry, I've met two ladies who do nothing but drive around their community of 40,000 and cut toe nails for the elderly. They see each client on an average of once every 2-3 months - more or less depending on the client.

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  2. For my Mom, here's what I did for her feet:
    1st - get comfy shoes. let vanity go and go for good fit and safety so they won't fall. Mom's last pair of shoes cost $100, they are all leather, have velcro closures with elastic to accommodate one swollen foot and one regular, thinner foot.
    2nd - work slowly on the tough spots, this takes time to slowly get rid of callouses, you can't remove too much at a time or it causes pain. My goal is to soften without causing cuts or scrapes that might bleed or become infected. Mom had thick callouses so after soaking her feet, I gently used a file or pumice stone to remove the top layer of the callous.
    3rd - lotion, shea butter and cocoa butter lotions seemed to work best

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