I attended a presentation given by a podiatrist last week and this inspired me to learn more about feet. The context of the talk was ‘falls prevention’: the gathered audience was considering how the risk of falls for older people living in care homes could be reduced.

Having well cared for feet is vital. Foot problems can quickly lead to discomfort and affect the way we walk, which can then cause knee, hip and back problems. And having foot injuries and infections contributes to poor mobility, which in turn, leads to loss of muscle tone, strength and agility.

Yet foot health is often neglected.

“How many people in the room file their toe nails with an emery board after cutting them?” asked the podiatrist. One person out of around 40 people put her hand up. “Who in the room moisturises their feet every day?”  Two people said they did.

The podiatrist gave good advice about taking care of our feet:

Wash your feet often
Keep your feet clean by washing them every day in warm soapy water, but don’t soak them, as this might destroy your skin’s natural oils.

Dry your feet well
Dry your feet thoroughly after washing them, especially between the toes which is where fungal infections such as athlete’s foot can develop.

Moisturise and file
If your skin is dry, apply moisturising cream all over the foot, except for between the toes. Gently remove hard skin and calluses with a pumice stone or foot file, but not too much as hard skin has a protective effect.

Cut toenails carefully
Trim your toenails regularly using proper nail clippers. Cut straight across, never at an angle or down the edges. This can cause ingrown toenails.

Shop for shoes in the afternoon
Feet swell as the day wears on, so it’s important to shop for shoes in the afternoon, when your feet are at their largest.

Wear sensible, securely fitting footwear
Wear comfortable shoes. Wear the right shoes for the occasion. Avoid loose fitting slippers and limit the amount of time wearing flip flops.

Change your socks often to avoid foot odour
Change your socks daily to keep your feet fresh.

In my experience, consulting a specialist health practitioner about our feet is something we would only think about doing if we had a problem, and even then, many people would only seek help if the problem was causing them pain.

Research from The College of Podiatry found that nine in 10 people experience some sort of foot problem, with one in five admitting to having foot pain often or constantly. This research suggests that people are willing to put up with ‘sore, aching and painful feet’, rather than seek help.

Feet come low on the priority list. We rather take them for granted!

For people living with dementia, keeping feet healthy and free from infection or injury, is exceptionally important. Dementia increases the risk of falls. Changes in sensory input, causing distortions to sound perception, sight and touch sensations; co-ordination difficulties and problems with balance and gait; alterations in interpretation of the environment, causing illusions and mis-perceptions, for example, of depth, colour, pattern and temperature; anxiety and loss of confidence; disorientation in unfamiliar places; changes to insight, judgement and ability to reason; poly-pharmacy and the side-effects of medication: these are all contributory factors.

To mitigate against the usual falls risks and these additional risk factors related to dementia, seeking help from a podiatrist on a regular basis is a good step to take.

Podiatrists are health care professionals who have been trained to prevent, diagnose, treat and rehabilitate abnormal conditions of the feet and lower limbs. They also prevent and correct deformity, keep people mobile and active, relieve pain and treat infections.

Podiatrists can give you advice on how to look after your feet and what type of shoes to wear. They can also treat and alleviate day-to-day foot problems, including: toenail infections, corns and calluses, verrucas, gout, athlete’s foot and heel pain.

A person living with dementia is just as likely to experience general health problems as a person who doesn’t have dementia, and yet the health issues of people with dementia are often overlooked.

It may be that the person cannot communicate verbally that they are experiencing pain and discomfort, or they may be unaware of a problem with their feet, such as a fungal infection or athlete’s foot, that could be detected by regular examination and treated successfully. With co-morbidities too, especially vascular disease, diabetes and rheumatoid arthritis, keeping feet in good order is critical.

In most areas of the UK, podiatry services will be available to people with a diagnosis of dementia free of charge through the NHS.

For people over 60, the advice of podiatrist, Emma Supple, on the NHS website is: “Go to see a professional for a foot MOT, every six months, and never put up with foot pain as if it is normal. Your feet shouldn’t hurt.”

Your GP will be able to make a referral and, in some localities, you can self-refer.

I accompanied my parents on a holiday a few weeks ago, a lovely week in north Norfolk and the weather was wonderful. My Dad spent the whole week limping and complaining that his foot was hurting and saying that he thinks he has an ingrown toenail. When I asked whether he had been to see the doctor or practice nurse about it, he replied: “No, it really isn’t worth bothering about, there’s nothing they will be able to do”.

My view – as you would imagine – is that it is always worth bothering about. I’ve made an appointment for him with the local podiatry service (and I shall go too). I am optimistic that the treatment will improve his quality of life significantly.

If you have experiences that are relevant to the theme of this blog, please do get in touch: barbara@liftedcare.com

I’d particularly like to hear about positive interventions from podiatrists for people living with dementia, and any challenges that are posed with seeking treatment for foot problems if you live with dementia or are caring for a relative with dementia. And if you are a podiatrist or chiropodist and have experience of treating people with dementia, please do share your tips for successful approaches.


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