Do I really need to worry about my ageing parent’s feet? In a word – yes. Let’s be honest, our feet are something we tend to take for granted. They’re there, at the end of our legs, and mostly go unnoticed unless they ache after a long walk or develop a blister that reminds us of their existence. Older people’s feet, however, should not be taken for granted, and overlooking their feet can have debilitating consequences.
Have you cut your toenails recently isn’t a question you’re likely to think of asking your parent. It would probably seem a bit weird if you did. But, and it’s an important but, foot care for the elderly isn’t always prioritised as much as it should be either by older people themselves or those looking after them. What you should be asking on a regular basis is whether they’ve had a professional foot check lately and encourage them to go if they haven’t. Why?
Older men, often more so than women, are notoriously bad at taking care of their feet and that can lead to serious health problems. A small wound on the foot of an elderly person suffering from diabetes for example, if left untreated, can lead to amputation. And that’s just one of the reasons why foot care for the elderly should be given greater importance than it usually is.
What happens to our feet as we age?
It’s a sad fact of life that the everyday wear and tear we put our feet through over the years starts to manifest in multiple ways as we age. In addition, general age-related changes, such as thinning skin or vision loss, and certain health problems, like diabetes or dementia, also impact the health of our feet and how well we are able to care for them.
The common problems older people have with their feet are:
- Fallen arches – Fallen foot arches are primarily caused by loss of tendon elasticity in old age. While it may not sound too serious, it can cause an increase in shoe size which, if it goes unnoticed and shoes are not changed, can provoke discomfort when walking as well as creating painful foot sores.
- Bunions – Bunions, a bulge on the lower joint of the big toe, are often hereditary and many young people have them, but they can also develop in later life. A bunion can be painful or become inflamed affecting the way an older person’s shoe fits or their general mobility.
- Corns – Corns are an area of thickened skin that can form on the sole of the foot or the top part of a toe. They’re painful and can make walking uncomfortable.
- Cracked heels – Cracked heels develop when a build up of hard skin is allowed to accumulate on a person’s heels. The hard skin can develop deep cracks which can make wearing shoes, no matter how soft, painful.
- Fungal infections – Older people are more vulnerable to fungal infections which can affect toenails and the areas between their toes
- Fat pad atrophy – Fat pad atrophy is a loss of the soft padding on the soles of the feet. When the padding is diminished, a person’s feet become more sensitive.
- Deformation of toes – Diseases such as arthritis and rheumatism can cause toes to twist and become deformed making getting a good fit on shoes difficult and walking excruciating.
Foot problem signs to keep an eye out for
Spotting that your elderly parent is having problems with their feet isn’t easy, especially if they aren’t living with you. When you visit them in their home, they’ll more than likely be wearing shoes or slippers rather than have their bare feet on display. And they may be resistant to exposing their feet for you to check simply out of pride or embarrassment.
If you can convince them to show you their feet, you should examine and check for the following:
- Skin Condition: Look for any signs of discoloration, dryness, redness, swelling, or irritation. Check for cuts, scrapes, blisters, or any open sores, as these can become more serious for elderly people.
- Corns and Calluses: Check for these particularly between the toes and on the soles.
- Toenails: Look for overgrowth, ingrown nails, or fungal infections.
- Deformities: Look for any deformities of the toes or feet, which could be bunions or hammertoes.
- Swelling: is there any swelling in the feet or ankles? If so this could indicate circulation problems or other underlying health issues like lymphodema.
- Temperature: Do their feet feel warm or cold? Cold feet might indicate poor circulation.
- Pain and Sensation: Check if they are experiencing any pain, numbness, tingling, or loss of sensation in their feet. These could be signs of nerve damage or other issues.
If you’re not able to closely inspect their bare feet, there are some telltale signs though that you can look out for that might indicate your parent is having foot problems and they are:
- They’ve started hobbling around the house rather than walking normally
- They seldom where shoes, but prefer to spend the day in slippers
- They’re disinclined to go out for a walk or to go shopping
- They’ve become more prone to tripping or falling
- There’s a fusty, unpleasant smell coming from their feet
- They mention that their feet ache or their corns or bunions are playing up
Why your ageing parent should regularly see a footcare specialist
The majority of elderly people lose flexibility and experience vision loss to some degree as they age. This can make a simple task like cutting their own toenails or moisturizing their heels difficult if not almost impossible. Yes, you could do it for them, if they’re okay with that, but they should also go to a podiatrist – a qualified foot care specialist. Why?
Podiatrists (your parent may refer to them by the old-fashioned name, chiropodists) are skilled in corn removal, the treatment of ingrowing toenails and can also spot the signs of diabetes and poor circulation just by examining someone’s feet. They are also able to treat or alleviate many other foot problems people can develop in their later years.
Even if your parent sees an NHS podiatrist because they have diabetes or foot-related mobility problems, when it comes to cutting and caring for toenails, a session with an NHS podiatrist won’t be nearly as thorough as a private treatment.
Private podiatrist appointments are longer and more comprehensive, and include thinning thickened nails (which usually cause discomfort in the elderly), removing cuticles, and thoroughly removing and smoothing hard skin.
For more basic footcare, Age UK and Age Concern are two charitable organisations for the elderly that hold toenail cutting and foot care clinics on a regular basis. There are also pedicurists in most areas of the UK that are willing to make home visits if your parent is unable to attend a clinic or salon.
Having their feet cared for by a podiatrist will help your parent maintain their mobility longer as well as be comfortable and pain free. It’ll also help them stay more stable on their feet and help prevent falls so even if they have to pay for foot care, it’s worth every penny. Not only that, it can feel like a nice, relaxing and luxurious treat if you book them in somewhere like a Margaret Dabbs Foot Clinic.
As Nikoletta Louka, a principal podiatrist at one of the Margaret Dabbs clinics in London, explains “Caring for the feet of our elderly clients is not just about addressing physical discomfort – it’s about restoring their sense of dignity. When an elder person comes in for their first medical pedicure, they often arrive feeling self-conscious and embarrassed about their feet. But when they leave, they’re like a different person. It’s incredibly rewarding to see the transformation in their feet, and to watch them walk out feeling revived and confident again.”
What happens at a podiatrist appointment?
A typical appointment with a podiatrist can last anywhere from thirty to ninety minutes. What will happen depends on what problems your parent is experiencing with their feet. The podiatrist will conduct an initial assessment which includes:
- Asking about a person’s medical history – your parent should take a list of any medications they are taking with them.
- A visual examination of feet and lower limbs
- A physical examination of feet and lower limbs
- An examination of footwear – your parent should take the shoes they wear the most often
- A discussion about the diagnosis
- A discussion about treatment
- Recommendations for general foot care
It may be that once the podiatrist has made their initial examination, your parent will need to attend regular appointments for treatments. Once a course of treatment has been completed, they should then attend six-monthly appointments for revision and prevention purposes.
Even if your parent isn’t experiencing any problems with their feet, going for a general foot check and medical pedicure with a podiatrist once or twice a year is still a very good idea.
As Nikoletta underscores from her professional experience, “I can’t emphasize enough how important footcare is for elder people. Removing thickened nails, corns or calluses enables them to walk comfortably, which means they are more likely to get out and about and maintain their social life, which supports their brain health. A lot of times I’ve noticed that when a patient becomes immobile, they lose a lot of their social life and deteriorate much faster than they should. I witnessed a massive decline in my patients over the pandemic, as they were stuck at home with no one to talk to and very little exercise.”
How to find a good podiatrist
There are several ways to search for a reputable podiatrist in the area where your parent lives. The obvious one to start with is getting recommendations from your parent’s local friends or neighbours.
Your parent may well already know an older person who has problems with their feet and who visits a podiatrist on a regular basis. And you may find your parent more willing to attend podiatrist appointments if they know someone who already goes there.
If you don’t have any luck with this route, you can also ask your parent’s general practitioner for recommendations on local podiatrists specialising in foot care for the elderly. Alternatively, you can search online for podiatrist services in yours or your parent’s local area via the NHS website. You just need to enter the first part of a postcode into the NHS podiatrist search engine and you’ll be presented with a list of qualified podiatrists who are practising nearby.
There’s also a similar podiatrist search engine on the Royal College of Podiatry’s website. You will need to enter a complete postcode or the name of a town or city to get details of practising podiatrists near you. This webpage is also excellent if you want to check a podiatrist’s credentials or find out if they make home visits.
How much does going to a podiatrist cost?
It’s worth shopping around for podiatrists as prices can vary greatly from place to place and between practitioners. Initial assessments with a private podiatrist can cost anywhere from £40 to £140.
Treatments or follow up appointments are usually charged separately and can vary from £30 for toenail trimming to £45 for corn removal and from £300 up to £650 for ingrowing toenail operations. Other treatments, such as those for fallen arches or fat pad atrophy, depend on the severity of the condition and the recommended solution of the podiatrist.
Encouraging good foot care in the elderly
Encouraging good foot care in the elderly is so much more than getting them to trim their toenails and moisturise their feet once in a while, and trips to a podiatrist from time to time are not enough on their own. Good foot care includes:
Foot hygiene: Ensure they are washing their feet regularly, drying them thoroughly, and applying moisturizer to prevent dry skin. It’s important they also change their socks or tights daily, and if they get damp or wet. A once-weekly home foot spa is great for keeping hard skin under control too.
Foot and ankle exercises: Introduce them to simple, non-strenuous foot and ankle exercises that they can do while sitting in a chair – even just propping their feet up on a stool or low table, wiggling their toes and pointing and flexing their feet can make a difference.
Correct footwear: Having the right footwear that supports your feet when you’re older is essential. That doesn’t mean your parent needs to forego fashion trends entirely, but a cheap pair of sandals from a bargain retailer isn’t what they should be going shopping for. Look for footwear that’s labelled as orthotic. This type of footwear is designed to provide extra support and comfort for elderly feet. Also look for shoes that are not too tight around the toes, as feet tend to get wider with age. One retailer of orthotic shoes is Clarks and while that will be a name your parent is familiar with, there are many more fashionable brands that have good, comfortable shoes for older people too, including Ecco, All Birds, Skechers.
Make foot care a priority and you’ll be helping your elderly parent to maintain their mobility longer and lower the risk that they’ll suffer a fall. Make sure they get regular yearly or six monthly check-ups with a qualified podiatrist and it will help keep their feet in tip-top form and ensure any issues are spotted before they become too problematic.
- Can elderly get foot care on the NHS?
Footcare is only usually provided by the NHS to patients who have certain health conditions such as diabetes, vascular disease or rheumatoid arthritis. Contact their GP to find out if they are eligible.
- What is the difference between a podiatrist and a chiropodist?
There is no difference between a podiatrist and a chiropodist. Podiatrist is a more modern term for a foot care specialist while chiropodist is now considered a little old fashioned.
- How much does it cost to see a podiatrist in the UK?
How much it costs to see a podiatrist depends on several factors. One, where you live in the UK, north is cheaper than south, and what treatment you will need. Initial assessments vary from £40 to £110 while treatments can cost anywhere from £30 to £650.
- What conditions do podiatrists treat?
Podiatrists treat a range of foot problems including corns, callouses, ingrowing toenails, fungal infections, fallen arches and fat pad atrophy.
Your terminology toolkit
Podiatrist – A foot care specialist
Chiropodist – The old-fashioned term for a podiatrist
Orthotics – The medical term applied to devices used for the alleviation of bone pain