Your podiatrist, chiropodist, or other healthcare professional may prescribe orthotic inserts to be worn at all times. These insoles are molded from a cast of your foot. They may be rigid, semi-rigid, or soft. Your healthcare professional will decide which type is right for you depending on your condition. They are often expensive. Cheaper over-the-counter insoles available at any drug store may be sufficient.
You should inspect your feet regularly, checking for changes in skin color or temperature, thickened or discolored nails, and any sign of a break in the skin or abrasion.
For older people with diabetes—who make up the greatest proportion of older adults with serious foot disorders—a thorough foot evaluation at least once a year is essential. Many older people—particularly those with diabetes—have impaired vision, making it harder to find small changes or skin problems. If your vision is not adequate, find a podiatrist or other trained healthcare professional who can check your feet regularly. If you have diabetes and your circulation to your feet is impaired or you have foot problems, you will likely need to see a podiatrist approximately every 3 months.
If you are in pain, always tell your healthcare professional promptly. Foot pain is not normal. Early attention to a problem may prevent a much more serious disability later.
Lifestyle & Management
To maintain healthy feet, follow the recommendations listed below:
- Inspect your feet regularly. If this is difficult, have someone else do it.
- Trim your toenails straight across, not at the corners or sides. Clippers may be easier to manage than nail scissors if your nails have thickened.
- Make sure that your shoes fit, and that there is wiggle room in the toe box (the front of the shoe). Go shoe shopping late in the day, after your feet have swelled from a day of walking, and fit shoes to your larger foot. Try them on while standing, and choose shoes that are at least half an inch longer than your longest toes. Remember that there is no such thing as “breaking in” shoes.
- Wear soft socks and stockings that are not too tight and have no irritating seams or bumps.
- Avoid walking in bare feet, even in the house.
- Wash your feet regularly and thoroughly, and dry them well. Several times each week, soak your feet in warm water to which you have added Epsom salts or a moisturizer. Apply skin cream often to dry skin on your feet and ankles.
- If you have diabetes, see your podiatrist at least once each year, and make sure to keep your blood sugar under control.
- Beware of medicated over-the-counter remedies for corns and calluses, which may do more harm than good.
- Never cut calluses or corns with a razor or other sharp tool.
- If you have numbness in your feet, use warm water to wash them and always check the temperature with your hand first. Avoid heating pads which may burn your feet.
- Do not sit with your legs crossed if your circulation is poor, since this restricts blood flow.
- Walking, bicycling, swimming, and doing simple foot exercises every day will help keep your feet in shape.
Diet and Exercise
If you have diabetes, the health of your feet depends a great deal on how well you can control your blood sugar. A healthy diet is crucial. Follow your dietitian or healthcare professional’s recommendations and eat plenty of fresh fruits and vegetables, complex carbohydrates rather than refined foods and sweets, and low-fat proteins. Make sure your fluid intake is adequate. Remember to take your medications at the right times if prescribed.
Regular, gentle low-impact exercise—especially walking, stretching, swimming and bicycling—will help keep the muscles, tendons, and ligaments of your feet flexible and healthy.
Foot problems can lead to:
- An increased risk for falls and fractures
- Reduced mobility, independence, ability to carry out daily functions
- Chronic pain
- Decline in general health due to restrictions on exercise
- Urinary incontinence during exercise (flat feet)
- Lower quality of life
- Higher risk of hospitalization and long-term care.
If you are a caregiver or family member looking after an older patient, you need to know how to do an adequate daily foot inspection, particularly for patients with diabetes, poor circulation, foot numbness, poor eyesight, or immune deficiency diseases.