When providing foot care for a client, the nurse would perform which of the following?

Foot care can prevent mobility problems and social isolation; it is a crucial part of nursing care, particularly for older patients, who may be unable to care for their own feet

Abstract
Nursing and healthcare literature about foot care focuses predominantly on people who have diabetes. There is a lack of clarity about which health and social care professionals should provide foot care to patients who can no longer manage to carry out this activity of daily living but do not have diabetes. This article explains why patients may no longer be able to look after their own feet and aims to give health professionals guidance on foot problems, assessment and care, and advise them on when it is appropriate to refer patients for specialist advice.

Citation: Soliman A, Brogan M (2014) Foot assessment and care for older people. Nursing Times; 110: 50, 12-15.

Authors: Alison Soliman is Namaste Project lead at Central London Community Healthcare Trust; Mark Brogan is an independent podiatrist.
This article has been double-blind peer reviewed
Scroll down to read the article or download a print-friendly PDF including any tables and figures

Diabetes Foot Care Guidelines

Diabetic foot care is essential as diabetes can be dangerous to your feet—even a small cut can produce serious consequences. Diabetes may cause nerve damage that takes away the feeling in your feet. Diabetes may also reduce blood flow to the feet, making it harder to heal an injury or resist infection. Because of these problems, you may not notice a foreign object in your shoe. As a result, you could develop a blister or a sore. This could lead to an infection or a nonhealing wound that could put you at risk for an amputation.

To avoid serious foot problems that could result in losing a toe, foot or leg, follow these guidelines.

Inspect your feet daily. Check for cuts, blisters, redness, swelling or nail problems. Use a magnifying hand mirror to look at the bottom of your feet. Call your doctor if you notice anything.

Bathe feet in lukewarm, never hot, water. Keep your feet clean by washing them daily. Use only lukewarm water—the temperature you would use on a newborn baby.

Be gentle when bathing your feet. Wash them using a soft washcloth or sponge. Dry by blotting or patting and carefully dry between the toes.

Moisturize your feet but not between your toes. Use a moisturizer daily to keep dry skin from itching or cracking. But don't moisturize between the toes—that could encourage a fungal infection.

Cut nails carefully. Cut them straight across and file the edges. Don’t cut nails too short, as this could lead to ingrown toenails. If you have concerns about your nails, consult your doctor.

Never treat corns or calluses yourself. No “bathroom surgery” or medicated pads. Visit your doctor for appropriate treatment.

Wear clean, dry socks. Change them daily.

Consider socks made specifically for patients living with diabetes. These socks have extra cushioning, do not have elastic tops, are higher than the ankle and are made from fibers that wick moisture away from the skin.

Wear socks to bed. If your feet get cold at night, wear socks. Never use a heating pad or a hot water bottle.

Shake out your shoes and feel the inside before wearing. Remember, your feet may not be able to feel a pebble or other foreign object, so always inspect your shoes before putting them on.

Keep your feet warm and dry. Don’t let your feet get wet in snow or rain. Wear warm socks and shoes in winter.

Consider using an antiperspirant on the soles of your feet. This is helpful if you have excessive sweating of the feet.

Never walk barefoot. Not even at home! Always wear shoes or slippers. You could step on something and get a scratch or cut.

Take care of your diabetes. Keep your blood sugar levels under control.

Do not smoke. Smoking restricts blood flow in your feet.

Get periodic foot exams. Seeing your foot and ankle surgeon on a regular basis can help prevent the foot complications of diabetes.

Why choose a foot and ankle surgeon?

Foot and ankle surgeons are the leading experts in foot and ankle care today. As doctors of podiatric medicine – also known as podiatrists, DPMs or occasionally “foot and ankle doctors” – they are the board-certified surgical specialists of the podiatric profession. Foot and ankle surgeons have more education and training specific to the foot and ankle than any other healthcare provider.

Foot and ankle surgeons treat all conditions affecting the foot and ankle, from the simple to the complex, in patients of all ages including diabetes. Their intensive education and training qualify foot and ankle surgeons to perform a wide range of surgeries, including any surgery that may be indicated for diabetic foot care.

For more tips on taking care of your feet if you suffer from diabetes, watch the animated video Foot Care for Those Living with Diabetes.

Which assessment does the nurse check first before providing special oral care to the client?

What is the priority concern when providing oral hygiene for a patient who is unconscious?