The Importance of Nursing Foot Care for Elderly Parents

shutterstock_3306989Increasingly, McDermott Footcare receives out-of-town and out-of-province enquiries from people requesting nursing foot care services for their parents or other family members who live in Toronto, Canada.  This indicates families’ close involvement in the care and well-being of their elderly parents.

Often, people express concerns that mom and dad are unable to care for their feet because of these common underlying factors:

  • a diagnosis of diabetes
  • arthritis that makes self-care challenging
  • limited mobility
  • poor eyesight
  • inability to reach their feet
  • a diagnosis of Alzheimer’s Disease or dementia
  • other medical conditions that limit self-care
  • the use of blood thinner medication
  • thickened, fungal toenails that are difficult to clip

In the elderly population, fungal nail and skin conditions as well as painful corns, calluses and structural changes are common.  An important consideration to note is that parents may be reluctant to show their feet or talk about foot-related issues because they are embarrassed by the appearance of their feet.  Patience and understanding are needed when discussing these issues with elderly parents since mom and dad hesitate to show their feet, even to their adult children. Very often a new client will say to me: “oh nurse, you’ve never seen feet as ugly as mine.”   Mom and dad need reassurance that they can seek nursing foot care without embarrassment or fear of judgement.

If mom or dad express pain and difficulty when walking, gently ask them about their feet.  In most cases, maintaining regular nursing foot care visits will resolve their concerns and enable them to remain active and on their feet.

Copyright Terry McDermott. May not be reproduced in whole or in part without permission of author

Summer Foot Care Tips For Diabetics (And Others)


In the words of George Gershwin, from his opera, Porgy and Bess, “Summertime, and the livin’ is easy…..”  It’s time to kick off our socks and shoes and feel the warmth on our hardworking feet.  It’s very tempting to walk about in our bare feet, enjoying  the softness of the grass and squishing the sand between our toes.

However, for people with diabetes and other people with decreased nerve sensitivity and circulation in their feet, walking barefoot could turn a pleasant summer day into a medical dilemma.  Diminished ability to feel different sensations in the feet as well as poor wound healing due to poor circulation can cause problems.

A person who cannot adequately detect sensations of pain will not be aware of cuts to their feet, especially the bottom and in between the toes.  It is not unusual for a diabetic patient to be unaware that they have developed a cut, splinter or other abrasion until someone, such a certified foot care nurse, detects the issue. By then, there is often the beginning of an infection which must be dealt with aggressively.  The existence of poor circulation, which goes together with poor nerve functioning, means that the body needs help fighting the infection.  Diabetics have a higher than average incidence of lower leg amputations.  Even the smallest infection can quickly become very aggressive.

Another reason it is never a good idea for diabetics to walk in bare feet is the decreased ability to feel changes in temperature.  The pavement as well as the sandy beach can be problematic if we are unable to detect how hot these surfaces can become.  It is easy to scorch and burn the bottoms of the feet without realizing it.  Even a minor burn can become a major infection.

Plantar wart from a public pool.

Without the protection of sandals or other appropriate footwear, it is possible to develop fungal, viral and bacterial infections from walking on public surfaces such as pool decks, saunas, change rooms.  Plantar warts, athlete’s foot and toenail fungus are the most common conditions that are picked up from these surfaces.

Because we tend to perspire more in warm weather, athlete’s foot is a common problem.  Again, in diabetics and others with nerve/circulation deficits, athlete’s foot must be diligently treated.  Athlete’s foot that is allowed to spread can cause abrasions and infection.  Read about why athlete’s foot is dangerous in diabetics and what to do about it here.

Don’t forget to liberally apply sunscreen to your feet when wearing sandals.  Skin cancer in the feet often goes undetected.  For a primer on skin cancer and the feet, as well as pictures of what different skin cancers look like, read here.

 We often develop dry, cracked heels in the summer because of the amount of activity we do and because of the effects of the sun and hot weather on the skin.  Here are 8 tips for dealing with dry, cracked heels.

As well, with our toes exposed, women enjoy the pampering of pedicures.  Be educated about getting a safe maniciure/pedicure, here.

Wear well-fitted sandals that support your feet. Check your feet daily, once in the morning and once in the evening.  If this is difficult to do, have someone check your feet for you or use a mirror held against the bottom of your foot to get a good view.

It’s easy to take care of our feet while we enjoy the beautiful weather.  Have a wonderful summer!

Copyright Terry McDermott. May not be reproduced in whole or in part without permission of author

Athlete’s Foot: What Is It? What To Do About It?

At McDermott Footcare, I see Athlete’s Foot on a fairly regular basis.  Here is a primer on what it is, how you get it, how to prevent it and how to get rid of it.

Athlete’s foot (a.k.a. tinea pedis) is caused by a skin fungus.  The skin fungus or dermatophyte is known as trichophyton rubrom.  A common name is ringworm, although it’s not a worm. Here’s what it looks like under a seriously high-powered microscope:

Tinea doesn’t limit itself to the feet.  Variations of tinea infections can show up on other parts of the body.  It is very contagious and can even be caught from cats and dogs.

What does Athlete’s Foot (Tinea Pedis) look like:

  • Most of the time, Athlete’s Foot is found between the toes, especially between the fourth and fifth toes.  It looks like scaling, flaky skin and you may notice some cracking (fissures) in the skin between the toes.  It may be itchy.   The flaking and itching may extend to the bottom of the feet.
  • It may progress to a moccasin-type outline, covering the same area that a moccasin shoe would cover.  You’ll see scaling, flaking, redness, a rash.  It may be itchy.
  • Much less common is Athlete’s Foot with open sores.  This may occur in people with immune – deficient conditions or diabetes.

How do I get Athlete’s Foot?

  • Tinea thrives on hot, sweaty feet that spend a lot of time in covered footwear, especially non-breathable shoes and socks.
  • Athlete’s Foot fungus is found on the floors of public swimming pools, saunas, locker rooms, washrooms, shower stalls.  Walking barefoot in any of these areas increases the chances of picking up the fungus.
  • Poor basic hygiene of the feet is another  cause.

How do I prevent Athlete’s Foot?

  • Daily washing and thorough drying of the feet, especially between the toes, is the first step.  Avoid moisturizer between the toes.
  • Wear sandals or other appropriate footwear in public swimming pools, saunas, locker rooms, shower stalls, washrooms.
  • Wear breathable shoes and socks.  See my McDermott Footcare page (above) on Socks and Shoes for some pointers.
  • Don’t share shoes.
  • Avoid sharing towels if you have Athlete’s Foot or with someone who has Athlete’s Foot.
  • Wash your hands thoroughly – at least 15 seconds – if you touch an infected area.  Be careful not to touch your face or any other part of your body or anyone else before thorough hand washing.

How do I get rid of Athlete’s Foot?

  • Mild, uncomplicated Athlete’s Foot can usually be cleared up without prescription medications.
  • Try a foot soak of 1/4 cup white vinegar with enough warm water just to cover your feet.  Soak for 15 minutes daily until the scaling, flaking, redness, itching are gone.  If you’d like, add a couple of drops of tea tree oil to the solution.  Dry your feet thoroughly after soaking, including between the toes.
  • Over-the-counter Athlete’s Foot powders work well.  Using a cotton ball,  lightly dust the powder over the affected areas.
  • Wear breathable, moisture-wicking cotton socks and breathable canvas or leather shoes.
  • As much as possible, avoid wearing nylon pantyhose.
  • You don’t have to get rid of your shoes.  Spray a solution of a few drops of tea tree oil or white vinegar and 1 or 2 ounces of water inside the shoes.  Air out the shoes.
  • If none of these suggestions solve the problem after a couple of weeks, or if the condition worsens, see your doctor.  She/he can prescribe an anti-fungal cream.

Copyright Terry McDermott. May not be reproduced in whole or in part without permission of author