Hand, foot & nail care for older adults

Advice around hand, foot & nail care for older adults

Taking care of nails, hands and feet is essential for anyone, but especially so for older adults who may have additional health issues. When something as simple as an ingrown toenail could affect mobility issues, the importance of hand and foot care cannot be overstated. Here, we are looking at why taking care of hands and feet is vital as you get older, some of the typical problems that can occur, how to look after nails, what symptoms to keep an eye out for, some other challenges that may come up as you age, and how a home visit or live-in care could help. At Home Instead, our aim is to help people age positively and in place by bringing expert care to their home. For nearly 20 years, we have been providing the highest standard of care, and creating industry-leading training programmes for our Care Professionals that are accredited by nursing and medical professionals. Today, we are the world’s largest global domiciliary care network, supporting over 100,000 older adults with personalised, tailored care at home. So whatever questions you have about hand, foot and nail care for older adults, we can help.

What are some common hand and foot problems older adults experience? 

There are a few common problems that tend to come up for older adults regarding the hands, feet and nails, but the ones that can become more of a cause for concern are usually issues with the feet. Some of the problems you may come across include things like:

Arthritis

61% of those aged 65 and olderlive with a musculoskeletal condition such as arthritis, and although there are different types of this condition, most are characterised by joint inflammation and pain, leading to limited mobility and dexterity. This could mean for older adults it is more difficult to check their own feet and hands, and they could have trouble walking and balancing, which could result in falls. 

Dry skin

While dry skin may not seem like a major issue for most people, in older adults, dry skin can become worse over time, leading to cracked skin and potential infections. Dry skin is common due to decreased oil production in the skin as we age, so maintaining an effective moisturising routine is important for older people. 

Nail issues

The rate at which nails grow decreases by around 0.5% per year from age 25 onwards, so for older adults, nails grow very slowly. Studies also suggest they can become thicker, more brittle, misshapen, and discoloured, so they require regular nail care. Onychomycosis (a fungal condition) is thought to be the most common nail disorder, but others include onychorrhexis (causing nails to split and become brittle, flaky or soft), and ingrown toenails (resulting from infrequent trimming). 

Bunions and corns

Bunions (hallux valgus) and corns (hyperkeratosis) are common issues experienced by older adults. They often develop from points of pressure and friction on the feet, and can be extremely uncomfortable when wearing shoes or walking around. A 2019 study found that one of the most common foot problems experienced were bunions, followed by toe deformities and nail issues.

Foot deformities and pain

Foot deformities (such as hammertoe) are common in older adults, and these can be present from an early age or can develop after an injury. However, many foot deformities and pain issues develop as a result of ill-fitting shoes, like high heels or footwear with pointy toes. Ensuring issues with the feet are corrected as soon as possible can avoid problems in future, so appropriate shoes and regular foot check-ups from a care worker or health professional are important.Addressing foot and nail issues through regular upkeep and any necessary medical interventions can help to improve comfort and maintain mobility in older adults. In particular, if you are caring for someone who lives with a long-term condition such as diabetes, chronic circulation issues or something else, regular checks are vital to ensuring good health. If you notice any potential problems, let the person’s doctor know as soon as possible so action can be taken if needed. Remember, studies have found that older adults may be unable to perform foot care themselves due to physical challenges and other factors, so if you are caring for an older person you may need to help them maintain healthy feet, hands and nails.

How can older adults take care of their hands, feet and nails? 

There are a few things older adults (or their caregivers) can do on a regular basis to maintain good health in their hands, feet and nails. These include:

• Moisturising skin regularly to prevent dryness or skin cracking 
• Trimming nails properly by cutting straight across the nail – never cut them too short as this can cause ingrown toenails
• Wearing sturdy, comfortable and supportive footwear that has been measured to fit the person’s foot shape – this can help to avoid bunions, foot deformities and more 
• Choosing shoes with high sides, low heels, and good grip to reduce risk of falls or slips, as well as avoiding going barefoot
• Washing feet and hands regularly to maintain good personal hygiene and avoid infections, transferring bacteria, and unpleasant odours
• Drying feet thoroughly after washing and always wearing clean socks to avoid conditions like Athlete’s foot 
• Using a pumice stone to soften hard skin or calluses 
• Regularly checking for abnormalities, injuries and any signs of underlying issues 
• Regularly exercising (if possible) to maintain good range of motion and dexterity 

Remember, if you are caring for an older loved one who is unable to check their own feet due to mobility issues, you should routinely examine their feet and hands for the aforementioned signs and symptoms. One of the things you may need to do on a regular basis for them is cut their nails, so here are a few tips that could help with this:

1. Soak the feet to soften skin and nails – this is helpful if nails are hardened 
2. Sterilise any instruments you plan to use, such as small scissors or nail clippers, to avoid infections 
3. Use the instrument to cut the nails horizontally across, never rounding the corners as this can lead to ingrown toenails 
4. Use a file to remove any rough or sharp edges 
5. Afterwards, remember to thoroughly wash and sanitise the instruments with soap and water to avoid bacteria lingering on them for next time 

Important: If your loved one has diabetes, it is extremely important to ensure that cutting their nails does not result in cuts on their feet, as these can lead to infections. Often using a nail file instead of clippers can be helpful to avoid any sharp instruments near the feet, but you may also wish to have regular podiatry appointments to cut nails safely instead. 

What other challenges do older adults have with hands and feet? 

As well as some of the common issues mentioned above, older adults can face specific challenges with their hands and feet due to arthritis, general pain, decreased sensation and more. Having reduced flexibility and strength can lead to difficulties performing tasks that require fine motor skills. For example, buttoning up their clothes, tying their shoelaces, or getting a glass of water. Similarly, those with foot issues may struggle to get up and down stairs, go out for a walk, or even put their shoes on without help.  It is important to keep an eye on your loved one’s foot and hand issues if you are caring for them, as even something that may seem insignificant and easy to deal with for the majority of people (such as an ingrown toenail) could become a major issue for an older person. This can lead to pain, discomfort, and reduced independence, and can result in stressful podiatry or GP appointments to deal with issues that have not been caught early. For these reasons, it is incredibly important to address any challenges your loved one is facing so their health and independence remains a priority.

How can home care help with hand, foot and nail care in older adults? 

While hand, foot and nail care may seem like the least of your priorities as a caregiver, it is an extremely important step in maintaining the health of your loved one. By enlisting the help of a home care service with skilled caregivers, they can help with tasks like:

• Maintaining a daily moisturising routine to ensure hands and feet remain hydrated, and prevent dryness and cracking
• Assisting with nail trimming to reduce the risk of ingrown nails and other conditions 
• Monitoring for signs of abnormalities or changes in the condition of the skin and nails
• Providing gentle massages to improve circulation and alleviate any discomfort

By providing personalised care in the comfort of the person’s own home, these simple hand, foot and nail care services can significantly enhance the quality of life of an older adult, and can promote their independence. In addition, live-in caregivers can offer dedicated support for many different types of care, and can help to maintain a personalised hand, foot and nail care routine for older adults while assisting with everyday tasks like washing feet, putting on socks, and ensuring shoes are comfortable and fit well – this is important for safe mobility in the home. At Home Instead, we offer fully personalised nail care that includes: 

• A pre-visit risk assessment for conditions like diabetes, haemophilia, poor circulation and more (our Care Professionals will not carry out nail care on patients with unstable diabetes, and will require approval from the person’s GP – patients with unstable diabetes will require specialist foot care from their GP)
• A Care Professional with an accredited nail cutting and care qualification
• Regular checks for signs of ill health, and if necessary, recommendations for clinical intervention (our service does not include chiropody, so our team will advise if a separate medical check-up is required) 
• Full pedicure service, including trimming, filing, and cuticle maintenance
• A full clean to refresh nails and ensure feet remain free from infections 
• A relaxing massage of the hands and feet to promote wellbeing 
• Optional moisturising and nail polish application (if desired) 

If you are currently looking to organise regular hand, foot and nail care for your loved one, our award-winning home care at Home Instead could offer the bespoke, person-centred care you need. You can reach out to the Home Instead team to discuss your needs and allow us to create a personalised package to support you.