Our feet support our whole body. It therefore makes sense to take good care of them. It affects our mobility and to a significant degree, our motivation to walk, exercise and stay active. As we know, physical activity and regular exercise is encouraged at any age, including older adults living with symptoms of dementia. Therefore, foot care is an important aspect of dementia care.
Appropriate and comfortable footwear, such as, wearing the right size and fit as well as non-slippery shoes have many benefits including of course, preventing an older adult from slipping or falling. A fall for an older adult can be detrimental, devastating and deadly.
Ideal footwear has the ability to promote an active lifestyle and increased socialization. If a person living with symptoms of dementia shows a decline in interest going out or seemingly afraid to move or walk, it’s important to check their footwear to investigate. As a reminder, “there’s always a reason behind the behaviour”.
Do you know that the recommended frequency for replacing running shoes is every 500 miles or approximately 1 million steps? Something to note is that approximately, 10 minutes of walking is equivalent to about 1,000 steps. Therefore, replacing footwear, when necessary, even when they still “look new” is ideal for a person’s well-being.
A tip for caregivers is to consider buying a couple of pairs of shoes or more as “back-ups” of the shoes they already have, so that when it comes time to replace them, it will not be as confusing or a dramatic change for the person with dementia. This idea could reduce a struggle to convince them to wear the newer shoes.
Basic Tips for Healthy Feet for People Living with Symptoms of Dementia
Here are some basic tips to help caregivers assist the person they are caring for:
· Choose appropriate footwear. Whenever possible, seek the advice of an expert, like a podiatrist or an Occupational Therapist (OT) in selecting the right footwear for the person you are caring for.
· Check the footwear. Inspect their shoes or slippers on a regular basis to check if there are any sharp or uncomfortable objects such as a pebble stuck inside or on the soles of the shoes or slippers. Oftentimes a person in later stages of their dementia may not notice nor have have the ability to remove the pebble and instead continue to wear the shoes/slippers with this discomfort.
· Inspect the person’s feet regularly. Check for injuries, cuts, calluses, discoloration, dryness, cracks and even foul odors. Seek support from a professional to address any of these issues.
· Daily foot care. Feet should always be pat dry after a shower or a bath, particularly, in between the toes, before putting on their socks or shoes. Feet that have not been properly dried can cause fungal infections. Another great tip is to make sure that socks are changed regularly, particularly, during the summer months when it is hot as some individuals living with dementia might not remember to do so.
· Cut toenails regularly. Letting the person’s toenails grow long can increase the risk for injury. Toenails can get snagged in the socks and cause discomfort, even pain, when wearing shoes. Similarly, cutting toenails too short, can likewise cause discomfort and traumatize the person from having their toenails cut in the future. Having a professional foot care nurse perform this duty would be ideal, especially if they have additional training in dementia care.
· Avoid shoes that can trigger agitation. Depending on the stage of dementia, we may want to choose footwear that could reduce agitation. For example, shoelaces may be a cause of confusion and frustration for someone with dementia. In these cases, purchasing a slip-on sneaker or ones that have a velcro strap may be a better option.
· Treat the person to a relaxing and healing foot spa and massage. This can be a good treat for someone (or anyone) who enjoys this type of relaxing service. For example, a foot soak and/or applying a moisturizer. It can also be a good form of social and bonding activity that we can do with the person we are caring for. If done regularly, this can be an activity that they can look forward to as a treat which can help increase their trust towards you and support their overall physical and mental well-being.
One final note to keep in mind is that if the person you are caring for is not able to effectively communicate as they used to, we must always keep in mind that there is a person behind the dementia who can still feel. They may still want to look good and be presentable and they also deserve to be comfortable…this includes their foot care.
As caregivers for people living with symptoms of dementia, there are several ways we can help support and maintain their well-being and likewise, make our role, as their primary caregivers, less stressful and more fulfilling. Footcare is an important, yet, possibly, one of the more neglected aspects of dementia care. Let’s make sure that this becomes a part of their complete care plan.