Happy Hands and Feet

09/12/18

The elderly are particularly vulnerable to foot conditions due to poor vision and decreased mobility. Regular hand and feet maintenance can help prevent these health issues from developing, as well as boost your client’s self-esteem.

Even though carers are not to undertake ANY nail cutting, special attention can be taken to prevent infection, odour, and injury of a client’s hands and feet.

Clients with poor vision and decreased mobility are at risk of hand, foot or nail disorders and care of these areas can be administered during a personal care routine or at another convenient time.

In between manicures and pedicures, you could encourage use of home care products to maintain healthy hands and feet.


Hands
The stiffness and swelling that often go with hand pain can sap hand strength and diminish the ability to carry out routine functions, like buttoning clothes.  One common cause of hand pain is osteoarthritis. Hand pain can also result from nerve conditions or tendonitis.  

Exercises, splinting, injections or anti-inflammatories
There are a number of treatments for hand problems but exercises could help manage pain, retain hand function and avoid surgery. There are also hand splints, injections or anti-inflammatory drugs, although carers should always speak to the clients’ family, GP and/or physiotherapist before taking any action.

Hot and cold
Heat can loosen hand stiffness – washing hands in warm water or use of a hot water bottle may help.  Hand pain caused by an activity can be soothed using something cold – flexible gel pads or a bag of frozen peas (covered, of course).

Hand cream and sun protection
Encourage application of a rich hand cream every day, as often as needed. Hands are exposed to the sun most of the time without SPF protection, so to prevent more damage when outside, use an SPF 15-30 hand cream.

Use gloves when washing up
Constant washing and drying dishes can damage and dry hands and nails. Perhaps wear rubber gloves for washing up, and protective gloves for gardening.

Try a homemade nourishing sugar scrub
Simply mix together two tablespoons of olive oil or grape seed oil with two tablespoons of brown sugar. Gently rub the mixture into hands or feet, focusing on any calloused areas. Rinse under warm running water and pat dry for ultra-smooth, hydrated skin.


Nails
Dry or brittle nails? Nails that have strange dots or ridges? We have some solutions to help keep nails in the best condition.

Eat protein
Sources of protein, for example chicken, seafood, eggs, milk and yogurt, oats and nuts, form an essential part of a healthy diet, and will help hair and nails thrive.
 
Magnesium
To stay on top of magnesium levels, encourage clients to  eat lots of leafy, green vegetables, like spinach, spring greens or kale. A magnesium supplement could be taken, but, as always, check with the client’s family and/or GP first.

Ridges in nails?
Vertical ridges are simply a part of the ageing process and are harmless, though they may become more pronounced as one ages. Buffing can smooth these but avoid this if nails are dry or brittle.
 
Nail spooning
Iron deficiency can be indicated by 'spooning' of the nails, which means that they dip in the middle instead of having a regular convex shape. If the client's nails are 'spooning', an iron supplement may be required, again check with the family and GP if appropriate.

Dry nails
If nails are flaking, perhaps apply a little olive oil directly to them to massage in, or invest in a good hand and nail cream.

Nail polish
Remember to give nails a regular break from polish and use an acetone-free nail polish remover. Nails may become discoloured if a bright colour nail varnish is used. A base coat provides a barrier between the nail and the colour and keeps the nail from drying out.
 
Bitten nails?
Wearing thin gloves at home can help stop a nail-biting habit. Or to discourage the habit, wear a hairband on the wrist to distract or use as a visual aid to stop subconscious nibbling!
 
When to see a doctor
Consult the doctor for underlying health problems, if nails are ridged horizontally, have consistent pitting or dents, large brown areas, dark vertical stripes or are completely white. Skin, hair and nail supplements can be worth taking, especially if prone to weak, splitting nails. But remember supplements need taking regularly for at least three months, as results will not show straight away, and ALWAYS check with your client, the client’s family and their GP before recommending any supplements.

Age UK provides local nail-cutting services and private chiropodists can be found online.


Taking care of your client's feet
The elderly are particularly susceptible to foot problems due to poor vision and decreased mobility.

Age takes its toll. The skin thins, joints may stiffen and feet become more vulnerable to the cold. The best advice is to visit a professional chiropodist for a ‘foot MOT’ every six months and never put up with foot pain as if it is normal. Feet should not hurt.

It is considered best practice that toenails should be cut by a trained chiropodist because infection can occur via cuts to the toe. This is a particular risk for those with diabetes.

Check
Disposable gloves should be worn to carefully check all skin surfaces and areas between toes at regular intervals, as feet are prone to contagious fungal infections.

Wash feet often and dry well
Keep feet clean by washing them regularly in warm soapy water, but do not soak them, as this might destroy the skin's natural oils.  Dry thoroughly, especially between the toes where fungal infections, such as athlete's foot, can develop.

Moisturise
If skin is dry, apply moisturising cream all over the foot, except for between the toes, which should be kept dry and clean to prevent fungal infections developing. You can gently remove hard skin and calluses with a pumice stone or foot file – but do take care, as skin can grow back harder.

Shoe shop in the afternoon
Feet swell as the day goes on, generally due to gravity, but also for many other reasons. If shoes fit in the afternoon when feet are at their largest, you can be assured they should always be comfortable. Wide fitting, sensible shoes are also best, not open-toed sandals.

Photograph by Juan Pablo Arenas

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