Foot health – how much consideration have you given it? If your answer is very little, we completely understand why. You’ve probably come to accept foot health is just a toenail trim for your residents; treating it as a non-essential add-on pampering treatment, because let’s be honest, that is all most care home residents currently receive from their foot health provider. But what if we were to tell you quality foot health treatments administered by regulated, qualified professionals, will improve your resident’s quality of life, prevent falls and hospitalisations, and can even reduce the chances of premature death. Would you give it more consideration then?

Care Home Podiatry are launching the Campaign for Better Foot Health to give you all the free training, guidance and resources you’ll need to give foot health the attention it rightfully deserves. Our mission is to improve care home standards to ultimately improve care home residents’ lives, because the truth is both care home providers, and most importantly care home residents have been shortchanged for too long. We firmly believe everyone should have access to #betterfootcare. We’d love for you to engage with the Campaign for Better Foot Health to make this a reality.

Part One: Why is foot health so important for people living in care homes?

“Our care home has got foot care covered, someone pops in and cuts all the residents toe nails every 8 weeks”

….Sound familiar?

If your visiting foot health provider is simply cutting your residents toenails, both you and your residents are getting shortchanged. You, and most importantly your residents, deserve better!

Poor foot health can lead to increased risk of amputations, gangrene and even a higher mortality rate than prostate, breast and colon cancers! But don’t take our word for it, we’ve pulled together all the research and data on the implications of poor foot health in the post below. Have a read and then tell us if you think it’s time to demand #betterfootcare

Foot conditions are common

The truth is most care home residents will have some foot health concern. A big study of older adults1 found;

  • A quarter of adults over the age of 65 live with foot pain
  • 75% of older adults suffer a nail condition
  • 60% have toe deformities
  • 58% have problematic callus or corns
  • Bunions, cracked skin, ingrown toe nails, fungal infections and ulcerations (wounds) are also common.

You might be thinking these sound pretty minor, and yes, they can be, but they can also be early warning signs of more serious problems. For example, corns and callus are caused by pressure on the skin – exactly the same thing which causes pressure sores and foot ulcers. Having a qualified, regulated professional in place to catch these problems early helps prevent more damaging or dangerous problems for your residents.

Learn more about how a Podiatrist would treat simple nail and skin problems here.

Foot problems reduce quality of life

It sounds obvious to say, but having a problem with your foot really does affect your quality of life. Studies have shown that foot pain significantly reduces people’s ability to walk, their ability to carry out physical activities and to interact socially2.

The impact of this cannot be overstated – the importance of exercise and social interaction on the health and well-being on care home residents is well known, and a treatable problem such as foot pain should not be getting in the way of these essential elements of care home life.

Foot problems are linked to falls

Half of all care home residents fall every year, some more than once. Falls are one of the most common causes of unplanned hospitalisation, hip fracture and death in older adults living in care homes3, so understandably managing them is high on the agenda for care home managers and care coordinators.

Recent scientific studies have shown that having a foot problem greatly increases your chance of having a fall. Foot pain, toe deformities and bunions are particularly linked to an increased falls risk4. Because of this link we strongly recommend that foot checks are part of routine falls assessments carried out by care homes.

Find out how Care Home Podiatry can help with your falls prevention work here.

Diabetic foot problems are serious

This is where the amputations, gangrene and the higher mortality rate than lots of cancers can come in. Shockingly 1 in 4 care home residents currently has Diabetes6, with numbers expected to significantly increase over the next 30 years. Foot problems are one of the most serious issues faced by people living with Diabetes. If your visiting foot health provider is just cutting your residents with Diabetes toenails, it might be time to reconsider your foot care provider.

Poorly controlled Diabetes can cause the health of residents feet to significantly deteriorate:

  • Loss of feeling – Diabetes can lead to nerve damage which causes tingling, burning pain and permanent loss of feeling in residents feet.
  • Decreased circulation – Diabetes can contribute to the build up of blockages in blood vessels, meaning less blood gets through. Healthy blood flow is essential to keeping bodily tissues alive.
  • Foot deformity – Feet can begin to change shape as a result of changes in the muscles of the feet and legs. This often starts with clawing of the toes and can progress to developing a high arched foot. These changes in shape make the foot more prone to rubbing in footwear and increase the pressure and friction on the sole of the foot when walking.

These changes then place people at high risk of very serious Diabetic foot conditions including:

  • Diabetic foot ulcers are wounds that can take months or even years to heal. Diabetic foot ulcerations can lead to infections, sepsis, the need for limb amputations and even death. Diabetic foot ulcerations have a higher mortality rate than breast, prostate and colon cancers7. Mortality rate within 5 years of a foot ulceration can be as high as 75%7.
  • Gangrene is caused where there is no longer enough blood supply to keep toes or feet alive and they start to turn black. In some cases surgery can be performed to improve circulation, but in most cases surgical removal (amputation) is required.

For more information check out Diabetes UK’s guide to Diabetic feet.

High quality Foot care is essential!

Hopefully this post has highlighted why foot care is so important to both you and your residents, especially if you’re aiming to provide the best quality care for your residents and achieve CQC outstanding. If you agree with us that it’s time for everyone to receive #betterfootcare then join the Campaign for Better Foot Health and make use of the free training, resources and guidance.

In Part 2 we will start uncovering what is wrong with the current standard of foot health provision across the care home sector and outline why it’s time for change. In 2019 The Care Quality Commission released the damning report “Smiling Matters” on the state of oral care in the care home sector – should foot health be next?

  1. Dunn, J.E., Link, C.L., Felson, D.T., Crincoli, M.G., Keysor, J.J. and McKinlay, J.B., 2004. Prevalence of foot and ankle conditions in a multiethnic community sample of older adults. American journal of epidemiology, 159(5), pp.491-498.
  2. López-López, D., Becerro-de-Bengoa-Vallejo, R., Losa-Iglesias, M.E., Palomo-López, P., Rodríguez-Sanz, D., Brandariz-Pereira, J.M. and Calvo-Lobo, C., 2018. Evaluation of foot health related quality of life in individuals with foot problems by gender: a cross-sectional comparative analysis study. BMJ open, 8(10), p.e023980.
  3. Rapp, K., Becker, C., Cameron, I.D., König, H.H. and Büchele, G., 2012. Epidemiology of falls in residential aged care: analysis of more than 70,000 falls from residents of bavarian nursing homes. Journal of the American Medical Directors Association, 13(2), pp.187-e1.
  4. Menz, H.B., Auhl, M. and Spink, M.J., 2018. Foot problems as a risk factor for falls in community-dwelling older people: a systematic review and meta-analysis. Maturitas, 118, pp.7-14.
  5. Sherrington, C., Fairhall, N., Wallbank, G., Tiedemann, A., Michaleff, Z.A., Howard, K., Clemson, L., Hopewell, S. and Lamb, S., 2020. Exercise for preventing falls in older people living in the community: an abridged Cochrane systematic review. British journal of sports medicine, 54(15), pp.885-891
  6. Sinclair, A.J., Gadsby, R., Penfold, S., Croxson, S.C. and Bayer, A.J., 2001. Prevalence of diabetes in care home residents. Diabetes Care, 24(6), pp.1066-1068.
  7. Robbins, J.M., Strauss, G., Aron, D., Long, J., Kuba, J. and Kaplan, Y., 2008. Mortality Rates and Diabetic Foot UlcersIs it Time to Communicate Mortality Risk to Patients with Diabetic Foot Ulceration?. Journal of the American Podiatric Medical Association, 98(6), pp.489-493.