Geriatric podiatry in Barcelona

What foot care can be done at home?

To keep the feet healthy, MedlinePlus recommends examining them regularly, wearing comfortable shoes that fit well, washing them every day with soap and warm water and cutting the toenails straight across, without cutting them too short.¹ If you have diabetes and thick nails, cutting them yourself is not an option (see the next section).²

Swelling of the feet and ankles that does not hurt is common in older people and is due to a build-up of fluid (oedema). It is more frequent with overweight, advanced age, varicose veins or a lot of time spent standing, and it can also be due to heart, kidney or liver failure or to certain medicines.³

The following are suggested as home care for swelling:³

• Raising the legs above the level of the heart.³
• Exercising them.³
• Following a low-salt diet.³
• Wearing compression stockings, taking breaks when travelling and avoiding tight clothing on the thighs.³

Do not stop taking any medicine without discussing it first with your professional.³ The sources cited do not detail the drawbacks of compression stockings, so ask before using them.

What is better treated by a podiatrist and not done yourself?

If you have diabetes, thick toenails are best treated by a podiatrist. With diabetes you should not try to cut them yourself; if they are also thick and discoloured, possibly due to fungus, you should not either, and if your vision is not good or you have little sensation in your feet, you should go to a podiatrist to have them cut.²

With diabetes, most people should have corns or calluses treated by a podiatrist. If the podiatrist allows it, you can gently use a pumice stone after showering, but never medicated pads or shaving or cutting calluses at home.² The risk of doing it yourself is a wound: a small wound can end up as a diabetic foot ulcer if it becomes infected.²

The sources cited do not say how to treat thick nails or calluses if you do not have diabetes, or how often to see the podiatrist, nor do they compare paid consultations or treatments, so there is no evidence here that favours any paid option.

Which changes in an older person's feet should be checked?

A change in an older person's feet should be checked when there are sores, redness, warmth, fever or new swelling.²³ These are the signs:

1. Diabetes: if you have diabetes, contact your professional immediately about any foot problem, without trying to treat it yourself.²
2. Wound or ulcer on the foot: sores or cracks; with diabetes, a small wound can end up as an ulcer if it becomes infected.²
3. Signs of infection: a swollen foot or leg that is red or warm to the touch, or fever.³
4. New swelling, or swelling that has got worse, in only one leg.³
5. Swelling that gets worse with heart or kidney disease, or that home care does not relieve.³
6. Tingling, a burning sensation or pain in the feet if you have diabetes.²
7. Difficulty breathing or chest pain: call the emergency number.³

Swelling that does not hurt is common in older people, but these changes should not be ignored.³

This list is a guide, but it does not replace an assessment by a healthcare professional.