Over the past 10 years, there has been a significant increase in the population of seniors over the age of 65. Current statistics from major western countries vary from 15% to 18% of the population. This is a growing segment for pedicures since 90% of this population has one or more foot-related problems. Senior and geriatric clients have a higher risk for certain conditions. Understanding the changes in this age group is essential to being able to service their needs adequately. Recognizing and understanding changes and problems with the foot and lower limb will help to meet their needs.
These changes include issues with the following:
- Circulatory system
- Skin and nail changes
- Structural changes and deformities
- Other senior concerns
It is not uncommon for seniors to experience problems due to normal wear and tear on their feet. In addition, the number of people with chronic diseases such as Type 2 diabetes, thyroid conditions, cancer survivors etc., is steadily increasing, particularly in the over- 65 age group. All the more reason these clients need special attention and understanding in order to modify a pedicure for their specific needs.
Chronic Venous insufficiency (CVI) is the most common vascular condition, manifesting with the presence of spider veins, distended capillaries, varicose veins, foot and ankle edema, lack of hair growth on legs and toes, and thin, often discolored, shiny skin. This is caused by diminished venous return flow and impaired elimination of metabolic waste. It typically causes decreased sweat production contributing to dry skin. Poor circulation can also make a client more susceptible to the development of ulcers from wearing the wrong shoes, socks, or other scraps bangs and abrasions.
Peripheral Vascular Disease in the lower legs (PVD) is due to the narrowing of the blood vessels that become damaged, leading to ischemia (lack of blood supply). The resulting diminished blood flow to the feet always leaves a client at risk for infections and ulcers.
Peripheral neuropathy is a condition which is frequently seen in seniors, particularly those with Type 2 Diabetes. Symptoms may include tingling, burning, numbness as well as loss of sensation to touch and temperature.
Skin and Nail Changes:
Due to metabolic and circulatory issues, the skin becomes thin and fragile leaving it very susceptible to injury and infection. The skin on the feet often becomes dry and rough making them susceptible to infection through micro-lesions. Corns and calluses may be prevalent on pressure points causing discomfort and possibly pain when walking. Loss of fat pads on the ball of the foot is typical with aging feet potentially causing pain. Nails frequently become dark and thickened and often have onychomycosis with separation of the nail plate from the nail bed.
Structural Changes and Deformities:
Bunions, toe deformities such as hammer toes and heel spurs can cause pain and can results skin problems such as corns and calluses. Feet widen with age and not everyone changes their shoe size accordingly. This can lead to pressure on the toes and metatarsal heads. Poorly fitting shoes can make problems worse and also lead to immobility as people walk less. Use of a cane or walker will help with walking when there are knee and hip problems or following surgery or injury to the back or legs. Arthritis causes inflammation, loss of function and pain in the joints, again diminishing mobility. With advancing age, people have greater difficulty reaching their feet, are less active and less agile which makes it difficult for them to care for their own feet or put on proper shoes.
Other Senior Concerns:
Poor eyesight can lead to the client not seeing injury or change in the skin on the feet. This is worse in the presence of neuropathy. Clients should be encouraged to check the bottom of their feet in a mirror on the floor regularly. Medications influence the body’s metabolism, possibly affecting the skins’ normal function, further leading to dry skin. Medications like blood thinners may leave the skin of feet at risk of injury.
- Complete a thorough skin and nail assessment before starting the pedicure
- Gently cleanse the foot for 3-5 minutes in warm, not hot water using the Footlogix Foot Soak
- Pay attention to the skin between and under the toes
- Take care when moving the ankle and toe joints so as not to push beyond their range of motion
- Use Footlogix Callus Softener before working on calluses and nails
- Take care when trimming nails and when skin is fragile. Reduce thick nails with an electric file for comfort
- Gently clean the nail groove and free edge
- Use a Footlogix mousse product for a gentle foot massage and hydrating the skin
- When massaging the leg, use Footlogix Massage Formula and gentle effleurage working upwards towards the knee