Top Five Footcare Tips for Care Homes

It is important for people with diabetes to take good care of their feet as, if not properly managed, diabetes can cause damage to the feet which can lead to ulcers, limb loss, and other serious complications. By taking care of your feet, you can look out for early signs of diabetic foot problems and prevent conditions developing in the first place or getting worse.

According to the NHS Resolution report (Diabetes and lower limbs complications: a thematic review of clinical review of clinical negligence claims), up to 85% of diabetes related amputations are avoidable through early diagnosis of risk and complications, good preventative foot care and fast access to a specialist team when needed.

DUET diabetes have provided a range of practical foot care advice for care home managers and their teams to help prevent common diabetic foot problems, enhancing resident health and quality of life.

Five top tips for foot care for people living with diabetes

1.     Carry out daily foot checks - check feet daily for changes to the skin colour, skin hardness or thickness, changes to the toenails, and bruises, cuts, or any other wounds. Noting these symptoms can lead to early detection of any diabetes related foot conditions.

2.     Maintain clean and dry feet - thoroughly wash feet everyday using warm, soapy water and make sure they are completely dry afterwards, including between the toes.

3.     Moisturise (but avoid between toes) - use a suitable emollient (moisturiser), to keep the skin hydrated and healthy. Moisturise feet daily, but do not put cream or powder between the toes as this can clog the skin and cause problems.

4.     Make sure footwear fits properly - wear soft socks (bamboo is a good choice) and don’t go barefoot. When buying new footwear (whether shoes or slippers), ensure they are properly fitted so they do not rub or put any unwanted pressure on the feet, particularly if any deformity is present (specialist footwear suppliers are available). The best shoes are those that are broad fitting, have a rounded toe, have a heel height of 10-12mm (i.e. not completely flat), and are fastened to make sure they are not too loose and your foot doesn’t slide around while walking. 

Also, it is important to check that nothing has fallen into footwear before it is worn – someone with nerve damage may not feel that a small jam jar (the type you get at a hotel breakfast) may be in there by accident (a real example!).

5.     Be careful when cutting nails - accidentally cutting the skin can lead to foot problems. Trim nails so they aren’t too short and gently use a nail file to file any sharp corners. Seek advice and treatment for ingrown toenails or other nail conditions from a healthcare professional.  Arranging for a podiatrist or foot health practitioner to provide general footcare for residents living with diabetes is a good solution.

How does appropriate footcare help to prevent common diabetic foot problems?

Having diabetes does not automatically mean foot problems will occur.  Yes, diabetes can cause/exacerbate a variety of common foot problems, however they can potentially be prevented and managed through the right footcare.

●     Poor circulation in the feet can make it harder to fight infection. Wearing compression socks* and gently moving the foot/feet around can help boost the blood flow.

●     Skin changes such as dryness and hardness can cause the skin to peel and crack. By moisturising feet daily, the skin is more likely to remain hydrated, supple and healthy.

●      Nerve damage, also known as neuropathy, in the foot can reduce the ability to feel pain, which means a foot injury may not be felt. Protecting feet by wearing soft, stretchy, breathable socks and supportive shoes will help to prevent injury.

●     Untreated breaks in the skin (foot ulcers) can lead to infections and can potentially cause limb loss. By making sure all footwear fits properly can help prevent ulcers forming by avoiding rubbing.

●     Infections in the feet can potentially lead to limb loss. Regular diabetic foot checks can allow residents and care providers to reduce the likelihood of foot problems or stop them from getting worse, by ensuring that swift treatment is implemented. 

[*seek medical advice regarding the use of compression socks]

Why is footcare better for residents’ health and wellbeing?

Care providers should encourage residents to be part of their diabetes care plan and involve them in their diabetes care, provided they are able and interested in doing so. Through coaching, residents can gain the knowledge, skills and confidence to manage their own diabetes by performing their own daily foot checks, washing and drying their feet, and applying moisturiser. There are various aids available to assist1.  For those who are unable to physically manage their own care, it is still important for them to understand the care process and signs and symptoms to look out for.  It’s all about education, communication & collaboration!

Practical footcare advice for care home managers

Residents with diabetes should be given a comprehensive foot examination which is repeated annually as a minimum*. Individuals who have been identified as being at risk for diabetic foot problems should be examined more frequently. The care home team can also help residents with their daily foot checks, looking for changes in skin and nails.

Any changes noted should be documented and the appropriate action taken.  This may include professional care for diabetes being sought, such as having a diabetes specialist see the resident or visiting a podiatrist to gain recommendations for footwear.

Care home managers can also provide their team with role relevant diabetes training through specialised courses to empower them to provide safe, responsive and person-centred diabetes care.

*dependent on level of risk of developing a foot problem, they may require more frequent examinations (NICE NG19)

DUET diabetes Workshops

DUET diabetes is an approved CPD training provider, empowering people working in social care, health, beauty & wellness roles; enabling them to make a positive difference to adults living with diabetes, by increasing their knowledge, skills and confidence.

DUET diabetes runs evidence based, interactive in-person workshops led by experienced healthcare professionals covering a range of topics, including Diabetes Awareness and Diabetic Foot Screening.

The Diabetic Foot Screening workshop is led by an experienced Podiatrist, encouraging practitioners at all levels to develop or maintain core skills and capability in screening the diabetic foot. This workshop can be used by care home teams to help people living with diabetes to maintain (or even improve) their foot health.

1such as, but not limited to: the Toe Towel, Pedistick, Aidapt Lotion Applicator, Back Bliss Lotion & Cream Applicator.  The last two are marketed for back application but are equally useful for reaching other parts of the body!

Find out more about the Diabetic Foot Screening workshop. 

Explore our range of workshops.