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Putting their best foot forward Providence Foot Care Clinic gives local seniors a leg up on discomforts that can impede their ability to walk By JOHN DARLING If feet could talk, they'd probably form support groups and say they feel used, uncared for and walked on - and it only gets worse with age. The casual disregard we give our feet in youth can turn into serious health problems in older years, especially if complicated by diseases of aging. And foot ailments usually aren't covered by Medicare. Most foot problems can be prevented with routine foot care practices, but seniors often lose the body flexibility (and interest) to take care of their feet - or their spouse's - and that can mean expensive visits to physicians, paid for in cash. To promote proper foot care, Providence Senior Center three years ago created a Foot Care Clinic to provide toenail trimming, massage, shoe-fitting, foot skin care and education for self-care at home. It's been working. Last year, the clinic logged 1,790 visits, often using the opportunity to screen seniors for other health needs, said Lori Braughton, foot care clinic nurse. One patient, she said, had let her toenails grow so long that they became ingrown and painful. Her shoes didn't fit. In response, she began to hobble and eventually was using a walker. Clinic nurses trimmed her nails, got her on regular visits and soon had her walking normally for her age. "Foot problems are a lifetime in the making," said Providence Senior Center director Karen Bartolini. "They build up from years of inattention, ill-fitting shoes and other health problems." Fungus, cracks, athlete's foot and discoloration of nails can add to the difficulty of foot care. Providence staff teach patients to wash their feet daily with mild soap and warm water, then rinse well and dry thoroughly; trim their nails to match the curve of the end of their toes, with corners slightly rounded; change socks daily; use skin creams; and buff corns and calluses. A clinic visit is $35, and Medicare doesn't cover such preventive care. If patients have a systemic disease, they're referred to podiatrists, and Medicare covers that if the foot problem is a result of ailments such as hip or knee replacement or cardiovascular problems, said Bartolini. Braughton teaches patients self-massage, which desensitizes irritated muscles, skin and nerves. "Our feet love a good massage. The simple act of touch and movement communicate to our feet a wonderful sense of relief. They feel much lighter and more comfortable," she said. To self-massage feet, she said, soak them in a foot bath, then rub them with lotion, gently massaging each toe between your fingers. Move to the back, rubbing the ball, arch and heel in a circular motion. Some seniors can't reach their feet anymore. In that case, apply lotion on a washcloth and move your foot back and forth on it. Getting a good shoe fit is critical to foot health, Braughton said. Some tips: Foot sizes change with time, so keep measuring. Sizes vary with the manufacturer. One foot is usually bigger, so get shoes of the bigger foot's size. Shoe shapes vary, so trace your foot on paper and try to match it against the bottom of a shoe. Your foot size changes with the time of day, so if you work out at 4 p.m., shop for your workout shoes at 4 p.m. Measure your foot while standing and leave 3/8" to 1/2" space at the big toe. Get shoes that are comfortable when you buy them. They don't stretch. If your wear orthotics, fit the shoe with them in. Providence Foot Care Clinic is at 769 Spring St., Medford. House calls and foster home visits are made by appointment; call 732-6251. John Darling is a free-lance writer living in Ashland. Mail Tribune Home | Ottaway Newspapers, Inc. | Dow Jones & Co., Inc. | Privacy | Contact Us Copyright � 2001 Mail Tribune, Inc.