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Delane Asked March 2021

Can caregivers in assisted living and memory care cut toenails and finger nails? Our ED wants the caregivers to cut them to save money.

xrayjodib Mar 2021
Delane,

I can somewhat understand the cutting of fingernails to prevent scratches etc. However, toenails are a different story!
Done incorrectly, ingrown nails can occur, if diabetic, injury and infection can take place without the patient even knowing because of neuropathy.

My Aunts facility has a Podiatrist that comes once a month. I private pay $70.00 to have her toenails cut properly.

IMHO, the facility has no business cutting nails!!

I think you should contact the local Council on aging for assistance!

God bless!!

Geaton777 Mar 2021
My MILs facility won't even let a licensed/certified/experienced pedicurist come in and do anything to her feet. We've asked and they absolutely won't permit it. But they will allow a family member to do it... it's not as easy as it sounds. The nails get very thick and the LO doesn't cooperate when you touch her feet.

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JoAnn29 Mar 2021
As said, Medicare pays for a podiatrist to cut toenails. Not sure if its a policy of the facilities or a regulation of the state. I cut my Moms finger nails. You may want to tell your ED it maybe a liability to have aides do it for the reasons mentioned.

MJ1929 Mar 2021
The caregivers at my mom's place file fingernails, but don't usually cut them. They did cut her nails today because she's started scratching herself bloody, but that's not the norm.

As far as toes -- podiatrist only. Cutting the toenails of an old person is like trimming a rhinoceros' horn.

BurntCaregiver Mar 2021
In most places the CNA's or nurses aren't allowed to cut finger and toe nails. An aide will file someone's nails sometimes, but they won't trim them.
Usually a facility offers podiatrist services at different times if a resident needs nails trimmed.
It always costs extra though. It won't be covered in the regular monthly bill.

earlybird Mar 2021
Most facilities do not allowed the staff to cut patients toenails because of potential for injury, infection and liability, all of which could lead to an amputation of a toe, foot or part of leg, especially in diabetic patients with poor circulation. My mother is a diabetic and she has her appointment every 9 weeks with a podiatrist for cutting and trimming her toenails. I would never cut my moms toenails and risk injury or infection. It is best to leave the task to a professional podiatrist.

cwillie Mar 2021
Hm. I'm with BarbB, how does that save money?
At my mom's nursing home the psw's could trim fingernails but not do any foot care, that was done by an outside agency and we paid extra for it.

Geaton777 Mar 2021
In my MIL's facility the podiatrist is the only one who does the nail trims and inspects their feet every 90 days.

BarbBrooklyn Mar 2021
How is that going to save money? Save money for whom?

AlvaDeer Mar 2021
No, they should not. Cutting the nails on toes of seniors is a very dangerous pursuit Often the nails are hardened and thickened. A small nick on the toe of a senior can have such dire repercussions that they can lead to death. There are many dangers with circulation of elders. Some a diabetic, and a small cut could result in the danger of infection, gangrene, amputation, sepsis.
My recommendation to any personnel working in Senior Assisted Living or doing inhome care would be absolutely NO to nail cutting.

funkygrandma59 Mar 2021
I don't see why not, if the caregiver is comfortable doing so. I know that sometimes when people get older their toenails in particular, get quite thick and can be more tricky, but with the proper nail clippers they can be cut. My husband was completely bedridden in our home for the last 22 months of his life and I was the one who cut his fingernails and toenails, with no issues.
I know that most facilities have professionals come in on a regular basis to do peoples nails, and of course the patient or their families have to pay for that service. Not clear as to why this assisted living facility doesn't want to offer that anymore when it's the patient who pays for the services, not the facility. Unless there's a seperate fee that I'm not aware of.
lealonnie1 Mar 2021
If I was a CG at an ALF or MC, I'd flat out REFUSE to cut a resident's fingernails or toenails & then have holy hell to pay when the family had a fit when the resident started bleeding and/or the nails were trimmed incorrectly! The liability of such a thing is TREMENDOUS! The ED of this ALF must truly be a newbie in the field to even suggest such a thing, imo!! He's opening up a huge can of worms!!!!!!!! :(
lealonnie1 Mar 2021
Not in the Assisted Living places my folks have lived in, nope. When an unqualified person cuts fingernails & toenails for an elder, they run the risk of cutting too deeply and causing a bleed. Many elders are taking blood thinners which can lead to profuse bleeding and a trip to the ER can ensue. A qualified Podiatrist normally comes into the facilities to do these trims, and Medicare normally pays for it too. My mother has it done every 3 months (which is how often Medicare will pay, according to her plan) and she pays the co pay of about $38 I believe it is.

My motto with Assisted Living is, in for a penny, in for a pound. There are certain services you do not want to scrimp and save money on. Not to mention, how, exactly, does this ED feel like he's 'saving money' by having his CGs cut the nails of the residents? Makes NO sense!

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