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She has a PSW come in twice a week and I find it hard that the lady doesn't notice. The smell is getting stronger and its very hard to sit in the same room with her. I have tried putting powder in her footwear but she complained so I've stopped. Would appreciate advice on how to tackle this.

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I agree that it could be some kind of fungus or infection, until you get to the doctor you might try a few drops of tea tree oil in her foot soaks and added to the lotion you use on her feet, take time to massage it in well around her toenails.
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A Personal Service Worker, or PSW, does not diagnose or treat disease. Your mom needs to see an MD, a Podiatrist, ASAP. In the meantime, throw away ALL her footwear and disinfect her feet with a good soaking, 20 minutes and scrub off ALL the dead skin. Then apply antifungal cream or powder. Buy her shoes or slippers that can go in the wash and be disinfected.
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You should take her to a podiatrist. Medicare will usually pay for this. She could have an infection or something with her toenails.
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You could try soaking her feet in a dilute epsom salt solution, then dust them with an anti-fungal foot powder. You could also try baby powder -- the type with corn starch.
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