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My 98-year-old mother has very thick toenails from fungus. The podiatrist never soaks them before trying to trim them and causes her a LOT of pain. I would consider getting her a pedicure if there is someone who knows how to deal with delicate elderly feet. Also was considering purchasing a Dremel tool and doing it myself.

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I believe you should allow the podiatrist, trained in dealing with this condition to deal with it. I would inform him of course that the lack of softening the nails causes discomfort for your Mom, and ask if there is a reason that could not be considered.
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You find a different podiatrist! This one is not making a good choice about nail care--maybe he/she doesn't really want to spend his day cutting geritatric toenails. There's not much $$ in that.

I take care of my DH's feet. I make sure he's had a good bath soak and then I check his feet carefully for any hotpsots or sores and then cut these 'talons' back and file them with clean, new files.

He's not unable to do this for himself, but he's 6'4" and has a hard time getting those feet up into the stratosphere! It's not a burden for me at all b/c a snaggly toenail can open up a cut on MY leg very easily, as he kicks around in bed a lot.

I would treat mom to a good pedicure--I had one a couple days ago and they did use a Dremel (the actual brand name!) on my toenails and fingernails. A GOOD pedicurist will do a good job and mom shouldn't have much pain. Sometimes with ingrowing nails, there is some discomfort, but not actual 'oh ouch' pain.

The secret is to not let them get out of control. A pedicure every month--will keep the nail sunder control.

Any medication that is used orally or topically really has to be precribed by a Dr. for some reasons, anti-fungals are hard on the liver, so she should have a topical solution.

At 98, the best you can hope for is controlling the length of the nails.
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If they're as thick as my mom's were I don't think much softening is possible, but you could try a good long soak before you leave for the appointment. Going more often might also minimize the discomfort as it would mean less nail to remove and less of a chance for other painful problems to arise..
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Medicare only pays for a podiatrist every 10 wks. Moms always soaked her feet. She did suffer from in grown toenails. Aides and Nurses are not allowed to cut toenails. So I would not trust a person doing someone doing a pedicure either. If not done right, you can get infections. I may use the podiatrist every 10 weeks because he will note any problems and have a pedicure in between maybe.
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I wouldn't go for a manicure/pedicure. Those places aren't clean enough to be sure she'd avoid a terrible infection.

Speak up with the podiatrist. That's where the work needs to be done.
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Good Morning,

What I do is soak mother's feet the night before we go to the Podiatrist. This is one thing I will not do--cut toenails, since Mom is on blood thinner. Her shoes fit better but remember don't have them cut too short, it will cause your mother pain. Tell them what you want.

Our Podiatrist is wonderful. The elderly love him, his own mother is unwell and mother goes every 9-10 weeks whatever her medical coverage will cover. He is personable and has a way with the elderly.

We have the routine down pat. I would stay away from a Pedicure. Too much can go wrong and if infection sets in you are replacing one problem with another.

Keep it simple or perhaps, shop around for a Podiatrist that meets your needs. I find out a lot of valuable information, believe it or not, in the hairdressers.

I hope I was of some help to you.
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I 100% agree about staying with a podiatrist and considering soaking at home if you feel like that is a necessity. As others have mentioned you are never 100% sure about the cleanliness of a salon/spa type setting and if you start trying a bunch to see what works you are just setting her up for a potential infection that she might not have the immune system to combat.

Additionally - if she has any other illnesses I think the podiatrist is doubly important. Especially something like diabetes, where foot care is critical and an injury to the foot, especially if diabetic neuropathy is involved, could cause way more than just a run of the mill infection - it could lead to something much more dire.

I think you may be having a much larger issue here if you feel like her podiatrist is not listening to her needs and it may be time to find one that specializes in geriatric foot care.
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I agree with others. No pedicure. They are simply not skilled for this task, such as working with special accommodations and Coumadin. Most podiatrists do not have accommodations for soaking, AND the sterilization (fungus is highly contagious) required between patients. My mom's podiatrist recommends soaking them beforehand for more comfortable trimming, suggests 10 minutes, shortly before our visit. I prefer a bit longer and work on lightly exfoliating the rest of the foot as well If you are searching for a new podiatrist, I recommend asking a care facility who they suggest, as many have private practice as well.
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BlueEyedGirl94 Mar 2023
This is an excellent point too! Any blood thinners and a medical professional is very important just in case!

My mom is not on blood thinners, but she is diabetic, and needs good foot care. She has been going to my cousin, who has been a nail technician for most of MY life, for years. She saw her before she was diagnosed with diabetes and my cousin went to an appointment with mom and talked to her doctor about the best way to continue handling taking care of her feet going forward. Mom's diabetes is under control without medication of any kind right now - she was on meds at one point (not insulin) but diet and exercise is all she needs right now- so maybe her feet are not nearly at risk as much as other diabetics.

My cousin sterilizes her entire station before mom comes to ensure that it is ready for her. She is super careful when handling mom's feet. She actually books out the length of two appointments so that she can take her time and not try to rush through it. She soaks for a long time, and spends a lot of time filing rather than clipping when she can to avoid possibly cutting her. She is very thorough and it has worked for mom for years.

But I imagine that is not the norm. It is a combination of the fact that she is our cousin and that mom has been going to her for years that she made the effort to be sure she could take care of her properly. I can't imagine it would be easy to find that as a new customer, especially in a lot of these popup places.

One thought if that is the direction - the podiatrist MIGHT be able to recommend someone. Maybe there is someone they recommend for homebound people that could come do it at home? That has been trained to do it safely? I don't know.

My FIL on the other hand - is on blood thinners AND is diabetic - insulin dependent and medication dependent. And has the most god-awful toe nails I have ever seen. There is no way we would ever allow anyone but the podiatrist to touch his feet. Anyone else would put him at risk. The smallest cut to his foot could potentially cause him to lose the foot. If he even stubs his toe we have to go to the doctor.
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I do my moms feet. Once a month I soak them in epsom salt then cut her nails. Podiatrist are known for being rough. I watched the cuts and toe infections after the “foot doctor” facility visits for 27 yrs when working facilities. Mom likes the attention, saves money and has had no cuts or infections!
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Regular Medicare mainly covers routine foot care by a podiatrist for diabetics or others with specific medical issues. If you are unable or uncomfortable caring for your loved ones feet you should search for a podologist.

A podologist provides routine care at a more affordable cost. Here is the difference.... A podiatrist is a medical professional legally authorized to treat most foot pain and discomfort. The podologist, on the other hand, helps alleviate discomfort by providing foot care services.

We were very blessed when our podiatrist recommended one. She has very high standards of care in how she handles our feet and the sterilization process of her instruments. If she sees something beyond her certification she refers clients to a podiatrist. Many podiatrists refer their patients to her. Here is a link to her website that shows some of the issues she has provided her TLC.... https://www.facebook.com/MrsGoodFoot

She has advanced training and specializes in geriatric foot care. My husband has his toe nails trimmed regularly along with occasional finger nail care. She regularly cares for my calluses and corns and occasional nail care.

Look for a podologist who has advanced training and is a Certified Master Pedicurist. You can search for one in your area by using the link below...

https://northamericanschoolofpodology.com/cmp-finder/

I found it best to click on the world map until it showed the ones in my state. When I entered my city and state it said there were none, but then it showed up when I zeroed in on the map.

You should never have an elderly person's feet cared for at a regular spa or mani/pedi salon unless you verify their credentials. When my husband was in cardiac rehab they had a specific session on the importance of foot care. The same emphasis was put on oral care because lack of good feet and teeth care can allow bacteria into the bloodstream and affect the heart.
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my2cents Mar 2023
Never heard of podologist. Sounds like a very good idea for elderly
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Go to a different doctor. I give my mom a "pedicure" right after her shower but dont have a dremel.
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Interesting question. My wife has toenail problems too both big toe toe nails fell off in the last two weeks. She has in home care and the nurse does not see a problem.
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Podiatrist's only cut nails. I use a pedicurist also. They have the tools for the nails but do a nice job on the feet and lower leg skin as well.
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my2cents Mar 2023
You have to be very careful with elderly feet. Scraping the bottoms could lead to wounds. Keeping cream on the feet and legs does wonders if you just do it yourself every day.
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Your mother needs a podiatrist. An actual doctor who knows how to handle elderly footcare and nails. You can have her soak her feet prior to the podiatrist cutting her nails. I had homebound care clients and made their appointments with a traveling podiatrist. His instructions were to have the client soak their feet for at least 30 minutes before his scheduled visit.
Usually if there is a senior center in a town they will offer nail clinics where a podiatrist comes and does the toenails. Call your local senior center and ask.
I know one who makes housecalls. Many of them will if a person is a shut-in and can't get to an appointment.
Look online and talk to your closest senior center because they will help you.
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To add to what has already been said, I would soak her feet regularly, but also try a soap like PediFix Tea Tree Oil Funga-Soap to soak her feet in. I would take a strong nail file and file the top surface and top edge of her nails down briefly and GENTLY (do not file with the aim of filing off ALL the fungus off the nail...just a couple of passes. File just enough to get the top layer off to expose the underlayer of whatever nail is there). Then get a tub with very warm water (warm enough for comfort), pour some PediFix in, and soak for about 15 minutes, daily or at least every other day. As the nails improve, reduce or eliminate the filing. You have to be patient, as it takes several weeks to a couple of months of this treatment. But I've seen this stuff work wonders. And because you're filing and not cutting, you don't have to worry as much about causing an injury.

(One note of caution--if you're mom is a diabetic, then doctors recommend against soaking the feet in any way, for reasons related to circulation and neuropathy. But if she is not a diabetic, that shouldn't be a problem.)
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Tell the podiatrist that it hurts. Or get another podiatrist. Does mom get home health care of any kind? If not, ask the doctor about it. Medicare will pay for some physical (legs) and occupational (arms) therapy in the home. Additionally, if you get this started, there will be weekly nurse visits. And most have podiatrist that will come to the home to trim toe nails every 3 months. You could soak the feet before the appt.

I had taken my mom in to an office visit to do it, but that dr was kind of rough. Talking to the visiting nurse, I found out about home visits and it was every 3 months like clockwork. This podiatrist did a 100% better job on the very first visit than any time at previously used dr. And, by doing it on time every three months, her feet never looked so good. Huge difference in the nails.

I would hesitate to go to a public nail shop. For me, they are rather rough. If you chose that route, you would definitely have to find someone who knows a pedicurist personally and is questioned about doing feet of elderly. And pay very close attention to sterilzation methods of the tools. For me, I'd try another podiatrist first and have a chat with staff before you bring her in regarding a good soak before appt and her history of pain with the process.
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a friend recently recommended the Trader Joe's Tea Tree body wash for softening toenails and reducing the fungus/thick nails that elderly feet often get. Mix in a warm bowl and let feet soak before attempting to cut nails. Mom's AL brings in the podiatrist monthly and MIL's Alzheimer's home has the CNAs do toenails when they do bathing. Good luck.
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Call your local senior center and ask for a referral to a senior care podiatrist or trained RN.
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I was a son taking care of his mom. Each week, I soaked her feet in just warm water, powdered them, and put special cream on to keep the skin soft.

I originally trimmed her nails, but despite my efforts, I would always seem to draw blood on at least one toe during the trimming process! It was wonderful when we started making quarterly visits to a podiatrist who took over the trimming duties. He suggested I put Vicks Vaporub on her toenails to keep them healthy. I thought "what?" But it does work, and I use it on my toenails. As a result of both our efforts, mom's feet and toenails were in great shape for the rest of her life.
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CaringinVA Mar 2023
That is so interesting about the Vicks! Although, I have heard people say that it is good for SO many things. Thanks for mentioning it!
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Both of my parents were referred to a podiatrist. They put something on the toes to dull the pain. I thought of it as novacain for the feet. And medicare covered it!
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akrupa: A good podiatrist will use a Dremel tool and also proper instruments to cut the nails with zero pain. Something is amiss with this specialist inflicting pain while cutting the nails.
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Find a different podiatrist to take her to.
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Our local hospital has one day a week with elder foot care. The charge is not exorbitant.
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I have a “foot nurse” (an actual RN) that comes every couple of months to take care of my wheelchair-bound 79 year old husband’s feet at his group home. The price per visit is around fifty dollars U.S., and she takes his vitals and mails me a written detailed report on the overall condition of his feet, since it is really difficult for me to check when I visit, and he has late stage dementia, so he cannot tell me when something hurts. She has been a godsend.
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She should probably see a podiatrist first. After that make sure she has a pedicure once a month.
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I took my Mom to a podiatrist who was recommended by her doctor for her tough nails and each of the three times I took her, he was so rough and her nails would bleed and it was painful for her. I decided no more of that and my daughter took over and used a dremel. She would put cream on her feet after and it was a nice pedicure. It was so much easier on her feet . Never went back and I felt bad I ever took her to him. He didn't seem to care because of her dementia I think.
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AQUAINST1 Mar 2023
The smaller Dremel works GREAT.
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