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I am a controlled diabetic and a Kaiser podiatrist does my toenails about 8 week intervals. I have had problems with ingrown toenails and they're OK now. It's included with their medicare plan. The problem with toes is that they are difficult to do on your own when they get thick.
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My mother's podiatrist cuts them, her insurance covers it (I think every it's three months.)
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The podiatrist is exactly the person to deal with especially if your father has health problems that affect his circulation. I go to the podiatrist every three months to get my nails cut and to have my feet checked. Medicare covers it.
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I take my mom to the podiatrist. It's VERY common to take older people to see them for nail clipping and it's important. Medicare pays for it. Also lately, her home healthcare lady files them down and paints them. :)
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Sometimes I'm terrified of my own toenails. (I'm 75). Most of them look ok, but I can't easily reach the outer toes and I worry I will cut myself. (I did cut my husband once when trying to cut his toenails.) Are you worried you will damage him? Or are you intimidated that they are so thick you can't get the clippers to work? Or are you just extremely disgusted by handling them? I would suggest the following approach. First take a basin and first soak then wash your dad's feet and dry them. I clip my feet after a bath because the nails are softer and easier to handle. Hopefully, they won't smell or look so bad after this. Get a thick emery board file that can file away thick nails. (Mine is thick and black and you can see the sandy surface and feel it grab your nails if you test it on your fingernails.) Now get a soft cloth and wrap it around the foot so that only the tip of the toes and nail is showing. Hold the toe firmly and file away. You will be trimming the toenail without touching the skin. You hold the file at a 45 degree angle and file along the top of nail (not underneath the nail because it's probably too thick to get underneath). Also you won't be looking so much at his feet since they will be covered. Pretend your father's foot is the shell of a tortoise that you are polishing. I have only tried this on myself. I don't use a cloth because I'm not terribly disgusted by my feet so I don't need to hide them. I hold the toe I'm working on with my fingers on top and underneath so it doesn't move. I don't know if this will work for you, but if it works you will save $50 in a pedicure fee. It does take some effort and time because it's much slower than clipping.
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In our area (West Michigan) the local senior center has a podiatrist who comes every two months and does the toenail cutting. He also uses an electric "sander" to get them smooth. He charges Medicare first, then your additional insurance to cover the costs. We've never been charged anything.
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M-I-L's assisted living facility has a visiting podiatrist. She is not diabetic so visits are not covered by Medicare, but it's $50 to see him, and he will cut the toenails. In between, her granddaughter (who is now an RN but has always been a good person!) trims her toenails.
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The topic made me laugh out loud. My mother was always terrified of toenails, even my bother's and my cute little ones when we were children. Dad had to cut our toenails! Even before she developed Alzheimer's, she went to a podiatrist almost her whole adult life for upkeep of her very thick toenails. When she was in the NH, I took her to a podiatrist to get her toes done. It was covered by medicaid.
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Chiropodist or podiatrist, preferably one who is retained by nursing homes and facilities near you and therefore has proven experience in dealing with elders' feet. Seriously, don't faff about with this: apart from the thicker, hard nail material which takes quite some clipping, there may well also be issues to do with skin integrity or even things like arthritis. Find someone who knows what she's doing. [Edit: or he. Ours was a he, and not nearly as expensive as you'd think, either.]
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I live in Maryland and my mom used to get her doctor to cut her toenails, but then he stopped doing it. She was under the impression none of the podiatrists would cut toenails anymore, so we never tried again. I used to take her for pedicures, but now due to other health issues, she cannot sit anywhere long enough for them to soak and then cut and file her toe nails. Either my sister or I do it and we both hate it. I wonder if Medicare changed the rules and then changed them back or the docs were just tired of cutting toenails around here. Perhaps I should re-investigate.
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Had the same problem with my mother. LOL I used to take her to Kaiser Permanente and they would cut her toe nails for a fee but now she is in a care home and they actually have the "traveling to nail care" come to the home. I have them cut about every 3 months. For a fee of course, but it's worth it!
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My husband is bedridden and obviously cannot get out. I contacted Visiting Physicians, who have offices nationwide, and they sent a podiatrist to our home. I was told Insurance will probably pick up the fee. I understand how you feel. My husband’s toenails are so thick I don’t have the strength in my hands to clip them. The doctor also prescribed lotion for his very dry feet.
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My dad’s toenails are awful. His are trimmed at a nail salon by sweet Asian ladies who aren’t bothered a bit by the job. He doesn’t do the whole pedicure, only has the nails trimmed. It’s proven to be far safer than him or any of his family attempting it. Added bonus, it only takes about 10 minutes and costs $6. I should add he’s not diabetic
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ME TOO! I called and you have to be licensed to do in this state. I take him to his primary doc. Medicare does not cover. It costs about $30. The license folks cost about same. We usually go about 4 times a year.
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I think the senior center in the town where my parents live have a foot clinic once of. month . So if he can use a transport chair, you might be able to bring him to something like that.
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When dad first moved in with us I took him to the nail salon and he got great pedicures! They were very good to him. Then he had more health issues, but I contacted At Home Podiatry that his insurance covered. They came every two months.
He's at a nursing home now and they have podiatry services there.
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It’s not overkill to contact a podiatrist. This is part of their practice. Many podiatrists offer in-home services, so be sure to search for one that does.
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Like said Medicare will pay for it. Mom went to her podiatrist all the time. He even visited her in her AL and NH.
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Medicare will pay for a podiatrist every 3 mos. The patient does not need to be diabetic, just unable to do it himself.
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Podiatrist will take care of this. If your area has visiting nurses call them. They will provide foot care.
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NurseRatched Sep 2018
Nurses cannot trim toenails, even with a doctor’s order. It’s outside our scope of practice. A podiatrist is your best bet.

What nurses can do is follow orders for foot wounds where applicable.

As mentioned below, there are specially trained and certified nurses who CAN perform foot care. Be sure to inquire whether your home care nurse is appropriately certified for such care.
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OMG!!! I thought, I was the only dealing with this toe nail issues. My husband won't let me touch his toe nails. It is disgustingly long. I am willing to trim even if I have to gag. He says i need to soak them first, when bring a container to soak his feet. He won't do it.
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Podiatrist first this will make sure there are no issues that need treatment, will get everything cleaned up then it is a maintenance issue.

My dad is diabetic so Medicare paid for a visit every 2 months and nobody else could legally cut them because of the risks. Non diabetic, I believe that anyone that is willing is able to do it, ask the caregivers. Some people are okay dealing with alien toes. Not me though, I gag just looking at yucky feet.

Let us know what you find out, different areas have different rules.
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Good grief we think alike. It’s my FIL and I am NOT touching them.... I think my husband should do it, or at least fin an alternative. I had a caregiver take him to a mani/pedi place, but that did not work out too well....
looking forward to seeing anyone else has any suggestions
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This is a common problem with aging that most of us never think about until confronted with it, I imagine most older people have difficulty seeing their feet, reaching their toes or manipulating the tools because of arthritic fingers. In my area podiatrists are usually only seen by diabetics or if there is a problem of some kind but there are monthly foot care clinics at local seniors centres and there are many nurses who have taken extra training in foot care who will come to the home.
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NurseRatched Sep 2018
These additionally certified nurses are the only ones who can address toenail issues, so be certain that the nurses you request for this purpose are legally able to handle toenail care. Without this additional specific certification, trimming toenails is not permitted within their scope of practice.
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Oh I know exactly how you feel! I hate feet, even my own which are actually quite nice for my age, ha! My Moms feet and toenails were more than I could handle. Luckily in my area is a traveling podiatrist! He came to moms apartment and trimmed her nails and removed one that she was losing. The first visit got charged to Medicare since it was an initial visit and assessment. Subsequent visits were $50. If she had been diabetic they would have been covered by insurance. You may try googling or calling podiatrists in you area to see if they make house calls. Also LPNs can trim nails, they do at Moms NH, even for the diabetic residents. I don’t know about cnas.
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Depending on her insurance you probably can get a podiatrist to care for her feet once every 9 to 10 weeks which is usually adequate. It's usually safer for the elderly to have a professional handle their feet anyways . Thicker toenails and fungus are common. Double check with her insurance then ask her primary to give you a referal.
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kdcm1011 Sep 2018
This is what we did. No more nightmares for us! At least toenail related.
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