A triumph of complex engineering, the human foot contains 26 bones, 33 joints, 107 ligaments, and 19 muscles. All play a critical role in balance and safe mobility. The importance of their meticulously orchestrated interplay is distinctly evident among seniors living in skilled nursing facilities, where the level and quality of routine foot care can cause or prevent a serious fall.

Foot problems and fall risk

Every second of every day an older U.S. adult suffers a fall.¹ These accidents are the leading cause of injury among people 65 years and older. And the death rate from falls is rising.²

Podiatry concerns often lead to falls, as foot pain and other foot-and-ankle issues can interfere with coordination and balance. In fact, seniors experiencing foot pain are 62% more likely to suffer recurrent falls, and more than 20% of older adults experience foot pain.³

Although many factors influence fall risk, common foot and ankle issues frequently play a consequential role. By providing proactive onsite podiatry care in collaboration with internal staff, skilled nursing facilities help prevent falls, contain fall-related costs, and minimize liability.

What does proactive onsite foot care look like?

Proactive onsite foot care delivered by an experienced provider such as Aria Care Partners has four essential characteristics:

1. It is comprehensive. Attentive care covers the full range of foot and ankle problems tied to aging and disease. A knowledgeable podiatrist experienced in working with skilled nursing patients understands how diabetes, rheumatoid arthritis, Parkinson’s, stroke, and other chronic conditions can affect foot health, balance, and mobility. These experts can take an in-depth medical history, assess foot biomechanics and strength, evaluate gait, identify the root cause of discomfort, and anticipate problems. Notably, they can create resident-centered treatment plans to help protect against falls.
2. It prioritizes prevention. Trimming toenails, removing calluses, and attending to cracked heels, blisters, pressure sores, and other irritants are basic care practices that prevent relatively minor issues from escalating into serious health concerns and falls. Educating patients, staff, and family members on proper hygiene, footwear, and exercises to maintain foot strength and flexibility is crucial. Consistent onsite foot care and advice bolsters prevention.
3. It entails careful wound surveillance and care. The right onsite podiatry care solution includes careful monitoring of small sores and wounds. Nearly 30% of people 65 or older have diabetes, making diabetic ulcers a significant concern.⁴ Those with an active foot ulcer are twice as likely to fall and three times as likely to experience a fracture as their peers with diabetes without a foot ulcer.⁵ An experienced podiatrist will provide wound care that encompasses advice on how to reduce fall risk when footwear is necessary that offloads pressure to protect wounds.
4. It includes personalized everyday footwear recommendations. Onsite podiatrists see residents in their living environments, enabling a 360° view of how changes to footwear might inhibit falls. Illfitting shoes, elevated heels, sling backs, and backless shoe styles often undermine balance control. Podiatrists bring knowledge of current and emerging footwear interventions that can improve walking and balance issues. Checking the condition, traction, and safety of shoes and how they fit is a simple but highly effective risk management practice. Custom-made orthotics to improve stability and/or mobility also are sometimes warranted.

Cascading benefits

Proactive onsite podiatry care anticipates problems as well as treats them. Working with an experienced external ancillary care provider allows a skilled nursing facility to offer foot care that is easily accessible, timely, consistent, and serves the needs of each resident. That promotes resident mobility and helps reduce the frequency and severity of foot-related falls. Ultimately, it supports high-caliber, life-affirming care that leads to better outcomes, reduced costs and liability exposure, and most important, improved quality of life.

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