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My sis and I are in FL and visited our mother in memory care for the first time since our governor opened nursing homes to loved ones. She said her right foot hurt, and while she's usually very difficult and belligerent about everything, she allowed us to look at her feet. We were shocked to discover that during the six months of lock down, her toe nails had grown up over, around and under her toes. We were horrified. We had an unusually good visit with her, but afterwards I immediately notified the nurse administrator. I wish now I had gotten photos, but I wasn't thinking straight. Before posting this I read other Aging Care posts about toe nail care. We know a podiatrist will be necessary at least for the first cut, because of the seriousness of the problem. But I'm terribly concerned Mom will refuse to allow anyone to care for her feet, including my sis or me. When we try to do things for her, like cut her hair, she'll just say, "I'll wait until I get home." I don't know what to do about this.

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Dear "Weeble,"

Maybe your mom will be more receptive to a Podiatrist than she has been when you and your sister want to do anything. So I would leave it in a Podiatrist's hands who may be more able to talk her into it as I'm sure they've dealt with difficult patients before.

My mom is in memory care now after having nearly died of severe dehydration and COVID back in April. Her new facility as well as hospice said her toenails needed attention. Between hospice, the facility and myself we have contacted a mobile podiatrist and they scheduled the visit for the 12th. Maybe you should just get it arranged instead of telling her ahead of time where she may be more apt to say she doesn't need or want it.

If it's as bad as you say, that's not good to continue to let it go. I wish you luck!
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Just have the facility schedule the podiatrist. If there is an issue, deal with it when it occurs.

There is an Italian proverb "don't put a bandage on your head until it is broken".

I think that applies here and to a lot of elder care.
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It was about 5 years ago that I noticed that Dad's toenails were wrapping around the end of his toes. He was wearing a pair of sock that had several holes in them.

When I commented on his nails, he immediately shut me down. I only worked for Podiatrists for 11 years, so of course I do not know anything about nail care.

Here in Canada we have both Podiatrists and Foot Care nurses. At the cottage where up until this year Dad spent the summer, I knew there was a Foot Care nurse working out of the medical centre. I called her up and prepaid for an appointment for when Dad would be over there. Dad was willing to have her take care of his toes because the appointment was paid for.

Does the care home have a regular Podiatrist that takes care of the residents' feet? If yes, ask that your Mum be added to the list. Don't tell Mum that you did it, if she asks, you about it, tell her it is one of the services included in her rent.

Also, it is important that her feet are looked after by a trained professional, a Podiatrist or a Foot Care Nurse.

Dad now pays for his own appointment with the Foot Care Nurse. Only once a year, but he claims he cuts his nails at other times.
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Countrymouse Oct 2020
Once a year - whether they need cutting or not..?! I'm glad you had that nurse on the scene :)
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Sometimes, if left untreated, an ingrown toenail needs to be removed entirely by a surgeon. It will grow back.

The surgeon will use a local anesthetic.

It is important that a professional treat your Mom's nails and that no one goes snipping around or causes bleeding. I agree with Tothill.

Podiatrist, Foot Care Nurse, or General Surgeon.
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AndreaE Oct 2020
I agree however my moms podiatrist uses a Dremel to sand the toenails off and there is no pain or injury since he knows what he's doing. I wait outside in the waiting room because I can't stand the thought of toenail dust flying all around the room lol. My mom wears a mask and so does the podiatrist.
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You may be able to use and embellish on our experiences with sheep. We started with sheep with long curly horns, and mated them to polled sheep. The ram lambs that inherited one horn gene and one poll gene had crazy short horns that pointed in all directions. One had a mini-horn that was pointed straight into an eye, and growing quickly. DH had to cut it off with an angle grinder, not easy because it was already very close and the sheep was hard to keep still.

Tell you mother than the toe nails may grow into the soles of her feet. If so the wounds will get infected, gangrene can follow and she may have her feet amputated. It may not be the most likely outcome, but the possibility ought to get her to accept treatment as genuinely important.
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Weeble, for reasons unfathomable to me, my mom is cool with going to a Podiatrist—(happens to be a he), because i guess he’s ‘A Doctor’. She couldn’t be dragged into a pedicure (we tried!!). Sadly, maybe because it was a ‘doctor’ and a man, she’s willing to be driven to and go every 2 weeks or so. The most absurd part of this is she has Tricare, which pays every penny. P.s., My constant thing is to not resent her for being a selfish, spoiled brat, which she isn’t, really, she’s a product of her time. At 66, I can’t afford a haircut or 2x year dental cleaning/checkups, much less a pedicure (late divorce, loss of career at 60), etc. Medicare doesn’t pay for podiatrists. I know it’s apples and eggs, but that’s why I’m here with y’all: )
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Medicare pays for my podiatry visits, Davenport. Not for routine nailcutting, but when I go in for other foot issues, he trims my nails.

Medicare also paid for my mom's routine, regular foot care when she wss in a NH.
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My mom refused nail care from a manicurist but desperately needed attention for her toenails. I could not do it with regular nail clippers. I mentioned it ever so slightly to her regular physician and he said she needed a podiatrist. Mom went and really had nothing to say about it because the Dr said so and not me. It went well. Medicare may pay if there are certain criteria met such as diabetes or neuropathy. The facility where she stays should be of help in getting her the attention that she needs. They may even have someone that goes to the facility to do this type of thing. I know prior to covid the local homes near me had dentists, podiatrist, and hair dressers visit on a regular basis for the residents. Good luck!
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My first thought would be for them to give her a mild sedative to make her sleep and when she woke up it would be done. Another thought would be to tell her before they will think about letting her go home her nails would need to be cut.
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My LO had regular visits from a podiatrist prior to Covid. The visits were scheduled through her Memory Care and paid for by Medicare.

As has been mentioned, sometimes medical professionals can get a lot farther than family members.
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Get a podiatrist in there ASAP.

My mom's feet look like a horror movie, but oddly enough, getting her toenails dealt with was the one thing she never fought us on. She fought when I tried to do it, and when Dad tried. We took her to the podiatrist, and he was simply "the NICEST man, wasn't he?"

Lordy.

Don't avoid trying to help your mom because of how you think she might react. She may surprise you.
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The Care Home should have seen this while cleaning her up and it should have never happened.

Have her Dr prescribe whatever treatment is necessary and refer her to a Specialist immediately.
As bad as you're saying, she will most likely have to be sedated.

In grown toenails can cause horrible pain.

Have this taken care of today.
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The nursing facility should have had this done. I would call administration and find out how this was overlooked. She's in pain from the lack of attention to that particular care. This might be considered elderly abuse on the part of the home. Hopefully they will jump on the chance to make it right.
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Tell the staff. Also they should have a podiatry comin in.
& don't tell her.
Our parents get away with alot from us, but not an engaging physician they don't.

Go to nurses station.. if you haven't already.
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She might surprise you. My mother fought me on a lot of things, but she loooooved when I bit the bullet and soaked her feet, cut her toenails, filed them, and cleaned everything up. It meant she didn't have to deal with it. You probably can get this taken care of on medical insurance's dime, though. You might want to report the care home to the appropriate authorities. I don't care how busy you are during Covid; you don't mess up people's toes.
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My sister who cares for Dad, Does his. However, One can use the Foot Doctor and in Explaining this to Her, Hopefully she will understand that Fungus can grow under the nail and Cause an Infection.
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One of my dad ‘s new caregivers soaked his feet in warm vinegar and then carefully trimmed his nails. I asked about the vinegar & it helps get rid of the toenail fungus. Strange, but it works! Good luck-
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SouthernSun Oct 2020
Straight vinegar and what type?
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Due to poor circulation, mom had very thick toenails and had her toe nails cut by a podiatrist. Medicare paid for a podiatrist, who made house calls, to come to the home. It's for your health and safety to have it taken care of. Take care.
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One question : does your mom have Alzheimer's? If so, you can say we will visit your home (if not sold) if you will let us care for your feet. Alzheimer's patients always thinks that they are visiting a place and they don't feel like they are welcomed there. Most Alzheimer's patients will do everything for the family if asked.
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She is complaining about her foot right? Than make it about the foot and not nail care. Tell her you look at her feet and you really like a podiatrist to look at it before it gets worst. Soak her feet before you have the podiatrist see her.. Make sure your podiatrist knows that some of the problem may be her nails. I see my podiatrist once every 4 - 6 months for the expressed purpose of nail care
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Often podiatrists will make regular visits to handle cases. If you explain the doctor will be doing the visit and taking care of the nails, that might ease her mind. Your nursing home should have names of podiatrists that do home visits.
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Typically a Podiatrist makes routine visits to Facilities and will make "rounds" to residents that need care. you can ask mom to be put on the list for each of the visits.
Some states have changed laws about nail care. When my Husband was on Hospice the CNA could cut his fingernails but not his toe nails. I recently heard that they can no longer do fingernails either.
Just tell her that the doctor is going to make a visit and I am sure once she gets into the routine she will get used to it. Also the more the nails are cared for the less pain involved in caring for them.
If she is on a medication for anxiety have the podiatric visit scheduled during a time when she is at her calmest and if she is not on a medication same thing schedule the visit when she is at her best. Maybe even after her shower or bath so she is more relaxed (if a shower or bath relaxes her.)
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She needs to have nail care start being part of her usual grooming routine. Take her a podiatrist for the first cut and ask for suggestions that would make this chore easier. You or your sister may have to be the ones to check her feet when you visit and do this care until she is comfortable letting staff do it. Please make sure that staff get to the point of taking on this care within 3 weeks or so since this is part of their job.
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Dear Webble,

Our LO's have suffered so much during this pandemic, glad to hear you were able to see yours. I've noticed with my LO before the pandemic that a podiatrist came regularly and was always accompanied by someone from his unit. Maybe your Mom will allow it if someone from her unit, that may be a familiar face to her? Or someone that has a pleasant disposition. I would certainly follow up to make sure she gets taken care of, its easy for them to get passed over. Get the date it is yo be done. Follow up the next day it was actually done. You would be surprised.
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my2cents Oct 2020
True, Robinsca33, people in the facilities have suffered enough with no contact and visitation, It is a crying shame when they have to suffer at the hands of the people PAID to take care of them, too.

I've seen first hand what can happen at facility care even when they know full well visitors may spot neglect or abuse. It makes my heart break to think about what might be going on if they know that no one will see it. Even if some of the patients complain, think about how many of will be dismissed by family because they have a little memory issue.

This particular post should light a fire under anyone's butt who has a loved one in a facility to become a better observer of overall care. If you don't live close, then hire someone to make visits, check the person for neglect, etc. Otherwise move them closer to where you live so you can do it in person. Too many drop by for a visit, chat it up a bit, and leave feeling they did their duty. There's more to it. Even with covid, ask for medical records on a regular basis that documents bathing, bedsore checks, TOENAILS (who'd have thought you would have to follow up on that!!), and medicine charts.

This post is so alarming to me. It kind of indicates lack of visitation was small compared to the potential of neglect and abuse.
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I take my 99 yo Mom about every 10 weeks to a podiatrist for nail care. Medicare does cover it. She doesn’t particularly like it, but I tell her it’s something that needs to be done and I am not comfortable doing it. She grumbles, but gets over it.
I would have the nurse or facility’s administrator put in a request for nail care and tell her it’s part of her treatment.
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Is it possible for you or sis to visit again? If so, see who podiatrist for facility is and find out their next time scheduled to come for services. Or schedule an appointment yourself. Explain situation to them so they are prepared for extra time with her.

Then tell your mom y’all are having a girls day which includes pedicure & manicure. Maybe do a picnic or some other fun stuff while visiting. Hopefully that would ease her into willingness to have her feet done.
Best of luck and hope it goes well.
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If the staff of the center have not made notes of such extreme findings, I would be concerned about your mother's overall hygiene care. Immediately speak with the managing physician and have the situation assessed and treated. You may get opposition from your mother but, for her health, don't back down. If she gets nail fungus you will have bigger issue, possibly nail removal. Perhaps they can bring in the podiatrist and present it as a manicure and pedicure "treat." If not, do what you have to do, knowing its due to your love for her.
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babsjvd Oct 2020
Yes, my mom is seen at AL by a nurse practitioner, he brought another nurse practitioner podiatrist with him to do the nails.
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You may be able to do something yourself. I purchased a special tool, not clippers, but nippers, for professional clipping of toenails. They are heavy duty stainless steel. YOur mom may be more trustful of you vs a doctor visit, so let her know that you are helping her to stay out of the doctor's clutches if that works! First you will need very good lighting. I soaked my mom's feet. Then use moisturizer to soften the skin and nail. I was able to take my time and nip away little by little. In case there is a little skin nip, have some triple antibiotic ointment and a bandage on hand. You will probably need several sessions. I have to keep up with it, as senior nails do grow fast. It may be too late for you, but I thought my mom also would have to go to the podiatrist.
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The nursing home should be scheduling routine podiatrist visits. Usually these and rehabs have one in place who does this. Toenails are a common problem with seniors. Good luck!
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I discovered the same thing with my mom. I told her that next time I visit, a few days later, I would bring everything with me and I would give her a pedicure. She was excited about that. Mom had recently complained that her shoes hurt her feet. I helped her shower, soaked her feet in warm water for 30 minutes then I cut and cleaned her toenails. Painted them pink. And I covered her feet and calves in lotion. I let her choose the Color. I think the offer of a pedi is what sold her. I left and she was very happy.
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InFamilyService Oct 2020
I ordered my mom a drummel from Amazon and its been a real help. Quick and easy.
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