Stepping Into Wellness: An Observational Study of Foot and Nail Care Needs of Older Adults in Senior Housing.

PURPOSE: The aim of this study was to describe foot care services requested and received during interdisciplinary wellness visits in low-income senior housing and to identify factors associated with the likelihood of requesting foot care services.

DESIGN

Observational, descriptive study.

SUBJECTS AND

SETTING

The sample comprised 439 residents; their mean age was 79 years (SD = 8), and more than three-quarters (n = 337, 77%) were female. The study setting was 4 senior housing communities in Maryland, located in the MidAtlantic region of the USA. These communities have monthly clinics that provide foot care and other health services.

METHODS

Residents completed intake assessments capturing demographics, comorbid conditions, and pertinent health behaviors. Foot care services included assessment, moisturization, nail clipping, and education. Data were collected over a period of 30 months. Data were analyzed using descriptive statistics and binary logistic regression to identify predictors of foot care utilization.

RESULTS

Of the 439 residents, 147 (34%) requested foot and nail care; slightly less than half 44% (n = 65) had diabetes mellitus. Common issues included xerosis, hyperkeratosis, and onychomycosis. Logistic regression revealed that age (P = .002) and number of comorbidities (P = .003) were significantly associated with receiving foot care. Each additional year of age increased the odds of seeking and/or receiving foot care services by 1.04 (95% CI: 1.01-1.06), and each additional comorbidity increased the odds by 1.14 (95% CI: 1.04-1.24).

CONCLUSION

Foot and nail care is a prevalent need among older adults in senior housing, and particularly among those with diabetes mellitus and multiple comorbid conditions. The interdisciplinary clinic model was effective in delivering care. Future research should explore the impact of foot care services on self-care behaviors, functional outcomes, and health care costs.