Many older Australians rely on family members, carers, or support workers to help support their daily health and wellbeing. While carers often assist with medications, mobility, meals, and appointments, foot health is another area that can gradually become difficult to manage independently.

Over many years working with older patients across the Sunshine Coast, we have found that carers often play a very important role in noticing early changes in foot health. Sometimes during appointments a family member might say:

“I noticed their nails were getting very thick, but I wasn’t sure what to do about it.”

Or a carer may explain:

“They mentioned their feet were sore, but they didn’t want to bother anyone.”

These types of observations are extremely valuable because many foot and nail problems develop slowly over time. When issues are identified early, they are often much easier to manage before they begin affecting comfort, footwear, mobility, or balance.

For many older adults, routine nail care becomes increasingly difficult due to reduced flexibility, arthritis, balance concerns, or medical conditions affecting the feet. This is why podiatry nail care can play such an important role in maintaining comfort, mobility, and independence.

Why Foot and Nail Care Becomes More Difficult With Age

As people age, tasks that once seemed simple can gradually become more physically challenging. Looking after the feet is a common example of this.

Many patients tell us they used to manage their own nail care for years but eventually reached a point where they could no longer safely reach their feet. Sometimes this happens gradually over time, while in other situations it may occur after illness, injury, surgery, or declining mobility.

Common reasons older adults struggle with foot and nail care include:

• reduced flexibility when bending down
• arthritis affecting the hips, knees, hands or back
• reduced hand strength
• poor eyesight
• balance concerns or fear of falling
• thickened nails that are difficult to cut
• obesity or reduced mobility
• reduced sensation in the feet

One of the most common comments we hear in clinic is:

“I used to cut my own nails, but I just can’t reach my feet anymore.”

When this occurs, nail problems and skin changes may slowly build up over time. Nails may become excessively thickened, curved, painful, or difficult to fit comfortably inside footwear.

At the same time, dry skin, callus, or pressure areas may begin developing unnoticed.

Why Thickened Toenails Should Not Be Ignored

Thickened toenails are extremely common in older adults. While they may initially appear to be a cosmetic issue, thickened nails can sometimes create significant discomfort and mobility problems if left unmanaged.

Toenails may thicken due to:

• ageing changes
• fungal nail infections
• repeated pressure from footwear
• trauma over many years
• reduced circulation
• arthritis or foot deformities

As nails become thicker, they often become harder to cut safely using regular nail clippers. Some nails also become curved or distorted, increasing pressure on the surrounding skin.

Over time, thickened nails may:

• become painful in shoes
• rub against neighbouring toes
• contribute to skin irritation
• increase pressure when walking
• alter walking patterns
• make footwear uncomfortable

According to the NHS guide to foot problems, nail and skin problems in older adults should not simply be dismissed as a normal part of ageing, particularly if they are affecting comfort or mobility.

When nails become very thick, attempting to cut them at home may also increase the risk of accidental injury.

The Important Role Carers Play in Foot Health

Carers do not need clinical training to support foot health. In most situations, the most valuable role carers can play is regular observation and communication.

Because carers often assist with dressing, mobility, or daily routines, they are frequently the first people to notice subtle changes in the feet.

Simple things carers may notice include:

• redness or swelling
• changes in skin colour
• dry or cracked skin
• wounds or blisters
• thickened or discoloured nails
• pressure areas or callus
• signs of pain when walking
• changes in mobility or balance

If something appears different from normal, it is sensible to mention it to a podiatrist or healthcare professional.

Often these small observations help identify problems before they become more serious.

Why Nail Cutting Should Be Performed by a Podiatrist

One important point we regularly explain to families and carers is that nail cutting should ideally be performed by a podiatrist for many older adults, particularly those with medical conditions affecting their feet.

While trimming nails may seem straightforward, there are situations where even a small injury around the nail can lead to complications.

Many older patients have conditions such as:

• diabetes
• reduced circulation
• peripheral neuropathy
• arthritis or foot deformities
• fragile skin
• reduced healing capacity
• medications such as blood thinners

In these situations, accidentally cutting the skin or creating pressure around the nail may increase the risk of infection or slow healing.

According to Diabetes Australia, proper foot care and regular foot assessments are important for reducing complications in people living with diabetes.

For this reason, we generally advise carers and family members not to cut or file toenails themselves when nails become difficult to manage.

Instead, arranging podiatry care is usually the safest and most appropriate approach.

What Happens During a Podiatry Nail Care Appointment?

Many people assume podiatry nail care only involves trimming toenails. In reality, podiatrists assess the overall health and function of the feet during appointments.

A podiatry assessment may include:

• nail care and nail reduction
• management of thickened nails
• checking circulation
• testing nerve sensation
• assessment of skin health
• identifying pressure areas
• footwear assessment
• mobility and walking assessment

This broader assessment is important because nail problems often occur alongside other foot health issues.

For example, a patient with painful nails may also have poorly fitting footwear, circulation changes, or pressure areas contributing to discomfort.

Addressing these factors together often helps improve comfort and mobility more effectively.

The Connection Between Foot Pain and Reduced Mobility

Foot discomfort can have a surprisingly large impact on daily life. When walking becomes uncomfortable, many older adults gradually reduce their activity levels without fully recognising the effect this has on their overall health.

People may begin:

• walking shorter distances
• avoiding social outings
• holding onto furniture when walking
• becoming less confident outdoors
• avoiding exercise
• spending more time seated

Reduced movement can eventually contribute to declining strength, balance issues, falls risk, and loss of independence.

According to the Cleveland Clinic falls prevention information, foot pain and poorly fitting footwear are recognised contributors to falls in older adults.

Maintaining comfortable, healthy feet therefore plays an important role in supporting ongoing mobility and confidence.

Why Footwear Matters for Older Adults

Footwear is another area where carers can provide valuable support. Properly fitted footwear helps protect the feet, improve stability, and reduce pressure when walking.

Supportive footwear should generally:

• fit comfortably without tightness
• provide grip and stability
• protect the feet from injury
• minimise rubbing and pressure
• support natural walking patterns
• have secure fastening where possible

We sometimes hear carers say:

“They prefer walking around the house barefoot.”

While this may feel comfortable, going barefoot can increase the risk of cuts, pressure injuries, or falls, particularly for people with reduced sensation or balance concerns.

Older adults living with diabetes or peripheral neuropathy may not notice injuries occurring underfoot until skin damage has already developed.

Common Foot Problems Seen in Older Adults

During podiatry appointments, there are several conditions we commonly assess and manage in older patients.

Thickened Toenails

These may become painful, difficult to manage, or uncomfortable in shoes.

Fungal Nail Changes

Fungal infections may cause nails to become yellow, brittle, crumbly, or distorted over time.

Corns and Callus

Pressure-related skin thickening commonly develops on the heels, toes, or ball of the foot.

Dry or Cracked Skin

Dry skin may lead to painful cracks around the heels or toes.

Diabetes-Related Foot Concerns

Reduced circulation and sensation may increase the risk of wounds and delayed healing.

Arthritis and Foot Deformities

Joint changes may affect walking patterns, footwear fit, and overall comfort.

What Happens if Nail Problems Are Left Untreated?

Nail problems often worsen gradually if ignored. Thickened nails may continue becoming larger and more difficult to manage. Pressure around the nails may increase, making shoes uncomfortable or painful.

Some people begin altering the way they walk to avoid discomfort, which can eventually contribute to knee, hip, or lower back pain.

Untreated foot and nail issues may also contribute to:

• reduced mobility
• falls risk
• pressure injuries
• infections
• reduced confidence walking
• social withdrawal

In people with diabetes or circulation problems, even small nail injuries may become more serious if healing is delayed.

Early intervention is usually far easier and more comfortable than waiting until pain becomes severe.

Supporting Independence Through Preventative Foot Care

One of the main goals of podiatry care for older adults is maintaining independence for as long as possible.

Comfortable feet allow people to continue moving safely around the home, shopping independently, attending appointments, exercising, and participating in social activities.

Preventative care focuses on identifying problems early before they begin significantly affecting mobility or quality of life.

This may involve:

• routine nail care
• pressure reduction
• footwear advice
• monitoring circulation and sensation
• managing skin health
• identifying mobility concerns early

For people receiving aged care or Support at Home services, maintaining mobility and reablement goals is often an important part of the overall care plan.

Working Together as a Care Team

One of the most positive things we see in podiatry is when carers, families, and healthcare professionals work together to support someone’s wellbeing.

Carers often notice subtle changes first because they spend time assisting with everyday activities. Sharing these observations helps podiatrists better understand how foot issues may be affecting daily life and mobility.

Sometimes the information a carer provides during an appointment is just as important as the physical assessment itself.

By working together, we can help support the person’s comfort, mobility, confidence, and independence more effectively.

When Should You See a Podiatrist for Nail Care on the Sunshine Coast?

Older adults should consider seeing a podiatrist if they are struggling to manage their own nail care safely or if they develop pain, thickened nails, skin changes, swelling, or mobility concerns.

A podiatry assessment involves more than simply cutting nails. Podiatrists assess circulation, nerve sensation, skin health, footwear, mobility, and pressure distribution to identify potential issues affecting the feet overall.

This is particularly important for people living with diabetes, arthritis, peripheral neuropathy, or circulation concerns. Early assessment often helps identify problems before they begin affecting independence or quality of life.

Across the Sunshine Coast, podiatry services may be available both in clinic and through mobile podiatry visits. Mobile podiatry can be especially beneficial for older adults who have difficulty attending appointments independently or who receive aged care support services at home.

Preventative Foot Care Supports Healthy Ageing

Healthy feet play a major role in maintaining confidence, independence, and overall wellbeing as people age.

While nail care may seem like a small issue initially, discomfort in the feet can gradually affect mobility, balance, exercise levels, and participation in daily life.

Regular podiatry care helps identify small problems early and supports safer, more comfortable movement over time.

Families and carers play an extremely important role in this process by helping notice changes, supporting footwear choices, and encouraging appropriate healthcare when needed.

Frequently Asked Questions

How often should older adults see a podiatrist for nail care?

This varies depending on the person’s health, circulation, mobility, and nail condition. Some people may only require occasional appointments, while others benefit from regular ongoing care.

People with diabetes, reduced circulation, or very thickened nails often require more consistent monitoring.

Why do toenails become thick with age?

Toenails may thicken due to ageing, reduced circulation, repeated trauma, fungal infections, or long-term pressure from footwear.

Thickened nails can become painful and difficult to cut safely over time.

Is it dangerous for carers to cut toenails?

In some situations, yes. Older adults with diabetes, reduced circulation, fragile skin, or reduced sensation are at greater risk of injury or infection if the skin is accidentally damaged.

This is why podiatry care is often recommended instead of home nail cutting.

What should carers look for on the feet?

Carers should monitor for redness, swelling, wounds, cracked skin, thickened nails, colour changes, or signs of pain when walking.

Changes in mobility or reluctance to walk can also indicate foot discomfort.

Can painful feet affect balance?

Yes. Foot pain can alter walking patterns and reduce confidence moving around safely. Over time, this may contribute to instability and increased falls risk.

Addressing foot pain early often helps support safer mobility.

What shoes are best for older adults?

Supportive footwear with good grip, stability, and proper fit is generally recommended. Shoes should protect the feet while allowing comfortable movement.

Loose slippers or heavily worn shoes may increase instability and pressure areas.

Are mobile podiatry visits available for elderly patients?

Many podiatry clinics offer mobile podiatry services for older adults who have difficulty attending appointments independently.

These services can be particularly helpful for people receiving home care or aged care support.