Waking up early every morning and stepping out to get some flowers from her garden has been a routine for 71-year-old Shashikala M from Bangalore. Walking barefoot inside her house and in the garden was a practice for several years until 2021 when she injured her foot after stepping on a sharp object in her garden which went unnoticed and turned into an infection.
Speaking to Happiest Health, she said that she didn’t pay much attention as it wasn’t painful. It’s only after she faced difficulty in walking and felt pain, she leant that the small prick had created a wound and there was swelling too. “There was pus formation. I met a doctor and was treated for the wound. There was an infection and it took me over two months to be mobile. This could have been avoided if I was wearing footwear while in the garden,” says Shashikala.
Barefoot walking, a big no for the elderly
Senior citizens experience reduced sensation of pain and touch due to which they don’t realize when they have a cut or an injury on their foot, says Dr Subrata Das, senior consultant, internal medicine and diabetology, Sakra World Hospital, Bangalore. “In the elderly, sensation of pain and touch can be impaired due to various reasons including ageing and other conditions such as diabetes, vitamin B 12 deficiency, and thyroid dysfunction,” he said adding that as they lose the sense of pain, most injuries are left unattended, leading to infection.
“Walking barefoot can pose significant risks for the elderly, primarily due to age-related factors such as diminished sensory perception, postural imbalance, a weakened immune system, and slower wound healing,” says Dr Kuna Ramdas, senior dermatologist, Kamineni Hospitals, Hyderabad. These factors collectively increase the likelihood of injuries, falls, and infections, making it advisable for elderly to wear appropriate footwear to mitigate these risks and maintain their well-being, he added.
Pros and cons of barefoot walking
Walking barefoot among the elderly presents a set of pros and cons. Dr Ramdas said that it can promote improved balance and strength by engaging foot and lower leg muscles, which is vital for maintaining mobility. “It also allows for a more natural sensory experience, aiding spatial awareness. However, there are substantial risks, including a heightened likelihood of injury due to a diminished ability to detect hazards like sharp objects and uneven surfaces, which can result in fractures, cuts, or sprains,” said Dr Ramdas.
Dr Das says that there are several infections that are known to enter the body through the feet, one such being hookworm infection where the parasites enter the body through the feet and can lead to severe anemia in elderly. “Walking barefoot can have complications such as foot ulcers and gangrene,” he said adding that diabetic foot is commonest in elderly.
He further suggests installing a mirror near the beds of elderly where they can check their foot once before going to bed. “It must be a regular practice to check their feet for any cuts, injuries or changes in their feet before going to bed. Family members or caretakers can also check their feet,” he said.
Don’t neglect the wound
According to Dr Ramdas, neglecting to treat cuts or wounds in the elderly can have serious consequences, including potential development of painful conditions like cellulitis, a skin infection, and in severe cases, the life-threatening condition of sepsis, blood poisoning.
“The elderly are particularly vulnerable to these risks. Therefore, it’s vital to promote safe mobility and foot health among older individuals by encouraging the use of supportive, well-fitting footwear for both indoor and outdoor activities,” said Dr Ramdas.
How to treat the injury?
“If there is a small cut or injury, wash the injury and apply an antiseptic. If the person has diabetes, they need to consult the doctor irrespective of whether the wound is small or big as that could lead to an infection,” said Dr Das.
He said that if it’s a simple superficial wound, the person can recover in a week after taking antibiotics and depending on the extent of the wound, it could take from weeks to months to recover. “In the worst case, if the infection has spread across, they might have to amputate their legs,” he explained.
Takeaways
Elderly persons must avoid barefoot walking. Due to reduced sensation of pain and touch in elderly, they don’t realize when they have a cut or an injury on their foot, making them more vulnerable to injuries that could lead to infections. It is important for them to regularly inspect their feet and ensure they don’t leave any wound unattended
