Proper Footwear for Older Adults

by Bruce Montgomery Ph.D. November 01, 2016

Proper Footwear for Older Adults

My senior sister Susan sent me an email the other day about a recent safety incident at her home.

“A few days ago, while carrying laundry down to the basement, as I swung my leg to go around the corner, I hit my fourth toe on the leg of a metal stool (which was positioned too close to the bottom of the stairs.)

It was the sharp pain of a stubbed toe, with more intensity and longer lasting, so I probably 'stoved' it considering the bruising on the top of my foot.

It wasn't such a serious break or bruise that I would go to Urgent Care, but it has lingered and reminded me of protecting my feet while indoors.

I sure prefer going barefoot around home, but now I'm going to wear shoes with the awareness that it is the safe thing to do.”

It was thoughtful for my sister to share her safety incident with me and to offer for me to share it with you.

In other blogs I have suggested that seniors wear proper fitting footwear around the home to avoid slipping. But let’s get a little more specific here – for the sake of toes, backs, hips, heads and knees.

I hit the jackpot by finding a systematic literature review and analysis by Menant et al. (2008) Optimizing Footwear for Older People at Risk of Falls published in the Journal of Rehabilitation Research & Development*. The authors reviewed 79 articles about what constitutes safe footwear for older people undertaking activities in an around the home.

Their findings were quite informative – especially given our tendency to take our footwear for granted. Here are some of the highlights from the literature survey:

  • Many older people wear inappropriate footwear both inside and outside the home.
    • Older people often wear slippers (especially in assisted living facilities and hospitals) because they are usually made of soft material and their flexible structure can comfortably accommodate painful feet and foot deformities
    • In one study, more than a quarter of older community dwellers walk in the home barefoot which is associated with an increased risk of falling
    • Older people who wear shoes, replace them infrequently, possibly because of a lack of knowledge about the importance of safe shoes and/or financial considerations
    • Older people tend to wear excessively flexible and/or overly long and wide shoes
    • Older people favor shoes without fasteners for the practical reasons that they do not have to bend down to tie laces or fasten straps.
  • Walking barefoot or in socks increases the risk of falls in older people by more than tenfold
  • Walking indoors or outdoors in high-heel shoes has been shown to increase the risk of falls in older people
  • Poorly fitted or slippery soled shoes or slippers increase the risk of falls
    • Participants in studies who had falls reported wearing shoes with slippery soles or slippers
    • A history of high-heel shoe wearing in women was a predisposing factor for falling
  • The authors recommend the following footwear for older adults in and around the home:
    • Appropriately fitted shoes both inside and outside the house, because walking barefoot and in socks indoors are the footwear conditions associated with the greatest risk of falling
    • Low-heel shoes because the detrimental effects of high-heel shoes on posture, balance, and gait are numerous and this type of footwear is also associated with an increased risk of falls
    • Thin, hard-soled firm shoes to optimize foot position.
    • A tread, slip-resistant sole and a treaded beveled heel may further prevent slips on wet and slippery surfaces

Recommended shoe features for older people (Menant et al., 2008)

For help with selecting proper footwear, make an appointment with a podiatrist. I did so recently and he diagnosed a foot problem that I had been having for several years. He also referred me to a high quality shoe store that would carry the shoes that are best for my feet and provide the proper motion control.

Thanks again to my sister for sharing her story and helping to remind us how important proper footwear is to our safety and comfort. Hope your toe heels quickly sis!

*Jasmine C. Menant, PhD; Julie R. Steele, PhD; Hylton B. Menz, PhD; Bridget J. Munro, PhD; Stephen R. Lord, PhD, DSc. Optimizing Footwear for Older People at Risk of Falls Journal of Rehabilitation Research & Development, Volume 45, Number 8, 2008, Pages 1167–1182.




Bruce Montgomery Ph.D.
Bruce Montgomery Ph.D.

Author

Dr. Bruce Montgomery is a licensed building contractor in Michigan and Florida. He is a Certified Aging-in-Place Specialist as designated by the National Association of Home Builders. He has also achieved an Executive Certificate in Home Modification from the University of Southern California. He has a wide ranging educational background, including a Master of Science degree in Entomology, with a Master of Science degree in Forestry and a Ph.D. in educational administration.