What Causes Swollen Feet & Ankles in Elderly? Caregiver Tips

For most people, the effects of swollen body parts come and go in a short while and only manifest in minor discomfort. For seniors, though, swollen feet and ankles might be pointers to a more serious condition known as edema. As one might imagine, there are numerous factors, lifestyle and medical, that may cause swollen feet. So, what causes swollen feet and ankles in the elderly? This guide will take you through the most common causes, possible treatments, and preventative measures you can take against swollen ankles and feet.

What Causes Swollen Feet and Ankles in Elderly People?

For most seniors, swollen feet often point to an underlying condition. However, if one has been standing or walking a lot, the ankles and feet may swell temporarily. If the swelling results from something else, though, and persists for a while, it might be a pointer to something else. Here are the common causes [1] of ankle and foot swelling.

Foot or Ankle Injury

An injury to the ankle or foot could lead to noticeable swelling. One of the most common ankle injuries is a sprain when the ligaments holding the ankle in place are overstretched beyond their natural range. If an older person sustains such an injury, it is important to rest the foot, use a compression bandage, or use ice packs to relieve the pain. If the pain persists after these home remedies, visit your doctor.

Lymphedema

Lymphedema is a medical condition in which lymphatic fluid accumulates in the tissues due to underlying problems with lymph nodes or lymphatic vessels. Basically, lymph is a protein-rich fluid that travels through the body’s network of capillaries and other vessels. The lymph nodes filter this fluid, removing any unwanted substances and pathogens. When there is an issue with any part of this system, the fluid might become trapped in the tissue, resulting in a buildup that causes swelling.

Venous Insufficiency

Venous insufficiency is a medical condition in which blood movement from the heart to the legs is inadequate. In a healthy human being, blood flows upwards to the heart and is prevented from reversing by venous valves. When these valves become weak or damaged, the blood might leak, resulting in fluid retention in the legs. The ankles and feet are among the most affected in this case. Some of the symptoms of venous insufficiency include infections, skin ulcers, and skin color changes.

Infection

Swollen ankles and feet can be symptoms of an underlying infection. Seniors with nerve problems or diabetic neuropathy are often at greater risk of foot infections. If you notice a blistered swollen foot on your loved one, get them medical attention as soon as you can.

Blood Clot

When blood clots form in the vessels that transport blood from the legs to the heart, blood flow becomes obstructed. This obstruction can result in swollen feet and ankles. Such clots can develop on the veins just beneath the skin (known as superficial clotting) or deeper veins (known as deep vein thrombosis). Besides causing swelling, deep clots can also become life-threatening when they travel to one’s heart or lungs.

Liver, Kidney, or Heart Disease

At times, swollen feet and ankles can result from underlying heart, kidney, or liver complications. Ankles that only swell in the evening might result from water and salt retention due to right-side heart failure. When one’s kidneys are not functioning as they should, it might result in fluid buildup in the body, causing swelling. If the swelling in your feet is accompanied by weight gain, loss of appetite, and fatigue, among other symptoms, see a doctor immediately.

Side Effects of Medication

Numerous drug classes can result in ankle and foot swelling as one of the side effects. Here are some common ones.

  • Anabolic and androgenic steroids.
  • Antidepressants such as monoamine oxidase (MAO) inhibitors.
  • Calcium channel blockers: These are blood pressure medications and might also cause swelling.
  • Diabetes medications.
  • Hormones: Testosterone and estrogen found in hormone replacement therapies and oral contraceptives might result in ankle and foot swelling.
  • Non-steroidal anti-inflammatory drugs (NSAIDs)

Types of Edema

We have been discussing a condition known as pitting or peripheral edema, which involves swelling on the legs, ankles, and feet. However, there are other types of edema [2] as described below.

  • Angioedema: Manifests in swelling beneath the skin. This condition affects deep layers of the skin and often develops on the face.
  • Cerebral edema: Involves the accumulation of fluid in the brain.
  • Dependent edema: This manifests in the lower part of the body, which is most affected by gravity. The symptoms are mostly felt in the legs when one is standing and, on the buttocks, when one is sleeping.
  • Hereditary angioedema: This is a sporadic genetic condition that makes a person’s capillaries release fluid into the surrounding tissue, resulting in swelling.
  • Lipedema: This is a condition of the fatty tissue (adipose) resulting in swollen legs and hips.
  • Macular edema: This manifests in a swelling of the macula, the portion of the eye that perceives detailed vision.
  • Papilledema: This is a condition that results in the swelling of the optic nerve. The swelling happens after a pressure buildup in the skill and the areas surrounding the brain.

How Family Caregivers Can Help Seniors Manage Edema

Here are some steps you can consider when taking care [3] of an edema patient.

Focus on a Low-sodium Diet

Make sure the older adult takes foods with more vitamins, antioxidants, and minerals. These include onions, beets, garlic, grapes, pineapples, pumpkin, and leafy green vegetables. Also, use sodium-free spices such as citrus and fresh herbs instead of conventional table salt.

Decrease Fluid Intake

Water is essential for keeping us hydrated and healthy. However, for edema patients, less is more. Consult your doctor to determine the optimum amount of fluids you can take each day. Excessive fluid intake might exacerbate an already bad situation. This step is essential for patients whose fluid regulating organs such as kidneys have partially failed.

Massage and Compression Therapy

Compression sleeves or stockings can prevent the buildup of fluids in the legs. You could also try to exert pressure on the affected body parts using compression therapy to help eliminate excess fluids. It is advisable to consult a qualified medical massage therapist before embarking on compression therapy at home. You could also try using leg and foot massagers that are readily available in online stores.

Mobility and Exercises

Ensure the senior carries out some leg-raise exercises severally throughout the day to prevent the pooling of fluids around the feet and ankles. You could also get wedges, pillows, and slings to help the older adult elevate their feet. Additionally, have the person walk around the house or outdoors a few times a day. Doing this enhances circulation and strengthens the person’s cardiovascular system.
You should consult your doctor or physician regarding the right exercise regime to suit the senior’s muscle strength and ability.

Exercises for Swollen Feet

Here are some excellent exercises seniors can try to alleviate the effects of swollen feet and ankles.

Point and Flex Exercises

A point-and-flex exercise is meant to restore mobility to one’s ankles and feet. To try it out:

  1. Have the senior sit on the floor or on a chair with one leg extended out and the other one elevated about a half foot off the floor.
  2. With the person’s arms at their sides and back straight, have them point their toes away and forward as far as they can without overstretching or straining.
  3. Have them hold the position for a few seconds before resuming the initial position.
  4. Repeat the exercise ten times, making sure to alternate legs.

The Alphabet

The alphabet exercise routine is an amplified version of the conventional point and flex. With the person sitting on the floor or on a chair, have them place their hands on their thighs. They should then extend their left out until it sits parallel with the floor. In this position, they should use their extended foot as a brush and paint letters in the air. Have them start with letter A and see how far they can get without straining. Once they have gone through all letters in the alphabet with one foot, have them repeat the exercise with the other leg.

Toe Squeeze

The toe squeeze exercise is meant to strengthen your toes and boost circulation around the leg. To try this exercise:

  1. Have the older adult sit and place a flexible ball between all their toes.
  2. Once the balls are in place, have the person squeeze their toes as hard as they can.
  3. Ensure that their back is entirely straight and their abdominal muscles tightened when doing the toe squeeze.
  4. Hold the squeezing position for about five seconds and repeat on the other leg.

Resistance Bands

This exercise is best performed using a rubber therapy band. However, feel free to use any resistance band you can find. Use the band to hold your feet together, ensuring the big toes on both feet are in contact. Sit down flat on the floor with your arms sticking out sideways and your legs extended outwards. Try to pull your feet away, feeling the band’s resistance as you try harder. Hold the pulling position for five seconds before resuming the initial position. Repeat the exercise ten times.

The Foot Rocker

The Foot Rocker is a slightly advanced version of the point-and-flex discussed earlier. To try the exercise:

  1. Start with assuming a good standing posture and take rocking motions on the ball of your feet.
  2. Pause for a few seconds and rock back to the initial position.
  3. Repeat the exercise ten times.

Tennis Ball Massage

The tennis ball massage is not exactly a form of exercise, but it can still alleviate the effects of swollen feet and ankles. Have the senior sit on a chair and place a tennis ball under the arch of their left foot. Have them roll the ball under their feet while applying some slight pressure. Each roll should last thirty seconds before switching feet.

Conclusion

Swollen feet and ankles are quite common among seniors for a wide range of reasons. However, an older adult does not have to experience the painful and uncomfortable effects of edema. By following the prevention, treatment, and exercises outlined in this guide, the effects of edema can be easily alleviated.

Citations

  1. https://www.webmd.com/a-to-z-guides/swollen-ankles-and-feet
  2. https://www.medicinenet.com/edema/article.htm
  3. https://www.griswoldhomecare.com/blog/2020/august/edema-in-elderly-adults-swollen-legs-ankles-and-/
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