Diabetic Foot Checks in LTC: A Step-by-Step Nursing Routine Guide

Foot problems are a common reason seniors with diabetes end up in hospital, and most start small: a corn, a blister, or dry skin nobody examined in time. In long-term care, residents with diabetes often cannot inspect their own feet, so the routine falls to nursing staff. A consistent diabetic foot check, done properly with the right supplies, catches trouble before it becomes a wound that needs weeks of treatment.

This guide walks through a practical foot-check routine for LTC teams, including what to look for, what supplies to keep at hand, and how to document findings so changes are noticed early.

Why Routine Foot Checks Matter in LTC

Diabetes reduces blood flow to the feet and damages the nerves that signal pain, so a resident can develop a blister or wear a rubbing shoe and feel nothing. Where many residents have limited mobility, feet may only be seen during bathing; a scheduled check makes inspection a regular part of care.

Data from PHAC routine practices guidance underline that skin breakdown is an infection risk in care settings. Once skin opens, bacteria have a pathway in, and diabetic feet heal slowly. Early detection of redness, cracking, or discolouration is the single most useful step a care team can take.

Supplies to Keep on the Foot-Care Cart

Foot checks do not need a sterile field, but they need clean, single-use supplies on a dedicated cart or tray so nothing is borrowed mid-procedure.

• Powder-free nitrile examination gloves, a fresh pair per resident
• Basin with warm water and mild soap, or disposable cleansing wipes for residents who cannot soak
• Soft towel (single-resident use or disposable)
• Penlight or strong light source for inspecting between toes
• Emery board or file for nails; never cut nails with scissors during a routine check without a care plan
• Alcohol prep pads for cleaning small instruments and prep areas
• Moisturizer for dry skin (avoid between toes)
• Sterile gauze sponges to cover any open area until the nurse assesses it

The Step-by-Step Foot Check

Perform the check in the same order each time so nothing is missed. Allow about five minutes per resident once the routine is familiar.

Step 1: Ask and observe. Ask the resident or PSW about any new pain, numbness, or changes they have noticed. Observe how the resident walks or stands if they are able.

Step 2: Wash and dry. Wash feet with warm water and mild soap, then dry thoroughly, especially between the toes. Moisture trapped between toes invites fungal infection.

Step 3: Inspect the whole foot. Look at the soles, heels, tops, and between each toe. Check skin colour, temperature, and any swelling. Look for calluses, corns, blisters, cracks, redness, or discharge.

Step 4: Check the nails. Look for ingrown nails, thickening, or discolouration. File nails straight across. Do not cut into corners.

Step 5: Feel for pulses and sensation. If the care plan includes it, palpate the dorsalis pedis pulse and test sensation with a monofilament. Record findings on the resident's chart.

Step 6: Moisturize and protect. Apply moisturizer to dry areas, avoiding between the toes. Put on clean socks. Never leave a resident barefoot during the check.

What to Document and When to Escalate

Document the date, findings, and action in the care record, and escalate to the nurse or wound-care lead immediately for open skin, bleeding, discharge, severe redness, swelling, or a temperature change. For residents with ulcer history, follow the pressure-injury protocol without waiting for the next scheduled check.

Keep the same staff member assigned where possible; continuity makes subtle changes easier to notice, and a clear documentation handoff prevents missed signs.

Making the Routine Stick

Add foot checks to the monthly care plan review and to the medication-pass schedule as a standing reminder. Post a visual checklist in the supply room and order a full month of consumables so the cart never runs empty.

Facilities that pair the foot check with diabetes medication reviews catch more problems earlier, because the same staff touch point covers both glucose management and foot health.

Frequently Asked Questions

How often should diabetic foot checks happen in long-term care?

Most Canadian LTC homes schedule a full foot check monthly for residents with diabetes, plus skin inspection at every bath or shower. Residents with a history of ulcers or neuropathy may need weekly checks per their care plan; follow provincial regulations and the facility's own policy.

Can PSWs perform diabetic foot checks in LTC?

Yes, within their scope and training. PSWs typically perform inspection and basic nail care, while nurses interpret findings and decide on escalation. Facilities should document the delegation in policy and train staff on what to look for.

What gloves are right for foot checks?

Powder-free nitrile examination gloves are standard: they protect staff from body fluids, contain no latex proteins, and allow enough sensitivity to feel pulses and skin changes. One pair per resident prevents cross-contamination.

What supplies should the foot-care cart always have?

At minimum: nitrile gloves, a basin or cleansing wipes, a single-resident towel, a penlight, an emery board, moisturizer, alcohol prep pads for instruments, and sterile gauze. Check the cart weekly so supplies never run out mid-procedure.

Last updated: September 7, 2026. CliniEco Medical is a licensed medical device establishment (MDEL #35334).