Head

• Encourage mouth care daily and ask residents about mouth infections, eating difficulties, or mouth pain
• Ask residents about tooth decay, gum disease, ulcers, loose teeth, or ill-fitting dentures
• Encourage regular food and fluid intake and watch for difficulty with eating or change in appetite
• Watch for possible signs of
— Hypoglycemia (too little blood sugar)
— Hyperglycemia (too much blood sugar)

Skin
• Remind residents to keep skin clean and dry
• Encourage them to use moisturizing soaps when bathing
• Urge residents to moisturize their skin to prevent chapping, especially in cold or windy weather
• Make sure residents see a nurse right away if they get a major cut, burn, or infection.

Legs
• Ask about tingling, burning, and numbness, especially at night
• Watch for discoloration, shakiness, muscle weakness, balance problems, or nighttime falls
• Discuss leg pain, particularly when walking or exercising, which disappears after a few minutes
of rest
• Investigate sores or infections that heal slowly

Feet
• Remind residents to wash their feet regularly and look for drainage, open wounds, or discoloration (including between the toes)
• Encourage residents to care for their feet, including moisturizing, nail cutting, and callus trimming
• Tell residents to check their feet often for cuts, breaks in the skin, ingrown toenails, or changes in color or shape
• Notice if residents’ shoes fit correctly
• Remind residents not to use hot water bottles, heating pads, or electric blankets on their feet
• Encourage residents to put feet up when sitting
• Tell residents to be sure their feet are thoroughly dry after washing and there is no moisture between the toes

 

References:
1. American Diabetes Association. Peripheral arterial disease (PAD). http://www.diabetes.org/living-with-diabetes/complications/heart-disease/peripheral-arterial disease.html. Accessed January 3, 2017.
2. American Diabetes Association. Diabetes and oral health. http://www.diabetes.org/living-with-diabetes/treatment-and-care/oral-health-and-hygiene/diabetes-and-oral-health.html. Accessed January 3, 2017.
3. American Diabetes Association. Skin complications. http://www.diabetes.org/living-with-diabetes/complications/skin-care.html. Accessed January 3, 2017.
4. American Diabetes Association. Foot care. http://www.diabetes.org/living-with-diabetes/complications/foot-complications/foot-care.html. Accessed January 3, 2017.