Chapter twenty-one
PERSONAL CARE
Keeping clean — clothes — footwear
|
|
Chapter twenty-onePERSONAL CARE
|
|
Keeping clean
Some top to toe personal care tips
Clothing
Feet and footwear
Keeping yourself 'nice to know' can be difficult and exhausting if you've got a rheumatic disorder. Fortunately there are lots of gadgets and tricks to help. Please don't be too stubborn to take advantage of them. You'll also work out your own pet ways of getting things done.
Get the advice of an OT, and thoroughly look into what's available before investing in any gadgets or adaptations. Look back at chapter 20 for where to find out more, including a list of commercial gadget suppliers, and Appendix 2 for suppliers' addresses. Contact your local Disabled Living Centre (DLC) or the Disabled Living Foundation (DLF) for more information, advice, and addresses. Don't, too, forget all those nifty devices around for non-disabled people like a non-slip bath mat or long-handled back brush (useful for feet). For general information look at:
Look at DLF's special 'Bathing made easy' website.
The bathroom
Make sure it's warm. If other people use it, bully them into leaving it just as they find it! Train them to clean the bath and loo themselves after use and to put things back in the right place for you.
A bath doesn't just keep you clean. A long luxuriating bath can do wonders for the morale and for relaxing weary bones and muscles. So don't give up too quickly if bathing becomes a chore. Sometimes the solution's surprisingly simple. YPA (younger person with arthritis) Chris Wood was overjoyed to find that taking her exercises seriously and regularly actually meant she could manage bending and kneeling again, and, despite some difficulty, she could at last use the bath she hadn't been able to use for over six years!
Bath rails can help, positioned with an OT's advice, and fixed by someone skilled at the job, who knows which walls can take the strain. Also, as Peggy Jay rightly points out:
"…placing the feet correctly before moving, and timing the thrust which is needed from the feet at a particular moment, is every bit as important as the help given by a rail…" (In Coping with Disability, DLF)
A bath board or bath seat solves the getting-in/out problem for some people. Whatever you use, beware of slipping. Slip-resistant mats are cheap and widely available. Other solutions may be more complicated. Look at DLF's 'Bathing made easy', and ask your OT about different types of bath and adaptations to existing baths, and about help with funding if needed. You can get high baths and low baths, walk-in baths and adjustable reclining baths, or you can get bath inserts to fit in or over existing baths.
Bath hoists help some people, though aren't always easy for someone with arthritis to operate alone. My OT loaned me a wonderful bath seat (DLF's website and leaflets show examples) which rises up and down in the bath at the touch of a button, and operates on a rechargeable battery. However, very stiff hips, bent knees or difficulty lifting your legs over the side of the bath might cause difficulties. I found I needed a grip bar on the wall to help, too.
Look at DLF's leaflets Choosing a bath and bath accessories and Choosing and fitting grab rails for more information, and get advice from your local Disabled Living Centre and OT.
Maybe taking a shower is easier than struggling to have a bath? Again, do get an OT's advice. Be sure you can get in and out safely, operate the taps, and cope safely with washing movements. Some showers have flat, walk-in access with no steps. Properly fitted grab rails may help — some fold up against the wall. You could sit on a special washable stool, some are adjustable in height. You'll also need shelves/hooks for soap and gadgets, and a non-slip mat. You might avoid the palaver of a shower-cap simply by working out exactly where the spray goes and keeping your head out of the way! Inexpensive adaptations might do rather than fitting a complete new shower unit. The DLF leaflet Choosing a shower and accessories gives more information.
Lever style taps are usually easiest to manage and put less strain on wrist, thumb and fingers. Portable lightweight plastic levers are available which you can use on existing taps and when away from home, or you could have yours changed permanently to lever style. Only certain types are permitted for domestic use, so get your OT's advice. Some water authorities may be willing to modify your taps, changing not only the taps, but the position too, if necessary.
Bottom-washing's difficult if you can't get in the bath or shower. You could try a long-handled sponge, or flannel mitt or a baby-wipe over the end of a long handle (eg bath brush used wrong way round). And see 'Using the loo' below.
Away from home, if using a strange bath/shower is a possibility, remember to take any easily portable gadgets with you, eg non-slip bath mat, long-handled brush, portable tap turner (or increase your grip using a damp cloth). Keep a note (in your Medikit, chapter 4) of what you'll need to take if you go away, so you don't forget.
Wherever you are, home or away, before you attempt to bath or shower, do first think through every movement from start to finish. Can you really manage everything, and safely? I well remember a wonderful bath (away from home) from which I had idiotically not pre-planned my exit. Eventually I solved the problem by soaking a towel completely (to stop it slipping), and only just struggled out by contorting myself on to it, over the side. My hostess was extremely puzzled by the sodden state of the towel!
Washing tips
You might prefer a sponge to a flannel as it lathers and squeezes out more easily. Or perhaps a homemade or bought flannel mitten; in France mittens are more usual than square flannels. Instead of a slippery tablet of soap you could try liquid 'soap' or aqueous cream (pharmacists sell big cheap pots), or get someone to make you a 'soap on a rope' to hang round your neck, or use soap in a home-made foam envelope. Sew two pieces of foam sponge together, inserting left-over soap pieces before you close up the edge completely.
Like me you might need a long-handled bath brush to reach feet and legs, and maybe your neck too. A long-handled dish mop might come in helpful! You can also buy special long-handled lambswool pads and sponges, and long oblong pieces of flannel with loops at each end for doing your back.
For the outer edges of ears, try 'cotton buds' — carefully — or a baby-wipe on the end of a long handle, and/or give the ears a regular good soak in the bath. Ask the pharmacist's advice on ear drops for any wax problems. Use lateral thinking for other difficulties, for instance if you can't easily take the nailbrush to your nails, take your nails instead to a fixed nailbrush.
Drying
Large or small towel? A large towel wrapped around you saves the bother of rubbing dry, but a small towel may be easier to manage. A towelling robe or cape helps some people. If you can't reach to dry your toes, try wriggling them in the towel to dry them, possibly using the other foot to help. Or shuffle them on the bath mat, and sprinkle talc into your slippers from aloft before stepping into them. A powder puff on a stick's another possibility.
Using the loo
Wear clothing that makes moving/removing easier. — Getting to the loo on time is often a clothing or equipment issue rather than a continence issue! 'Helpful' clothing could include 'open-gusset' or suspender tights (see below);
or French knickers wide enough to pull the crotch easily to one side; or a trouser device such as a 'pants clip' (which keeps lowered pants or trousers within reach when standing up after using the toilet).
Through your OT borrow a plastic 'seat raise' to overcome low loo seat problems and avoid straining bad knee and hip joints. Get OT advice on other adaptations, eg grab rails. Look too at DLF's Choosing toilet equipment and accessories for these and other ways of overcoming problems such as loo-flushing (eg broadened cistern lever or foot-operated flusher) and devices for people who find it difficult to clean themselves after using the toilet — for instance special bottom wipers (long handles which grip toilet paper), removable bidets (which fit into standard toilet bowls), and combined toilet/bidets which provide a warm water spray and hot air drier from inside the toilet bowl.
Why not borrow a commode for bad times or if stairs are a problem at night? Some disguise their purpose well. For temporary use, perhaps while staying with friends, a commode can be hired from the Red Cross. Or take a discreet plastic jug or portable 'urinal' (I do! — available for men and women, see 'Homecraft Rolyan' in chapter 20).
Hopefully, some of these will help increase your independence, conserve energy and cut down on pain and stiffness problems. Look back at chapter 20, under 'writing and gripping', for basic tips on enlarging handles to overcome gripping problems and improve finger joint care. Look too at ARC's Looking After Your Joints When You Have Arthritis for tips on reducing pain and joint strain by altering the way you do things, and look at the other booklets mentioned at the beginning of this chapter.
| Difficulty | Possible solution |
| • hair care | • Use long-handled brush/comb, or attach comb to a ruler or other long stick with insulating or sticky tape. Wash hair while having a shower. Apply shampoo with long-handled bathbrush, instead of hand. Ask if a local hairdresser does 'home visits'. Try sitting near a small wall-mounted convector or fan heater, but be very careful — don't touch it and do make sure no water can drip on to it. Use hair mousse or gel to make shape more interesting without having to blow-dry or use rollers. Apply by dipping comb/brush in the mousse if easier. |
| • teeth | • Rubber band wound round toothbrush handle increases grip. Or enlarge handle using suggestions in chapter 20 ('writing and gripping'). Try battery-operated or an electric toothbrush, lighter and cheaper than you might think; more efficient than weak hands. Too house-bound to get to your dentist? Talk to your GP and/or contact the dental officer employed by your local health authority. |
| • skin care | • Instead of soap try low-cost scent-free aqueous cream (from the chemist) or liquid soap. Use a soft long-handled artist's paintbrush to apply moisturiser to parts (like neck) which you can't reach. People with psoriasis or lupus may need special advice on skin care, and can get tips from the Psoriasis Association and Lupus UK or the Beauty Camouflage Care Service run by the British Red Cross, tel: 0870 170 7000, or the British Association of Skin Camouflage, tel: 01625 871129.
|
| • make-up | • Looking good will help you feel good too. Make-up brushes make applying eye shadow and rouge easier (or use longer artist's paintbrushes). Before you buy, test containers in the shop for ease of opening. A felt-tipped nail-polish pen may be easier than the bottle and brush method. See chapter 23 for make-up and skin care product buying by mail-order. |
| • shaving (men) | • Check weight and ease of use of electric/battery shavers before you buy Lightweight disposables may help on bad days. Lengthen the shaving handle or enlarge it using a wound-around rubber band, or suggestions in chapter 20 ('writing and gripping'). For a wet shave try aerosol foam lather. Or instead of shaving cream try shaving with olive oil! Or grow a beard! A cordless electric beard-trimmer (eg Braun's) will keep it smart.
|
| • depilation | • Sitting in the bath or shower apply cream or aerosol foam to legs using wrong end of long-handled bath-brush. Rinse off (thoroughly) using carefully directed shower spray or mugs of water. Or get it done professionally or ask a friend. For eyebrows or the occasional stray hair, you can get 'squeezy tweezers' — decreased-grip tweezers with a continuous loop nylon moulded handle which acts as a spring and reopens tweezers when pressure is released (eg easi-grip tweezers from Peta (UK))
|
| • cutting nails | • You can get a rubber handle (Body Care Nail File) which will grasp your nail file so you can hold it more easily. If you can't easily take a nail clipper or emery board to your nails, take your nails instead to a fixed 'Table-Top Finger Nail Clipper' or a similar emery board. Peta (UK) specialise in all sorts of scissors, nail care and other products for people with gripping difficulties. |
Taking trouble over the way you look boosts self-confidence, and focuses other people's attention on your best features. Stiff joints and dressing don't go easily together, but by choosing styles with care, using a gadget here, or a nifty trick there, you can work wonders. Tried and tested styles can be updated by bright and zany accessories. No need to go for specially designed clothing though it's available if necessary.
If you or a friend can manage simple adaptations yourself, so much the better. Have a go at learning to sew (see chapter 35). Even if you're not a wheelchair user, there are some useful alteration tips in DLF's Clothing ideas for wheelchair users and in another alterations leaflet. Some shops will do simple alterations to clothes you're buying from them, such as shortening and hemming trousers or shortening sleeves. Worth remembering too that dry cleaning shops will do some alterations, eg fitting zips, shortening clothes.
Your local DLC may be a good source of clothing information and advice. The Independent Living Centre in Devon is a particularly good example. Look at the website to see what their Clothing Advice Service can do, for instance give information about current styles available by mail order or locally to meet particular needs, lists of specialist suppliers, lists of local dressmakers, tailors and alteration services, etc.
Get helpful tips from other YPAs (younger people with arthritis), OTs, and look out in Arthritis News for fashion and personal care articles. Choose loose-fitting rather than tight garments, clothes with roomy armholes and reachable, manageable fastenings. Go for front openings rather than back. Slippery, lined garments may be easier too. Try dressing sitting down rather than standing. Opt for lightweight rather than heavy clothes. Several lighter layers are warmer than one heavy layer. Pockets can save wear and tear on hands and feet, so include pockets in any clothes you make.
YPA Peter Nightingale has some tips for dressing with stiff shoulders:
"To get jumpers and T-shirts on and off use a long stick. I use a walking stick, or sometimes a folding snooker cue. [Or a dressing hook or longreach gadget]. Put your arms in the sleeves of the jumper first and then with the stick up the front of the jumper (with the end resting at just below the neck) push it over your head. To get a jumper off: put one end of the stick up the back of the jumper and rest it near the top at the back of the neck. Rest the other end of the stick against the corner of a wall, or in a recess (eg hollow grip of a chest of drawers) at about neck height or just below. Walk backwards. The jumper will come over the top of your head. Release the stick and pull the jumper off from the front."
Jogging suits are comfortable and easy to get on, but choose them with ankle openings that aren't too tight. How about a loose but glamorous kimono for lounging around the house? Girls: look in men's departments for bigger, looser clothes, easier to fit over swollen joints, eg gloves and socks and jumpers. Try sports departments for tracksuits, warm clothes for skiers, weatherproof gear for fishermen/cyclists, etc.
Armchair shopping using leaflets and catalogues or the internet saves wear-and-tear on nerves and joints. You can sit and take your time 'window-shopping', and order online or by phone or post. Worth looking out for special offers and sales bargains — even the expensive firms have them now and again. You do need to be able to post any unsatisfactory 'returns' back. Avoid mail-order firms that expect you to run an agency unless you really do want to buy in a big way. Much more about mail-order shopping in chapter 23. Many of the firms listed there, including some of the charity catalogues, have bright, easy-fit, easy-care T-shirts, sweatshirts and leisurewear.
One YPA wheelchair-user, Kay, wrote a jolly article 'Fashion Frolics' in In Contact. Like some other people with JIA, Kay is 'petite'. She found a personal dress designer/maker, a possibly expensive but ideal solution! More about finding 'petite' clothes later. For cheap, good quality nearly new clothes try 'dress agencies' in upmarket areas (look on the internet or Yellow Pages or Thomson Directory). Try charity shops, too, another favourite with Kay:
"Once you have a system you can pick up a bargain or several. I usually have in mind what sort of thing I'm after, then I look at the labels to either find a brand I know I like, or to give an idea of the quality of the garment. Anything with holes, stains or threadbare patches I don't buy. The material itself is something to consider. Is it a natural fibre (nicer to wear I think) or a strong well wearing material that keeps its shape, like denim or corduroy? I can often come out of a charity shop with a three piece outfit that's only cost around £6.00! One of my best bargains yet has been a fashionably baggy (honestly, it wasn't just stretched) lambswool jumper for £2.00 and it is so warm!"
"My sister managed to get a Next skirt once for a few pounds… The charity shop in a quite well off area will usually have clothes donated by those who can afford to refit their wardrobes every month or so! For example, in one shop I go in, regular donations come from a lady who only ever wears things once!"
Helpful leaflets from DLF include:
| • gadgets | • All sorts illustrated on the DLF website (for instance in Equipment to assist with dressing and putting on footwear) and in the commercial suppliers' catalogues and websites in chapter 20. Dressing hooks are nifty devices, variations on the theme of a coathanger (with centre hook removed) plus hook end/rubber thimble. 'Snappi dressa' is a device to help people with limited shoulder movement get a coat on and off. Tape loops stitched to the top of socks, pants, skirts and trousers may help pull them up more easily. Gutter aids, flexible plastic devices with long tapes or rigid plastic handles, help you pull on socks/ stockings/ tights without bending down. Reaching aids (easyreach/ longreacher/ claw reachers) come in useful too. You can even get little child-sized litter picker-uppers (Helping Hands' 'kids kit') — Why not get them one just for fun and to encourage tidying-up habits?! |
| • buttons | • Big buttons and buttonholes are easier than small. Button-hooks can help with unavoidable buttons. You could replace buttonhole fastenings with easier-to-manage velcro® dots or press-studs, disguised by sewing the button back on top (eg on collar or cuffs). Make no-need-to-unfasten 'cuff-links' by joining two buttons together with elastic, or sew a piece of elastic between the cuffs which will stretch to let your hand through. Or you can get a 'Cuff and Collar Extender' which lets you keep a garment buttoned while you put it on. A small spring extends the button's reach and widens the opening. |
| • zips | • Thread tape or cord through the tab hole for an easier grip. You can get special zip puller-up devices (eg from haberdashery departments), or make your own with a big safety-pin/ nappy pin/ kilt pin plus length of string/cord. Someone with sewing know-how can adapt a top that's too tight to go over the head by cutting straight down the front (careful!), binding the two cut edges in a toning or contrasting binding, then putting a zip in. Or into side seams of garments for easier opening. Ease a stiff metal zip by running a soft lead pencil up and down it while closed. |
| • velcro® | • Easy to use 'touch and close' fastening device, available in several forms, colours and widths from shops or online or by post or phone from, for instance, Knitandsew.co.uk, or Kleins or Fred Aldous. Best used in small bits (eg velcro® dots or squares) rather than long lengths. Put the two faces together when washing to avoid catching on other garments.
|
| • hems | • For easier sewing of hems try iron-on hemming web or tape, such as Vilene Wundaweb from somewhere like Knitandsew.co.uk or Stitch1Knit1. For quick temporary repairs try double-sided sticky tape, but remove it before washing — Fred Aldous stock a wide range of adhesives and fasteners. |
| • small or petite fittings | • High Street and online stores with special small or petite fitting ranges include Principles, Next, Top Shop, Marks and Spencer, Dorothy Perkins, Principles, Wallis, and Debenhams. Also online and mail order are Lands' End and Petite Affair. Two specialist websites are Petitepersonalshopper and the 'Image planning — petite fashion comment' section of Fashion-Era.com |
| • rainwear | • A 'slinger' brolly keeps hands free till needed, though weak hands make coping with an open brolly difficult. Rain-hats can be squashed in a bag till needed and keep hair dry and hands free in the rain (except in high winds). Girl or guy, you could try a waxed hat or cap, for instance from Hawkshead outdoor clothing specialists, or Clifford James, or the RNLI shop, or Tilley Endurables. How about a traditional souwester design (eg from Baconsdozen),long at the back to keep water from running down your neck?! For other bad weather solutions try outdoor clothing specialists or fishing gear or cycle shops — for instance All Terrain Cycles do caps, neat ponchos, and jazzy fingerless gloves: use their site map to get an idea of their range. |
| • coats | • Try lightweight quilted coats/jackets or fleeces. Enlarge a jacket underarm by inserting a gusset, to make dressing easier. Some people prefer ponchos or capes. |
| • trousers | • Trousers with front pleats rather than darts may be easier. DLF leaflets suggest different options to try, eg men's washable trousers with elasticated waist and fly, false fly, velcro® fastening fly, drop front, etc. A 'pants clip' is a piece of flexible plastic which clips at one end to the waistband and the other to your top so you can keep your trousers within reach when standing up after using the toilet. Edgware braces are a home-made idea to stop trousers falling down when they're dropped for sitting on the toilet (for the pattern, contact the DLF Helpline, tel: 0845 130 9177, textphone: 020 7432 8009, email: advice@dlf.org.uk). See chapter 23 for online and mail-order menswear suppliers. |
| • underwear for men | • Online and mail-order suppliers of men's underwear include Marks and Spencer, Clifford James, Joseph Turner, and other clothing suppliers in chapter 23. |
| • underwear for women | • Front-opening bras may help, or fasten a back-opening bra at the front then swivel it round to the back. Look at DLF's Choosing a bra. Little Women is a specialist online and mail-order shop for bras, lingerie and swimwear in AAA, AA, A cup sizes. Loose-fitting knickers may be easier than bikini briefs. Vests and long-johns/passion killers are essential for keeping warm, and much more glamorous and colourful than they used to be! Mail-order/ online suppliers include Bella di Notte, Damart, Woods of Morecambe, and other clothing suppliers in chapter 23. |
| • socks | • Finding comfortable socks can be a problem for men with arthritis. Socks without elastic in the tops are available by post from H J Hall, or stocked online by Clifford James. Cosyfeet too, supply soft-top no-elastic socks, with seam-free and extra-roomy variations. If you find the plastic stocking/ sock gutter aids too awkward for pulling on socks, there's an alternative, the Soxon. Made of towelling on a frame; it fits better into socks because it folds into a narrow object (usable for stockings, too). |
| • tights and stockings | • It may take practice to put on open-gusset/ open-crotch tights or suspender tights with a 'puller-on'/ gutter aid, but they can be more comfortable and make going to the loo easier. Pretty Polly is one brand, from suppliers such as UKTights.com, or from MyTights.com Both firms stock plenty of other brands and types too, stockings, knee-highs, socks, etc. |
| • ties | • You could try tying a tie then cut down the centre-back, and insert some elastic so it can be pulled over your head. Or it might be easier to opt for a ready-made clip-on tie, now in a wide range of plain and patterned designs from, for instance Tiewarehouse or J H Meech & Sons Ltd. Filaspun will alter existing ties by inserting clips. |
| • jewellery | • Necklaces long enough to throw over the head avoid problems with tricky fastenings. For a choker effect get a really long string of beads and throw it around twice. If fastening real chokers is difficult, make your own from beads threaded on to round cord elastic. Once made, get it over your head with, say, a longreach gadget. Similar elastic (black) will do, too, instead of a chain, for avoiding fastening problems with a locket or pendant. |
| • woollens | • If you prefer jumpers and sweaters to easier cardigans, go for shawl collars (turned up or down) or yoke or turtle necks rather than tight polo necks. They're easier to get on over the head. Man-made fibres are lightweight, but wool and wool-blends are warmer — and some, like mohair and angora, lightweight too. Family firm Orkney Angora have a wide range of angora products, from underwear, headwear, knitwear, to socks, fingerless gloves, joint warmers and neck warmers, etc. |
| • keeping warm | • Several thin layers of clothing rather than one thick layer are warmer. Vests and long-johns/ 'thermal' underwear all help (see 'underwear', above, and 'woollens', above). Lots of body heat escapes through the head, so wear warm headgear and a scarf. Try sheepskin hats for warmth. Look at the Raynaud's & Scleroderma Association website (or send for their mail-order leaflets) for masses of 'keeping warm' tips and products, including magical tiny portable handwarmers/ footwarmers/ bodywarmers, activated by touch; some are microwaveable and reusable again and again. Instead of a hot water bottle, there's even a microwaveable furry teddy bear! Also 'silver socks' — the silver helps keep feet warmer. Silver gloves, too. Fingerless fleece mittens have a built-in pouch for inserting a handwarmer. Work out what sort of gloves suits you best — mittens or gloves or fingerless mittens (some have a flap over the finger ends). Besides the Raynaud's Association gloves, look at gloves for cyclists and golfers with incomplete fingers — some fasten with velcro®, as do some specially designed wheelchair mitts. Men's sizes allow more room for swollen joints, male or female. Large wool or sheepskin gloves are warmer than man-made fibres. Apart from the Raynaud's 'silver socks', you could try 'furry' lined shoes/ inner soles or line footwear with foil. For other ideas, look in sports shops and camping shops — skiers, anglers, bikers and polar explorers all need to keep warm! Two suppliers of sheepskin products are Celtic Sheepskin (hats, gloves, waistcoats, boots, slippers, etc) and Elm House Products Ltd (kiwi slipper-boots, hats, slippers and mittens and gloves, etc). Even the luxury of warm cashmere may become affordable if you wait for a sales bargain! Low-voltage battery heated gloves/ mittens/ socks (eg by BeWell Ltd ) are available for people extra-sensitive to cold. People with circulation problems, including those with Raynaud's Disease, may be able to have these prescribed by the NHS. Contact the Raynaud's Association for more information. |
For problem feet, get professional advice from a state-registered podiatrist/ chiropodist — they don't just cut nails! They can ease many existing painful foot problems, help prevent others, and they can advise on footwear choice and adaptations. Some people are eligible for free NHS podiatry treatment, check with your doctor. You may have to pay, but can usually self-refer if you wish, without having to see a GP first. The Society of Chiropodists & Podiatrists (SCP) provides information on foot problems and footwear, and can help you to find a podiatrist. See also chapter 4.
Helpful publications are:
Glamorous high heels aren't really a good idea, alas. Choose styles that give your feet good support and are easy to get on and off. Some people find that trainers, with velcro® fastenings, are best. Or elasticated laces may help. OT Heather Unsworth (in Coping with Rheumatoid Arthritis, Chambers) gives helpful general guidelines:
"Shoes held on by lacing, bars or ankle straps are generally best as they stop the foot from sliding forward and so cramping the toes. Some slip-on styles are not good, if they are only kept on because of compression between the toe and the heel. Mules are similarly not recommended as you are reliant on the toe bar to keep them in place."
"Choose a shoe with a supple and soft upper, preferably without seams that will cause pressure on the toes. This upper layer may not be leather. Choose shoes that are well-cushioned, flexible and non-slip. Thin inflexible plastic soles will not be comfortable, neither will leather. Similarly, a thin rubber sole glued to a leather sole will not improve the comfort at all, although it will make it non-slip. For soles, synthetic materials win every time!"
For people with arthritis, DLF's Finding Suitable Footwear recommends:
"insoles with good shock absorption, thick but flexible soles to protect the feet from the ground underneath, plenty of depth to accommodate the toes, soft uppers of leather or fabric and lightweight soles and heels. Trainers often fit this description. and can be a sensible choice when the condition first makes itself felt."
One flexible multi-fit shoe for men and women has a three-way opening with velcro®, and a soft leather upper, available from suppliers such as Clifford James (also has other velcro® shoes, eg smart ones for men). If you're looking for very small sized shoes, try the Small Shoes website. Companies stocking footwear for men and women with problem feet are Hotter and Cosyfeet, and Foot Friendly (no website), and there are many others on the British Healthcare Trades Association (BHTA) website (see below).
The solution to my own shoes problem came when I found a theatrical shoemakers who produce reasonably priced leather Twenties-style shoes, with a bar strap. Not exactly high fashion, but not too dowdy either, and oh what comfort! They're just right for my size 8 monstrosities after I've got extra heel pieces fitted one side (one leg's slightly shorter than the other), and replaced the button fastening with elastic so although the shoe still looks the same I can slip it on and off still fastened. Leather soles are lethally slippery so I roughen them with a cheese grater.
If your consultant recommends surgical shoes, take heart from Jacqueline S:
"Another traumatic experience was being reduced to wearing surgical shoes! The tears started… but after getting my first pair I found them so comfortable and the styles are quite acceptable. Now I have three pairs in different colours and two different styles. Since I started wearing them I find I can walk a good mile if I take my time."
Your consultant may refer you to an orthotist, who specialises in providing well-fitting shoes and insoles. Perhaps a simple arch support will help? Or other adaptation to existing shoes? Shoes can be adapted free on the NHS, or you may prefer to find and pay for an orthopaedic shoemaker/ orthotist to do the work privately. There's a list of orthotists in the members' section of the British Healthcare Trades Association (BHTA); use the links there to take you to websites listing services such as shoe adaptations, and footwear for men, women and children in various styles, colours, fastenings, width and depth fittings and full and half sizes. Footwear for Special Needs (priced, published by the British Footwear Association (BFA)) lists made-to-measure/ bespoke suppliers, and specialist footwear suppliers. More information about orthotists on the website of the British Association of Prosthetists & Orthotists
YPA (younger person with arthritis) Kay Jones, writing in In Contact
"…invested a hefty sum in Adams and Jones, who are a Glastonbury set-up that hand make shoes and will make them for people with feet problems. Admittedly the cost is high for the first pair but once your shoe last is made (the model for your particular feet), the cost of future shoes is less. Also due to the difficulty of dealing with problem feet you may have to send the shoes back a few times until the fit is as you want it… This is a mail-order service so you don't have to hike up to Glastonbury!" [Adams and Jones has since become Pugs Shoes, producing 'soft, comfortable handmade shoes'.]
If you, like Kay, want to find a specialist shoemaker independently, you could try to find one in your area. However they are expensive and you do need to be sure you're getting value for money — try for instance to find one who belongs to the British Healthcare Trades Association.