Nursing interventions for foot health and self-management in frail older adults with diabetes: A narrative review.

Diabetes and frailty are two interrelated health conditions that mutually exacerbate one another and have a detrimental impact on quality of life in older adults. Frailty, characterised by depleted physiological reserves, cognitive decline and impaired self-care capacity, complicates diabetes management. Consequently, this population faces an elevated risk of serious foot-related complications, including diabetic foot ulcer development and delayed wound healing. This narrative review evaluates the pathophysiology, epidemiology and nursing interventions for foot-health issues in frail older adults with diabetes. A literature review was conducted using the keywords 'frailty', 'diabetes', 'diabetic foot', 'self-management' and 'nursing interventions' in the PubMed, Scopus and Google Scholar databases. Recent studies, clinical guidelines and relevant reviews were prioritised for inclusion in the assessment, particularly those addressing frailty and diabetic foot care in conjunction. Studies indicate that frailty is associated with the development of diabetic foot ulcers, delayed wound healing and reduced adherence to foot care. Effective nursing interventions encompass more than just standard wound care; they also include early and proactive risk assessment, frailty screening, self-management support tailored to cognitive and functional status, caregiver involvement, behaviour change approaches and multidisciplinary collaboration. Furthermore, technology-enabled monitoring systems and digital health applications offer significant opportunities to improve care adherence and the early detection of complications in this high-risk group. In conclusion, comprehensive nursing approaches tailored to the unique needs of frail older adults with diabetes are critical for reducing complications and improving quality of life in this vulnerable population.