There was a hermit uncle in our family many years ago. His feet looked pretty much like that. Wore sandals year round. He had other "issues", so the toenail thing was the least of his problems.
23+ yrs ago, I worked as an emt-p on a private ambulance service in Chicago, and one of our contracts was running "elderly in distress" calls for Chicago's social services. That was usually some psych case (usually NOT elderly btw) that was under court supervision, and it was decided they needed to be hauled off for a physical/psych eval. These people never wanted to go, so our job was to basically wrestle them onto a stretcher, restrain them as needed, and haul them off to the er.
I did a few of these that are story worthy, but relevant to your post, this one guy we picked up was a hermit, lived in a house with newspapers and other crap stacked nearly to the ceiling (with mice or whatever can be heard moving around in there), with narrow channels leading from room to room. So this dude was a feisty and dirty feller (oh that smell), but whatever we finally caught him, strap him to the stretcher, transport him.
So we get him to the er, and they had to cut his clothing off basically, coz it was stuck to him. He skin was so bad, it was covered in sores and dirt. Oh man, when those shoes and socks came off, I have never witnessed/smelled a trainwreck like that before or since. Just picture talons like on a hawk, curled over themselves, growing into the front of his toes. It was just insane!
