The management of foot problems in the older person through podiatry services

2011 ◽  
Vol 21 (4) ◽  
pp. 331-339 ◽  
Author(s):  
Wesley Vernon ◽  
Alan Borthwick ◽  
Jeremy Walker
Keyword(s):  
At Risk ◽  
Older People ◽  
Self Care ◽  
Evidence Base ◽  
Professional Autonomy ◽  
Scope Of Practice ◽  
Older Person ◽  
Foot Care ◽  
Foot Problems

SummaryThe scale of foot problems in the population is high, and highest in older people. Whilst podiatry is solely concerned with the foot, other professions with a broader remit are also involved in foot care, as not only the foot may be at risk but also there may be serious systemic sequelae. Foot problems can be usefully viewed from a functional, hierarchical perspective. The interventions required are suggested by considering problems according to this hierarchy. Many approaches exist for the management of foot conditions from educated self-care to surgery. In managing such conditions, multi-disciplinary approaches are required. Podiatry has developed considerably over the years, has a growing research base, an extensive scope of practice and anticipated developments. The profession can develop further, particularly in its preventative role, in terms of professional autonomy and in further increasing its evidence base.

Foot problems

2017 ◽  
pp. 585-590
Author(s):  
Hylton B. Menz
Keyword(s):  
Quality Of Life ◽  
Older People ◽  
Weight Bearing ◽  
Older Person ◽  
Vascular Disorders ◽  
Foot Problems ◽  
Detrimental Impact

Foot problems affect one in four people aged over 65 years and have a major detrimental impact on mobility and quality of life. With advancing age, the foot undergoes several cutaneous, vascular, neurological, and musculoskeletal changes, all of which may impair this important weight bearing function and predispose the older person to the development of foot symptoms. This chapter provides an overview of the prevalence and impact of foot problems in older people, and briefly discusses the management of common foot problems in older people including skin and nail disorders, vascular disorders, and structural deformities. The important role of footwear in the management of foot problems is also highlighted.

scholarly journals 332 GEMS: Geriatric Emergency Service - Outputs and Outcomes from the Acute Floor Team

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii17-iii65
Author(s):  
Lorna Cornally ◽  
Megan Hayes Brennan ◽  
Danielle Reddy ◽  
Grainne Gallagher ◽  
Maureen O'Callaghan ◽  
...  
Keyword(s):  
At Risk ◽  
Older People ◽  
Median Time ◽  
Emergency Service ◽  
Scientific Evidence ◽  
Adverse Outcomes ◽  
Older Person ◽  
Home Team ◽  
Care Approach ◽  
Care Outcomes

Abstract Background Frailty is now a key concept in healthcare planning and delivery and is driving vertical and horizontal integration. The positive narrative of Frailty is further emphasised by the growing scientific evidence in the prevention, reversal and modification of Frailty. Early identification of Frailty and early intervention with Comprehensive Geriatric Assessment (CGA) is fundamental. Older people with Frailty admitted to hospital who receive a CGA early are more likely to return home. Benefits are seen early and are sustained (Ellis et al 2011). Methods The aim of GEMS is to improve care, outcomes and the patient experience for older people living with Frailty. All people aged 75 years and older who attend as an emergency are screened on triage using the Variable Indicative of Placement Tool (VIP). Screening is automatic and mandatory. The GEMS Acute Floor Team respond early to those who screen positive by starting a CGA. The GEMS Home Team case manage those who are admitted. Results Over 2 years 10,037 patients were triaged. The median time from arrival to VIP was 15 minutes. 43% screened positive for Frailty. 66% received a CGA. The median time from VIP to CGA was 1.7 hours. 84% identified at risk of polypharmacy, 27% at risk of malnutrition, 29% with delirium. 74% were admitted from home. 78% returned to pre-admission residence. 4% new admissions to NH care. Median length of stay was 7 days. The readmission rate within 30 days was 16%. 7% in hospital mortality. Conclusion The GEMS Team have developed and delivered a pioneering integrated care approach to the management of older person at high risk of adverse outcomes attending the acute floor.

Development and Formative Evaluation of a Foot Self-Care Program for African Americans With Diabetes

1997 ◽  
Vol 23 (1) ◽  
pp. 48-51 ◽  
Author(s):  
MARY ANN LEDDA ◽  
ELIZABETH A. WALKER ◽  
CHARLES E. BASCH
Keyword(s):  
African Americans ◽  
Diabetic Foot ◽  
Formative Evaluation ◽  
Self Care ◽  
Care Program ◽  
Foot Care ◽  
Patient Instruction ◽  
Foot Complications ◽  
Orientation Session ◽  
Foot Problems

African Americans with diabetes have a higher rate of lower-extremity amputation due to diabetic foot complications than the general public. Education about proper foot care can help prevent serious diabetic foot complications and assist in early detection of problems. The purpose of this project was to develop, formatively evaluate, and pilot test a self-care, take-home program for the prevention of foot problems in African Americans with diabetes. The program included a brief one-on-one orientation session and a take-home foot self-care packet. Through telephone follow-up subjects reported the following: good to excellent overall rating of the program, favorable reactions to the patient instruction booklet, an overwhelming positive response to the large hand mirror, and a positive effect on their daily foot-care practices. The Afrocentricity of the patient education materials was preferred by younger subjects; older subjects found this approach too restrictive.

Improving Preventive Foot Care for Diabetic Patients Participating in Group Education

2009 ◽  
Vol 99 (4) ◽  
pp. 295-300 ◽  
Author(s):  
Pi-Chang Sun ◽  
Shyh-Hua Eric Jao ◽  
Hong-Da Lin ◽  
Rai-Chi Chan ◽  
Chen-Liang Chou ◽  
...  
Keyword(s):  
At Risk ◽  
Patient Education ◽  
Diabetic Patients ◽  
Specific Information ◽  
Foot Care ◽  
Group Education ◽  
Association Group ◽  
Risk Patients ◽  
Foot Problems ◽  
Care Practices

Background: Diabetic foot care has yet to be enhanced in a universal health-care system in which specialized podiatric medical services are unavailable. This baseline assessment surveyed diabetic patients attending group education to improve current foot-care practices. Methods: Of 302 diabetic patients receiving usual outpatient care, 155 received group patient education on general diabetes-related information, which included foot care and an annual checkup by a diabetes association during the previous 2 years, and 147 did not. Patient foot-care behaviors, physician practice patterns, and patient self-perceived foot risk as cross-checked with the neurologic and vascular assessments were investigated by conducting retrospective medical record reviews and structured interviews. Results: More than half of the patients in both groups reported inappropriate self-care behaviors (eg, walking barefoot and heating or soaking their feet). The percentages of patients receiving documented examinations and referrals for foot problems were low in both groups and were not significantly different. Among at-risk patients, 56% of the diabetes association group but only 30% of the non–diabetes association group perceived themselves to be at risk for future foot problems (P < .01). Conclusions: Many diabetic patients were not offered adequate foot-specific information during group lectures, even those with high-risk foot problems. To improve this, combining caregiver and patient education in foot-care practices is important, and systems of networked multidisciplinary professionals are believed to be needed, particularly in delivering customized interventions to at-risk patients based on the initial evaluation. (J Am Podiatr Med Assoc 99(4): 295–300, 2009)

Biosensing in Old Age

Living Data ◽  
2019 ◽  
pp. 125-150
Author(s):  
Celia Roberts ◽  
Adrian Mackenzie ◽  
Maggie Mort ◽  
Theresa Atkinson ◽  
Mette Kragh-Furbo ◽  
...  
Keyword(s):  
At Risk ◽  
Older People ◽  
Old Age ◽  
Self Care ◽  
Monitoring Systems ◽  
Care Systems ◽  
Low Functioning ◽  
Remote Care ◽  
At Home

How does biosensing reach into the lives of older people living at home? Here we examine care monitoring systems for older people, or telecare, as this has become known. We focus in particular on the wearable falls detector, an alarm device which triggers, it is claimed, when a person trips or falls. We explore findings from ethnographies of home telecare and from citizens’ panel debates on how individuals and families live with such systems, and how falls detectors are constructed as workable. Following individuals' interactions with telecare we question the notion of self-tracking, preferring the term dys-tracking as better reflecting their relationship with automated devices. Falls detectors are technically highly complex, collecting data difficult to interpret. Ageing bodies are invariably assessed as low functioning and intrinsically at risk. Views from our citizens’ panels however, show a more active and imaginative constituency where practices of self-care exist alongside remote-care systems.

Role of the podiatrist and common foot problems

2021 ◽  
Vol 26 (Sup3) ◽  
pp. S30-S33
Author(s):  
Lisa Farndon
Keyword(s):  
Diabetic Foot ◽  
Treatment Options ◽  
Self Care ◽  
Foot Care ◽  
Foot Health ◽  
Foot Problems

In this article, the author discusses the role of the podiatrist in sustaining and maintaining foot health. A number of core podiatry problems that are most commonly seen in the population are described, along with possible treatment options and when to refer to a podiatrist. The author also explains what is required to carry out a diabetic foot assessment, providing helpful links to resources and literature to aid practitioners' understanding of the processes involved, as well as providing a list of foot care tips to aid self-care.

Health education programmes to improve foot self-care practices and foot problems among older people with diabetes: a systematic review

2016 ◽  
Vol 11 (3) ◽  
pp. 214-239 ◽  
Author(s):  
Siti Khuzaimah Ahmad Sharoni ◽  
Halimatus Sakdiah Minhat ◽  
Nor Afiah Mohd Zulkefli ◽  
Anisah Baharom
Keyword(s):  
Systematic Review ◽  
Health Education ◽  
Older People ◽  
Self Care ◽  
Foot Problems ◽  
Care Practices

Who’s at risk of entering Social Security Disability Insurance? A comparison of application and allowance rates for groups of at-risk individuals

2020 ◽  
Vol 53 (3) ◽  
pp. 341-352 ◽  
Author(s):  
Kara Contreary ◽  
Todd Honeycutt
Keyword(s):  
At Risk ◽  
Social Security ◽  
Disability Insurance ◽  
Risk Groups ◽  
Evidence Base ◽  
Social Security Disability Insurance ◽  
Program Participation ◽  
Before And After ◽  
Social Security Disability ◽  
Employment Characteristics

BACKGROUND: The U.S. government has implemented several programs to reduce federal expenditures on Social Security Disability Insurance (DI) and help beneficiaries return to work, but the limited success of these efforts has raised interest in approaches that help workers with disabilities remain in the workforce. OBJECTIVE: This paper provides information on individuals at risk of applying for DI benefits to help build the evidence base for policies that provide workers with disabilities support to eliminate the need to apply for and receive DI benefits. METHODS: Using three panels of the Survey of Income and Program Participation matched to SSA administrative data, we describe the employment characteristics of seven groups at risk of applying for DI benefits before and after application, as well as the outcomes of their DI applications. RESULTS: New private disability insurance recipients were more likely to apply for and receive DI than members of other at-risk groups. However, individuals with high healthcare expenditures made up the largest proportion of successful applicants across the at-risk groups considered here. CONCLUSION: While it seems plausible that individuals within an at-risk group who are likely to apply for DI benefits can be identified and provided supports to help them maintain employment, focusing on a specific group to promote employment over DI benefits may have a limited effect on the DI program because applicants come from multiple groups.

Designing for older people: But who is an older person?

2016 ◽  
Author(s):  
Raghavendra Reddy Gudur ◽  
◽  
Alethea Blackler ◽  
Vesna Popovic ◽  
Doug Mahar
Keyword(s):  
Older People ◽  
Older Person

Prioritization and management of calls from older people to GP out-of-hours services

2021 ◽  
Vol 33 (1) ◽  
Author(s):  
Suzanne Smith ◽  
Lucia Carragher
Keyword(s):  
Older People ◽  
Service Provision ◽  
Emergency Services ◽  
Oldest Old ◽  
Community Dwelling ◽  
Third Party ◽  
Older Person ◽  
Out Of Hours ◽  
Accident And Emergency ◽  
Community Dwelling Older People

Abstract Background Urgent out-of-hours medical care is necessary to ensure people can remain living at home into older age. However, older people experience multiple barriers to using out-of-hours services including poor awareness about the general practitioner (GP) out-of-hours (GPOOH) service and how to access it. In particular, older people are reluctant users of GPOOH services because they expect either their symptoms will not be taken seriously or they will simply be referred to hospital accident and emergency services. The aim of this study was to examine if this expectation was borne out in the manner of GPOOH service provision. Objective The objective was to establish the urgency categorization and management of calls to GPOOH , for community dwelling older people in Ireland. Methods An 8-week sample of 770 calls, for people over 65 years, to a GPOOH service in Ireland, was analysed using Excel and Nvivo software. Results Urgency categorization of older people shows 40% of calls categorized as urgent. Recognition of the severity of symptoms, prompting calls to the GPOOH service, is also reflected in a quarter of callers receiving a home visit by the GP and referral of a third of calls to emergency services. The findings also show widespread reliance on another person to negotiate the GPOOH system, with a third party making 70% of calls on behalf of the older person seeking care. Conclusion Older people are in urgent need of medical services when they contact GPOOH service, which plays an effective and patient-centred gatekeeping role, particularly directing the oldest old to the appropriate level of care outside GP office hours. The promotion of GPOOH services should be enhanced to ensure older people understand their role in supporting community living.

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