Nursing Foot Care: a wholistic approach

At McDermott Footcare, the first visit with a new client includes a concise assessment of pre-existing medical conditions. The reason is because pre-existing medical conditions are reflected in the health of the feet. It is important to consider what is happening to the entire body and not just the feet.

  • arthritis affects the joints in the feet resulting in pain, inflammation, swelling, calluses, and corns
  • a weakened immune system results in fungal and bacterial infections of the feet and toenails that are difficult to treat
  • steroids such as prednisone may cause brittle, thickened toenails
  • poor circulation to the extremities from conditions such as peripheral vascular disease and diabetes may result in pain, numbness, neuropathy, swelling, changes in the colour of the skin, bacterial and fungal infections of the feet and toenails, thickening of toenails, amputation

In nursing foot care, as in all medically-related care, a wholistic approach is best. Since care at McDermott Footcare is provided by a registered nurse, counselling and health teaching is provided as needed. Clients sometimes have health-related questions and they find the knowledge and advice of a registered nurse reassuring and helpful; this gives clients peace of mind.

A wholistic approach to nursing foot care must also recognize the importance of spiritual care. Honouring the person’s spiritual dimension, irregardless of their religious beliefs, is accomplished by treating clients with respect, being nonjudgmental, and actively listening to them.

In healthcare-related professions, it is easy to focus on the procedure that must be performed, the disease that must be treated, the diagnosis that must be addressed. But the persons we care for are so much more than the diagnosis with which they present. In order to give the best care, we must always take a wholistic approach and consider each person’s mind, body, and spirit connection.

Copyright Terry McDermott. May not be reproduced in whole or in part without permission of author


Lessons Learned from McDermott Footcare Clients

shutterstock_206475904Recently, McDermott Footcare celebrated our third anniversary of delivering caring, knowledgeable, quality, certified nursing foot care to Toronto and area clients whom we serve. It is a pleasure and an honour to provide excellent care to a growing number of delighted individuals.

Over the last three years, many people have benefited from McDermott Footcare’s certified nursing foot care services. And over the three years, they have taught us much about caring and respectful care for all.

Here are the lessons that we have learned from the people we serve:

  • It’s not just about the feet. Each McDermott Footcare client/patient has a unique life story. It is an honour to get to know each person served.
  • Clients/patients expect quality care delivered in a timely, professional, compassionate manner. McDermott Footcare is proud to meet these expectations.
  • Clients/patients often have other medically related questions that need an answer. McDermott footcare is qualified to answer all nursing related questions and provide additional teaching as needed. McDermott Footcare also provides consultation letters to the client’s /patient’s physicians as needed.
  • Clients /patients often have questions regarding day-to-day care of their foot related concerns, especially various nail conditions, care of corns and calluses, properly fitted shoes, and skin infections and rashes. McDermott Footcare provides clearly written, pertinent advice on the care of the feet as needed.

Thank you to the clients/patients who continue to place their trust in McDermott Footcare. It is an honour to serve you.To those whom we have not yet had the pleasure of providing excellent certified nursing foot care, McDermott Footcare looks forward to meeting you.

Copyright Terry McDermott. May not be reproduced in whole or in part without permission of author




Why Do My Calluses and Corns Keep Coming Back?


A plantar callus

As a Toronto and surrounding area in-home certified foot care nurse, this is a question I often hear. There are many reasons why corns and calluses keep coming back. First of all, what are corns and calluses?

What are the three types of corns?

Seed corn – often found on the ball or the heel of the foot, it is a small, white plug in the skin. It can be painful.

Hard corn – often found on the top of the toe or on the outside of the little toe. It has a thick, white surface.

Soft corn – found between the toes, most often between the fourth and fifth toes.

What is a callus?

A callus is an area of skin that has been subjected to repeated rubbing or friction. An area of dense, rough skin develops to protect the sensitive skin underneath. A callus on the bottom of the foot is called a plantar callus.

What causes corns and calluses?

  • ill-fitting shoes that are either too tight or too loose
  • narrow or pointy-toed shoes
  • high heels
  • structural problems of the foot including hammer toes, bunions, lack of fatty padding on the ball of the foot

How do I stop or at least minimize the occurrence of repeated corns and calluses?

  • have shoes properly fitted
  • avoid wearing very high heels
  • wear mid-high heels that are no more than 2 inches high
  • make sure shoes have well padded insoles
  • there are many good insoles available in the foot care aisle of a well-stocked pharmacy
  • apply moisturizer to affected areas. Use a moisturizer that contains urea since this is especially effective.
  • if you have bunions,  hammertoes or wide feet, make sure your shoes comfortably accommodate them
  • while showering or bathing, use a pumice stone to gently exfoliate dry, rough patches
  • have your corns and calluses reduced by a certified foot care nurse who is trained to do so.

A word about diabetes and corns/calluses:

The risk of getting an infection in the foot is higher in a person with diabetes. Poor healing of open sores and wounds in the foot leads to infection and a higher risk of lower limb amputation. For this reason, a person with diabetes is strongly advised to avoid reducing calluses and removing corns on their own.

Copyright Terry McDermott. May not be reproduced in whole or in part without permission of author

Vitamin D, Diabetic Neuropathy and Depression in Women with Type 2 Diabetes

A recent study conducted at Loyola University highlighted the efficacy of Vitamin D supplementation in treating pain and depression in women with Type 2 Diabetes. In the news release, Todd Doyle, PhD, lead author and fellow at the Department of Psychiatry and Behavioral Neurosciences, Loyola University Chicago Stritch School of Medicine (SSOM), presented the research findings.

Study participants were given Vit. D supplementation of 50,000 IU every week for six months. The research focused on the effect of Vit. D supplementation on diabetic neuropathy and depression.

The pain experienced by Type 2 diabetics is most often due to neuropathy: nerve damage caused by diabetes and often described as shooting or burning pain in the legs and feet. In addition, sensory pain described as numbness and tingling may also be experienced in hands, fingers, feet and legs. People who have had diabetes for 25 years are more likely to experience neuropathy.

The experience of living with pain from neuropathy may cause clinical depression. Living with Type 2 Diabetes is also a factor in the diagnosis of depression.

The results of the study are as follows:

  • depression improved significantly following supplementation
  • at the start of the study, 61% of participants experienced burning or shooting pain in their legs and feet. 74% reported numbness and tingling in their hands, fingers and legs.
  • three and six months following Vit. D supplementation, participants reported a marked decrease in neuropathic and sensory pain

While the study looks very promising, Dr. Doyle admits that further research is needed. The National Institute of Nursing Research has provided funding for further study.

The typical over-the-counter Vit. D supplement contains 1000 IU Vit. D3 in 25 mcg. The 50,000 IU dosage used in the study is extremely difficult to meet using available over-the-counter supplements.

The current treatment for managing Type 2 Diabetes includes medication,  maintaining target blood sugar levels, eating a balanced diet and regular exercise. Fasting glucose levels for individuals with diabetes is 3.9 – 7.2 mmol/L. After meals, the level is less than 10 mmol/L.

If you are interested in the research findings and using Vit. D to alleviate symptoms of neuropathy and depression, talk it over with your doctor first.

Copyright Terry McDermott. May not be reproduced in whole or in part without permission of author

9 Tips For Moisturizing Your Feet


McDermott Footcare nursing foot care clients enjoy a moisturizing foot rub as part of our services. The reasons are two-fold: a foot rub is a soothing finish to excellent quality nursing foot care and it is a good opportunity to give the feet some much-needed moisture.

Skin is an important barrier that prevents infections in the body. Skin that is dry is more prone to itchiness, rashes and infection. Extremely dry skin, especially in the heel area, can develop painful cracks called fissures. These fissures are susceptible to bleeding and becoming infected.

Dry skin is also more prone to developing painful calluses.

For these reasons, moisturizing the feet is very important. Here are 9 tips for adding much needed moisture to the skin:

1) Wash feet daily with a mild soap and warm water.

2) While feet are still damp use a pumice stone to gently scrub areas that are dry and flaky, especially the heels and callused areas.

3) Dry the feet and immediately apply moisturizer. For moderately dry skin, a regular moisturizer is effective. For extremely dry skin, including skin that has cracks (fissures), use an extra rich moisturizer that contains urea. These moisturizers are available over-the-counter in well-stocked drug stores and department stores.

4) Do not apply moisturizer between the toes. Excess moisture that builds up between the toes encourages the development of athlete’s foot fungal infection.

5) Soaking the feet once to three times a week in a solution of 1/4 cup white vinegar in a shallow basin of lukewarm water helps to improve the condition of the skin. Soak for only 10 -15 minutes since soaking for long periods dries out the skin. Apply moisturizer after towel drying.

6) For an effective night treatment try this: apply a rich emollient moisturizer to your feet and put on breathable cotton socks. The heat from the socks will help skin soak in the moisture.

7) For people who have difficulty reaching the feet, try this trick: put some moisturizer on a plate or other suitable tray. Move your feet around the plate or tray being careful to rub the moisturizing cream into the feet. Step on a towel and gently blot your feet to wipe off excess cream.

8) Alternatively, apply moisturizer to feet using a long-handled paint brush. Wipe off excess cream.

9) Ask your certified foot care nurse to recommend an effective moisturizer.

Related posts:

Vinegar Is Good For Your Feet

8 Tips For Dry, Cracked Heels

Copyright Terry McDermott. May not be reproduced in whole or in part without permission of author

Healthy Now and Later

Healthy Now and LaterMcDermott Footcare is pleased to introduce and partner with Healthy Now and Later, an invaluable new website committed to providing timely information on aging well. Topics include meal plans specific to medical conditions, a U.S.- wide database of financial assistance and not-for-profits, as well as other tips for everyone 55 and better to live life fully.

McDermott Footcare interviewed Leah Korkis, RN, the nurse-entrepreneur owner of Healthy Now and Later.

 Leah, please tell us about yourself.

I graduated from nursing school in 2010, but honestly I feel like I was born to be a nurse. I feel especially called to care for the older population, so I made it a point to work in what I see to be the most complex field in adult care; neurology. I absolutely fell in love. It was one night though while I was at work that I got a phone call that completely changed my life. On the other line was my Grandma who was in the emergency room with my Grandpa. It quickly became clear that my Grandpa was having a stroke. As I looked out the window at the first blizzard of the season, I knew that I had to continue to care for the individuals under my care. Instead though, I cared for them as if they were my Grandpa or my Grandma. That summer I moved in with my Grandparents and became a full-time nurse and full-time family caretaker. 

One of my favorite activities is cooking. My Grandma is the gatekeeper to many secret family recipes, so I see cooking as a means of connecting the past to the present. Each recipe is like a symphony of flavors that I can bask in with friends and family. Cooking truly bubbles over into all aspects of my life; my husband and I even met in a market.

Why did you start Healthy Now and Later?

  As a nurse and a caretaker I’ve gained a new perspective on health and what it means to be “well”. It’s such a subjective thing, to be “independent” and “healthy”, and yet most people strive to maintain both. In creating a website I wanted to reach beyond the walls of the hospital to look at what can keep people healthy and help individuals explore their own definitions of “independence” and “health”. I believe that wellness is rooted in how one lives, what one eats, and who one is surrounded by (or who one loves). In an essence, Healthy Now and Later was made to inspire those 55 and better to live well, eat well and love well (now and in the future) based on their own definition of each. This is what living life to the fullest is.    

How will readers benefit from Healthy Now and Later?

Each article within the blog and on the Healthy Now and Later website has much thought and research put into it. As I mentioned before, the meaning of “well”, “independence” and “healthy” differ from person to person. My aim is to provide high quality information, so others can make well-informed decisions that are best for them.

What are your future plans for the Healthy Now and Later?

My future plans for Healthy Now and Later are extensive. I’m excited to be partnering up with other experts within their field, like Terry McDermott of McDermott Footcare. Weekly additions will continue to compile articles in our disease-specific recipe blog, hot-health-topics, and our nation-wide database of caregiver resources. It’s exhilarating to see some of the bigger plans begin to unfold even now. For example, this coming week we’ll be having our first giveaway product. But this is only the beginning.  


8 Cold Weather and Winter Foot Care Tips For Diabetics

couple enjoying winter

Here in Toronto, diabetic nursing foot care clients of McDermott Footcare are beginning to feel the change in weather. With the cooler temperatures, many clients are wearing thicker clothing, including socks and closed-toe shoes instead of sandals. Cooler temperatures call for a change in foot care routines to ensure the continued health of people living with diabetes.

Here are 8 diabetic foot care tips for a safe, healthy autumn and winter:

  1. Socks:  Wear thick, breathable socks that wick away moisture. Feet continue to sweat in colder temperatures and it is important to wear socks that promote air circulation and wick away perspiration.
  2. Keep feet dry: This goes hand in hand with the advice above. It is important to keep feet dry. Feet that are allowed to remain damp may develop fungal and bacterial infections. Dry your feet thoroughly after bathing or after becoming wet from exposure. Pay particular attention to drying the area between the toes since this is where athlete’s foot infections most commonly develop.
  3. Proper footwear: Wear boots and shoes with a rounded toe box that allows the toes to wriggle comfortably. At the same time, foot wear should fit properly so that the foot is secure. Choose leather and suede over synthetic material since natural materials allow air circulation to the foot. Look for foot wear with adequate traction. Boots and shoes should provide sufficient warmth since diabetic neuropathy may prevent the person from realizing that their feet are becoming cold.
  4. Foot soaks:  Soaking the feet should only be done occasionally. Ten minutes is a safe amount of time to prevent over-drying or maceration of the skin. Maintain a lukewarm water temperature of 90 degrees fahrenheit (32 degrees celsius). Use a thermometer to gauge the temperature or have a non-diabetic person test the water first.
  5. Heated massagers, hot water bottles and heat pads: Because of neuropathy, diabetics have a decreased ability to feel hot temperatures on the feet. For this reason, it is advisable to avoid heated foot massagers, heat pads and hot water bottles.
  6. Moisturize, moisturize, moisturize: During the winter months, it is advisable to use an extra emollient moisturizer on the feet. Keeping the feet moisturized prevents heel cracks and fissures that are painful and are prone to infection. Avoid moisturizing between toes since added moisture encourages bacterial and fungal skin infections.  Ask your certified foot care nurse or doctor to recommend a suitable moisturizer.
  7. Check your feet:  Inspect your feet daily for swelling, heel cracks, dryness, open sores, cuts, bruises, blisters, corns, calluses.  Check for peeling and dampness between the toes since this is a symptom of athlete’s foot.  Use a hand-held mirror to check the soles of the feet.
  8. Nail care: Have a certified foot care nurse clip and file your nails regularly. Nails should be clipped straight across. Thickened, fungal nails should be filed down.

Related articles:

The Importance of Nursing Foot Care for Diabetics

Why Athlete’s Foot is Dangerous in Diabetes

Copyright Terry McDermott. May not be reproduced in whole or in part without permission of author