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

 

 

 

Summer Foot Care Tips For Diabetics (And Others)


In the words of George Gershwin, from his opera, Porgy and Bess, “Summertime, and the livin’ is easy…..”  It’s time to kick off our socks and shoes and feel the warmth on our hardworking feet.  It’s very tempting to walk about in our bare feet, enjoying  the softness of the grass and squishing the sand between our toes.

However, for people with diabetes and other people with decreased nerve sensitivity and circulation in their feet, walking barefoot could turn a pleasant summer day into a medical dilemma.  Diminished ability to feel different sensations in the feet as well as poor wound healing due to poor circulation can cause problems.

A person who cannot adequately detect sensations of pain will not be aware of cuts to their feet, especially the bottom and in between the toes.  It is not unusual for a diabetic patient to be unaware that they have developed a cut, splinter or other abrasion until someone, such a certified foot care nurse, detects the issue. By then, there is often the beginning of an infection which must be dealt with aggressively.  The existence of poor circulation, which goes together with poor nerve functioning, means that the body needs help fighting the infection.  Diabetics have a higher than average incidence of lower leg amputations.  Even the smallest infection can quickly become very aggressive.

Another reason it is never a good idea for diabetics to walk in bare feet is the decreased ability to feel changes in temperature.  The pavement as well as the sandy beach can be problematic if we are unable to detect how hot these surfaces can become.  It is easy to scorch and burn the bottoms of the feet without realizing it.  Even a minor burn can become a major infection.

Plantar wart from a public pool.

Without the protection of sandals or other appropriate footwear, it is possible to develop fungal, viral and bacterial infections from walking on public surfaces such as pool decks, saunas, change rooms.  Plantar warts, athlete’s foot and toenail fungus are the most common conditions that are picked up from these surfaces.

Because we tend to perspire more in warm weather, athlete’s foot is a common problem.  Again, in diabetics and others with nerve/circulation deficits, athlete’s foot must be diligently treated.  Athlete’s foot that is allowed to spread can cause abrasions and infection.  Read about why athlete’s foot is dangerous in diabetics and what to do about it here.

Don’t forget to liberally apply sunscreen to your feet when wearing sandals.  Skin cancer in the feet often goes undetected.  For a primer on skin cancer and the feet, as well as pictures of what different skin cancers look like, read here.

 We often develop dry, cracked heels in the summer because of the amount of activity we do and because of the effects of the sun and hot weather on the skin.  Here are 8 tips for dealing with dry, cracked heels.

As well, with our toes exposed, women enjoy the pampering of pedicures.  Be educated about getting a safe maniciure/pedicure, here.

Wear well-fitted sandals that support your feet. Check your feet daily, once in the morning and once in the evening.  If this is difficult to do, have someone check your feet for you or use a mirror held against the bottom of your foot to get a good view.

It’s easy to take care of our feet while we enjoy the beautiful weather.  Have a wonderful summer!

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

Life Is What Happens

Recently, a regular McDermott Footcare client told me that he’s moving to a retirement residence.  This is a surprise to me since he’s told me before that he doesn’t want to leave his house.

A retirement residence is for seniors who are mostly independent but may need minimal help to perform daily activities such as taking their medication and bathing.  Residents have their own suites but share some common areas such as the dining room.  It differs greatly from a nursing home or long-term care facility where people need greater assistance or complete care.

My client, Mr. X, is fiercely independent, generous and witty.  He lives alone, has trouble going up and down the stairs, difficulty bathing and cleaning his house.  He often forgets to eat and take his medications.  His closest relatives live out-of-town but they do the best they can to help him.  They worry about him all the time.

When I visit him for foot care, I ask him if he’s taken his pills that morning.  The usual answer is “no, I forgot.” I hand him his pills and remind him that since he’s diabetic, he can’t wash down his meds with the sugar-laden pop he likes to keep around.  I also remind him to eat.

So, why am I telling you this?  Well, it struck me how quickly my client’s life is changing.  Despite his earlier insistence that he can continue to function in his own home,  in one month his outlook is completely different.

Although we all experience many changes in our lives, I think the most significant shifts take place in old age.  The onset of illness, loss of independence and loss of loved ones take a hard toll on seniors.

I marvel at how my client is handling the impending move.  He’s given me a lesson in accepting life’s inevitable changes.   Instead of wasting time and energy fighting what he can’t control, he’s meeting his challenges head-on with a pragmatic, no-nonsense attitude.

That doesn’t mean he won’t struggle when he gets into his new place.  There will be major adjustments to make.  On top of all the other losses he’s experienced over the past few years, he’ll have to deal with the loss of the home he’s known for many years and the life he had in that home.  It won’t be easy but I believe he’ll be OK.

I wish him all the best.  May you continue to accept life as it comes with grace and dignity, Mr. X.

Foot Care and the Sandwich Generation

“Mom has an ingrown toenail.  Can you come and see her?” 

“My uncle has diabetes.  Do you do foot care on diabetics?”

McDermott Footcare is often contacted by people in Toronto and the GTA who would like a foot care nurse to come and care for a relative’s feet –  mom, dad, uncle, aunt, grandparent – someone they love.  The people who call  McDermott Footcare are busy juggling kids, jobs, lives, but they are also extremely committed to providing the best care for at least one elderly relative.  This is the sandwich generation – responsible for their own immediate family on the one hand and elderly relatives on the other. 

 The internet is full of articles and resources on this phenomenon.  Just Google “sandwich generation Toronto” and you’ll get too many sites for me to link on this blog. 

I am a member of the Sandwich Generation.  My balancing act consists of 8 kids ranging from grade school to a university graduate on one side of the scale and my mom, who is almost as much work, on the other side.  Before dad passed away from complications of Parkinson’s Disease, he was on the scale too.   I still haven’t managed to find the right balance and I know I’m not alone.

People who contact me on behalf of a relative share the common trait of being  dedicated to improving  mom’s and dad’s comfort and well-being.  One daughter schedules her mother’s  foot care appointments over her lunch hour so she can come home from work when I visit her mom.   A son whose father has recently been admitted to a long- term care facility insists that McDermott Footcare be allowed to continue caring  for his dad even though the facility  has their own foot care nurse.   Someone schedules visits for aunt, mom and dad to be seen all at the same time – that’s organized!  Others make sure that visits are regularly booked.   Of course, I look after my mom’s feet.

It’s not easy.   Some days we can’t tell right from left.  Unexpected events can be challenging.    But lovingly giving back to the people who gave so much for us makes everything worthwhile.

 

Tea, Cookies and Potpourri

On Thursday, Dec. 8, I spent a wonderful afternoon making Christmas potpourri and having tea and cookies with a lovely and lively group of seniors.  We were at a community resource centre.   McDermott Footcare had been invited to come and see what they’re all about.

Amidst tea served in porcelain cups, hot mulled cider and an abundance of Christmas cookies, we crafted our individual potpourri.  The resource room smelled of Christmas – cloves, ginger, cinnamon.  Kimberley Davies, Community Relations Manager of Amica at Bayview, guided us through our craft projects.

Some of the seniors reminisced about Christmases past, childhood winter adventures and a simpler time.   For me, that was the best part of the afternoon – getting to know the guests and listening to their stories. 

Thank you to the staff of the community resource centre for your hospitality.  Most of all, thank you to Jack, John, Lorna and the other guests who shared part of your lives with me over afternoon tea, cookies and potpourri.  What a great reminder that foot care is not just about feet 🙂

Why I Became A Foot Care Nurse

 It’s funny how seemingly random, unrelated events all come together to influence a major career decision.  Former patients, past incidents, personal circumstances all played a role in getting me where I am today.

As an RN working in both acute care and continuing care, I often cared for patients with different conditions.  My focus was always on the medical issues, the post-op complications, the controlled chaos of a busy unit.  Even though I sometimes encountered patients with foot issues, I was unprepared to do anything about them.  Even if I did feel compelled to address their overgrown nails and other problems, I didn’t have the time.

I still remember the first time I saw onychogryphosis nails (toenails that look like curled ram’s horns).  I was a brand new RN working on an orthopedic floor and I was so shocked I stared at the patient’s feet.  I didn’t know nails could do that! They were extremely fungal as well.  That disturbing image has stayed with me all these years. 

Fast forward to about 5 years ago.  My dad had Parkinson’s Disease.  He only allowed my mom to care for him and refused all of my pleading to bring in home care.  Dad’s feet were not as bad as that onychogryphotic patient of years ago, but he needed foot care badly.  Unfortunately, he refused all efforts to have his feet problems addressed and we were powerless to convince him otherwise.

On Christmas Day one year before he passed away, dad slipped and fell on the ice after Christmas Day Mass and ended up in the Emergency Room.  As I was prepping him to be seen by the doctor on call, I took off his socks and he became very upset.  He begged me to cover his feet because he was ashamed of  their appearance. 

When dad was in palliative care in the hospital, two weeks before he died, mom overheard a nurse remark on the awful condition of his feet.  She was certain my dad was neglected at home because his feet were horrendous.  The nurse’s unfair assessment hurt my entire family, most of all my mom.

After dad passed away, I convinced mom to let me hire a foot care nurse for her.  She hesitated at first, even argued and yelled at me the morning of the nurse’s first visit, but eventually she began to enjoy the wonderful care.  I was always present when mom was having her foot care appointments and would watch with fascination while the nurse did her thing.

So what do all these experiences have to do with my career move?  I needed a change from my increasingly demanding job as a visiting nurse in community.  While I loved my work seeing patients in their homes, the pace and hours of my job left me with little time and energy for the most important people in my life, my family.  I wanted to work; I needed to work, but I needed balance most of all.  So, I handed in my resignation despite that fact that I had no other position to go to.

After much thought, and even more prayer, I felt that foot care nursing was something I should pursue.  I went back to school and realized that I really enjoyed my course.  Because I was striving for balance between my professional and personal life, I decided that my best course of action was to be an RN in independent practise – start my own nursing business – as a foot care nurse.

I am very much aware of all the foot care episodes of the past when I visit my clients.  I remember all the patients who would have benefited from foot care; dad’s shame when his feet were exposed; mom’s initial reluctance and eventual pleasure from good foot care. 

My dad has taught me to be aware that some people are embarassed when they first show me their feet.  Many clients are certain that I have never seen anything worse!  (oh yes, I have) Feet are very intimate and people need to feel they won’t be judged if they place this part of their body in my hands.  A level of trust develops between my client and myself as I spend 30 minutes or more talking and listening to them as I do their foot care.  Many times, I will be the only person they see that day.  I may be the only one  to remind them to take their pills, make sure they eat on time and just ask them how they are. 

I enjoy my work – I really do.  The people who hire me,  either for themselves or for a family member, seem to like my work.  They arrange regular foot care visits with me every 4 to 7 weeks. That’s a pretty good indicator!  It’s a privilege to be allowed into clients’ homes and an even greater privilege to be asked to care for their feet.

 

About Nursing Foot Care

 In the world of foot care options, nursing foot care is a trusted, professional, convenient choice for discerning healthcare consumers.   Among the various alternatives available, only Registered Nurses possess considerable nursing knowledge and expertise  in order to provide timely,  holistic care which considers the well-being of the entire person.

As a Registered Nurse specializing in foot care, I hold a Certificate in Advanced Nursing Foot Care from an accredited educational institution.  As well, I update my skills and knowledge through continuing education for Foot Care Nurses.  The College of Nurses of Ontario, the Canadian Nurses Association and the Registered Nurses Association of Ontario regulate my practice as a Certified Foot Care Nurse and require that I adhere to Standards of Practice that apply to Registered Nurses,  Certified Foot Care Nurses and Registered Nurses in independent practice.

As a Certified Foot Care Nurse, I believe in the importance of quality foot care as an integral aspect of my clients’ health.  I recognize that my clients may face certain challenges that make it difficult for them to care for their own feet.  Changes in vision, flexibility, hand strength, coordination and mental acuity may make personal foot care onerous. 

 Conditions such as diabetes, rheumatoid arthritis, osteoarthritis, vascular disease and other degenerative conditions affect the health of the feet.  These conditions will often cause pain, nerve damage, skin problems, as well as circulation deficits.  All of these affect the health  and appearance of the feet as well as a person’s ability to use them.  I am able to address, in a non-invasive way, problems which  may develop.  I typically address concerns regarding thickened and fungal nails, corns, callouses, bunions, nerve and circulation deficits, athlete’s foot and other matters.

As a Registered Nurse, I strive to prevent further foot problems for my clients and to address current issues.  To that end, part of my care consists of providing  clear and simple health teaching which allows my clients or their families to better care for their feet between nursing visits.  If needed, I can also make referrals to other healthcare providers.

Clients who regularly receive nursing foot care express an increased sense of comfort and well-being.  The health and appearance of the feet are restored so that the client may once again participate in social activities and activities of daily living because their feet no longer cause discomfort,  pain and embarassment.  The client or their family is empowered and satisified.