How to Tell Someone They Need Foot Care

“We didn’t realize mom’s feet were in such bad shape. She was hiding them from us.”

“Dad won’t let anyone see his feet.  We only saw how bad they were when he was in the hospital.”

Comments such as these are sometimes heard at McDermott Footcare.  Family members are alarmed at the condition of their parent’s or other loved one’s feet and call for help.

It may have been many months and perhaps years since their parent has received foot care.  As the health and appearance of the feet deteriorate, the person is more likely to hide them from their family and from other people because of shame and embarrassment.  The person may also be uncomfortable about having someone touch their feet. When the family members contact McDermott Footcare, they are frustrated and feel guilty.

How do we handle this situation which is increasingly common?

  1. Family members should not blame themselves. They have not been made aware of the problem.
  2. Do not force nursing foot care on the person. Someone who is competent and capable of making their own decisions can decide whether or not they want the care.
  3. Even if the family requests the service, the nurse will not provide foot care without the patient’s consent. The nurse will always respect the wishes of the patient.
  4. The family can explain to their parent that nursing foot care is beneficial for their comfort, overall health and ease of walking. This conversation may need to be repeated several times.
  5. If the parent is in a nursing home or retirement residence, ask the nursing staff to talk to them about the importance of regular foot care.
  6. Request the help of the parent’s doctor to reinforce the need for foot care.
  7. Reassure the parent that the nurse understands their reluctance and is properly trained to address all foot care concerns.
  8. Above all, be gentle and patient when discussing the need for nursing foot care. Keep in mind that the parent may be fearful, embarrassed, uncomfortable or worried about the cost. Acknowledging their feelings and giving them time to understand your concerns will help to resolve their reluctance.


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

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




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

Nursing Foot Care: Frequently Asked Questions

Recently, McDermott Footcare was a guest expert at a community home care information seminar.  Here are some of the questions asked by the audience as well as frequently asked questions:

How do I know that a foot care nurse is properly trained?  Anyone claiming to be a foot care nurse should be able to show you a Certificate of Completion of an Advanced Nursing  Foot Care course.  In addition, the RN or RPN should have a current Licence to Practice nursing from a nursing regulatory/disciplinary body.  In Ontario, Canada, the College of Nurses of Ontario will be able to verify if the RN or RPN is a professional nurse in good standing with no disciplinary actions against him/her.   Only a RN or RPN can take courses leading to certification in Advanced Nursing Foot Care.

Why does the nurse have to take a nursing history/assessment?  As RNs and RPNs, we understand that there is a connection between the health of the feet and the health of the body as a whole.  Poor circulation and nerve function in the feet affect skin condition, and the ability of the feet to recover from open wounds and infection.  Certain medications affect the condition of the nails and skin, causing them to become brittle, fungal, thickened, discoloured, difficult to cut.   In addition, some medications decrease the body’s ability to fight infection resulting in fungal infections of the feet.  A properly trained certified foot care nurse will be able to satisfactorily explain the correlation between health, medications and feet.

Initial nursing assessment of a diabetic client.

How do I prepare for a home visit from a foot care nurse?  Choose a comfortable chair that you would like to sit in for the duration of the treatment.  A recliner works best as does a chair with a footstool.  If neither is available, the certified foot care nurse can improvise, creating a suitable area to place the feet.  One or two fresh towels are useful also.  There is no need to soak your feet just before or during the visit.

Using the client’s bed as a suitable work surface.

How long is a visit?  The first visit is usually a little bit longer since an initial assessment has to be obtained.  Typically, the first visit is about an hour, depending on the foot care needed.  Subesequent visits are shorter.

Will you teach me how to care for my feet between visits?  An important part  of quality professional nursing care  includes thorough health teaching.  A properly trained, certified foot care nurse should be able to provide appropriate guidelines for self-care of nails and skin between visits.  The RN or RPN will also be able to determine if further medical treatment is needed and advise seeing your doctor.

How much does nursing foot care cost?   Prices vary between nurses and in different jurisdictions.  The nurse may charge a distance fee.  Ask the nurse for their fee.

Can I claim this?  In Ontario, Canada, nursing foot care is an allowable income tax expense.  Some private insurance companies will reimburse up to 80% of cost.  Depending on the fee charged, the Department of Veterans Affairs will reimburse all or part of the cost.  Always ask the certified foot care nurse for a receipt.  Make sure the RN or RPN registration licence is included in the receipt since this is necessary for reimbursement.

Can I have a one-time only appointment?  Certainly.

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