Foot Care Presentations to Toronto Community Groups

McDermott Footcare gives informational foot care presentations to Toronto seniors’ and community groups. A recent two-day presentation and foot care demonstration was given to the St. Lucia Toronto Association.

Members of the St. Lucia Toronto Association asked many relevant questions regarding foot care. Here are some of their voiced concerns:

What can a certified foot care nurse do for me? A certified foot care nurse can:

  • clip and file toenails, including thickened, discoloured, fungal toenails
  • recognize the presence of athlete’s foot
  • recommend effective home remedies to treat athlete’s foot or
  • advise that a doctor’s treatment and prescription is needed  for more severe cases of athlete’s foot
  • take out ingrown toenails
  • reduce corns and calluses
  • provide padding for corns and calluses
  • advise clients re: purchasing proper shoes and socks

I am diabetic. How do I look after my feet?

  • eat a variety of healthy foods that fall within the guidelines of proper nutrition for diabetics
  • check your blood sugar as per physician’s recommendations to maintain blood sugar levels within accepted guidelines
  • check your feet daily for any cuts, abrasions, bruises
  • contact a certified foot care nurse to provide on-going care of your feet
  • click this link to read a McDermott Footcare article about diabetic foot care

What brand of shoe should I buy?

There are many brands on the market that make comfortable shoes; however, it is more important to look at the style of the shoe regardless of the brand. Click the link (here) to learn about guidelines for purchasing good shoes.

If your Toronto and area community and seniors’ group would like to have a speaker regarding how to maintain healthy feet, please contact McDermott Footcare at 416-997-2949 or at mcdermottfootcare@gmail.com

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

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

Why Assessment is Important in Foot Care

When a potential client phones or emails McDermott Footcare to ask about available services, I briefly explain that since I offer a nursing procedure, my first visit includes a very short assessment to find out what medications the person is taking and any medical conditions that affect the feet and toenails (and there are many).  Most people are fine with this.  On rare occasions, a person doesn’t want  the assessment  and decides not to have me come in.  That’s OK.  However, here’s why the strictly confidential assessment is so important:

  • As a Registered Nurse, it’s necessary to know what’s going on medically so I can give the best care possible.  Anyone who’s diabetic, has a heart, lung, blood pressure or circulation condition, is arthritic, has low immunity,  has difficulty walking, bending or seeing is going to be concerned about more foot care issues than overgrown  toenails.
  • Some commonly prescribed medications for the above conditions will cause changes to the health of the feet and toenails.  For example, long-term antibiotic use increases fungal infections to the toenails and skin of the feet.  Different types of steroids used in conditions of the lungs, the joints and cancer treatments make nails brittle and increase fungal infections of the feet and nails.
  • Past surgeries to the lower limbs and hips may cause poor circulation to the feet.  Fungal, thickened, discoloured toenails, lack of feeling in the feet (known as neuropathy) and poor skin condition are the result.  These surgeries may cause a change in the way we walk and the way we carry our weight.   In turn, corns and calluses may develop, making walking painful.

It seems to me that most of us don’t see the connection between what goes on in our feet and the rest of our body, but everything is connected very intricately.  That’s why conscientious, properly trained, certified foot care nurses get to know the whole person – not just their feet.

In my experience, not everyone wants a nursing assessment and decide that their needs are better addressed elsewhere.  On the other hand,  those who take the few minutes needed to answer the confidential assessment questions receive personalized, holistic, quality nursing foot care.

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