Diabetic Foot Ulcer—Does Healing Happen Quickly? Can we re-evaluate the common use of slipper socks in hospitals and skilled nursing facilities? For those at home, bare feet, slippers, socks, and moccasins are the usual suspects. How easy is it for our seniors to bump “at-risk” feet that frequently have peripheral neuropathy? What about the fall risk with those same non-supportive, non-firm footwear
81-year-old Amy, had diabetes with peripheral neuropathy in her feet, lived alone and was in High Lakes Transitional Care for exacerbation of her CHF (congestive heart failure). When Martha, Occupational Therapist (OT), brought up footwear she was surprised. “I’ve always worn my cozy pink slippers”. The 2-page shoe test was done for fall prevention. The results demonstrated the slippers were “poor” for torsional rigidity, heel counter rigidity and flexion stability. Then it was discussed how easy it was to bump the toes going around a corner or chair and how quickly a diabetic ulcer could happen. Amy suddenly exclaimed, “Oh that’s right, my brother Pete was diabetic and his insurance paid for custom diabetic shoes every year! Maybe I should do that.” Nursing updated Amy’s care plan to wear supportive shoes and Physical Therapy(PT) confirmed that need. PT recommended a front- wheel walker due to balance deficits seen from CDC STEADI Protocol tests. A referral to a podiatrist was done, knowing they would help with the insurance authorization process.
Prevention is everything! Martha, OT, had Amy use a long handle mirror to check skin integrity on her feet daily and apply lotion to the tops and bottoms of her feet after washing and drying them thoroughly.
Because of Amy’s dementia-cognitive deficits, Speech Therapy(SLP) did the MOCA (Montreal Cognitive Assessment) and the CLQT (Cognitive Linguistic Quick Test). The SLP treated the cognitive and safety deficits with spaced retrieval memory technique, simple diabetic handouts, etc. There was increased compliance in doing general diabetic care in coordination with nursing, OT, and the dietician!
Let’s have more YouTube videos on footwear and diabetic success stories! Many of our seniors have smart phones and are savvy on searching and have supportive family members.
See this article on cost effectiveness of diabetic foot ulcer prevention: http://bit.ly/2m4lT5U
Take my Fall Prevention Class to gain more insights, get valuable handouts for diabetes and how to increase senior compliance for both! In doing the 2-page shoe test, I have an 80% compliance rate.
Preventative diabetic care and the CDC STEADI Protocol for senior fall prevention coordinates well with the goals of better rehab outcomes, and decrease medical costs. Medicare/CMS-including bundled payment programs, accountable care organizations (ACOs), Medicare Advantage plans and health maintenance organizations (HMOs) have a new emphasis on value-based health care. We want less hospital re-admissions! Therefore, the quadruple aim is achieved. STEADI has a multitude of evidenced-based research. I’ve used STEADI successfully for 15 years. It is fun and easy to use in ALL medical or senior living settings. Telehealth is cost- effective in follow-up for diabetic care and senior fall prevention.
I provide Fall Prevention Classes to MDs, Medical Professionals, Insurance Companies and Senior Communities. Let’s decrease re-hospitalizations! https://www.geriatricrehab.biz/