Welcome to the Podiatry Arena forums

You are currently viewing our podiatry forum as a guest which gives you limited access to view all podiatry discussions and access our other features. By joining our free global community of Podiatrists and other interested foot health care professionals you will have access to post podiatry topics (answer and ask questions), communicate privately with other members, upload content, view attachments, receive a weekly email update of new discussions, access other special features. Registered users do not get displayed the advertisements in posted messages. Registration is fast, simple and absolutely free so please, join our global Podiatry community today!

  1. Everything that you are ever going to want to know about running shoes: Running Shoes Boot Camp Online, for taking it to the next level? See here for more.
    Dismiss Notice
  2. Have you considered the Critical Thinking and Skeptical Boot Camp, for taking it to the next level? See here for more.
    Dismiss Notice
  3. Have you considered the Clinical Biomechanics Boot Camp Online, for taking it to the next level? See here for more.
    Dismiss Notice
Dismiss Notice
Have you considered the Clinical Biomechanics Boot Camp Online, for taking it to the next level? See here for more.
Dismiss Notice
Have you liked us on Facebook to get our updates? Please do. Click here for our Facebook page.
Dismiss Notice
Do you get the weekly newsletter that Podiatry Arena sends out to update everybody? If not, click here to organise this.

Home Visits

Discussion in 'General Issues and Discussion Forum' started by yvonneg, Oct 20, 2011.

  1. yvonneg

    yvonneg Member

    Members do not see these Ads. Sign Up.
    Hi all,
    Any suggestions on how to keep yourself safe when conducting home visits.
  2. David Widdowson

    David Widdowson Active Member

    Fairly standard single worker advice.

    1. always have someone else who knows where you are and the times you are expected.
    2. always keep your mobile phone handy.
    3. when positioning yourself in a room put yourself nearest the exit, particularly if its an unknown new patient.
    4. always remain confident and in-charge, even if you do not feel it inside, give the impression you are the boss.
    5.At the door - if you feel immeadiate unease - leave.

    Hope this helps.

  3. Don´t do home visits probably the safest way.
  4. twirly

    twirly Well-Known Member

    Sound advice from David. I would add that if a new visit & you are in the slightest uncertain take a passenger in the car & ask them to call your mobile after ten minutes. There have been very few occasions I have felt uncomfortable during a home visit but on one occasion when the patient insisted on locking the door behind me as I entered I requested he unlock the door for the duration of the visit or I would leave immediately. He did ;) He was quite a nice chap really, just nervous of strangers! :rolleyes:. Patients perceptions of us can make us the scarey element.

    The scariest ever visit for me did not involve a patient but a bloody great big Mastiff which wanted to eat me! :deadhorse:. That visit was concluded without treatment.

    Good luck & stay safe.

  5. lucycool

    lucycool Active Member

    My mum used to do lectures for us folk about safety.. she worked for the suzy lampleugh trust. May I suggest you have a look on their website - or I could ask her to give some top tips?

  6. lucycool

    lucycool Active Member

  7. ag1

    ag1 Member

    I used to train all new rehab team members on safety when visting homes for initial assessments and the suzy lamplugh trust is a brilliant place for information on how to keep safe. I completely agree with what has been said so far and to add..... always ask for animals to be put in a locked room. If they sense any anxiety from the owner you just never know what they will do.

    That and make sure you have a safety plan so people know what to do if you don't answer your mobile when called. Make sure everyone knows the flow chart and take it seriously.
  8. cecilia1923

    cecilia1923 Member

    I give someone else a copy of my diary app for the day and I ring or text them before I go into see the client and do the same when I come out. That way, if something did happen, they would know where to find me. Also keep your mobile phone in your pocket, so you would be able to go to the toilet and and phone someone to come and help.
    I am finding it more and more common that I have to deal with the owners dogs. I have one lady who I treat in her recliner chair and her Alsation dog usually has its paws over my arm whilst I am treating her. I initially tried to put it in another room but it wouldn't go. I used to be really scared but I find that if it knows that I am the boss, everything is fine.
  9. Rob Kidd

    Rob Kidd Well-Known Member

    I guess one should ask the more fundamental question: why are you doing home visits at all? They are not good health care, not good occ health and safety for you or the patient - not good for anyone really. Surely far better to see them in a properly seated, properly lit surgery?
  10. twirly

    twirly Well-Known Member

    Hi Rob,

    Although I too agree that the best possible environment for treatment would be in a clinic. I feel the need to enquire what becomes of the housebound patient? Surely not everyone who requires our services are able bodied.

    Kind regards,

  11. lucycool

    lucycool Active Member

    Hey guys..

    This is from my mum - hope it helps!!

    Lone Working – Home Visits
    Common sense is not always common practice!
    In the car, put a tick-list of stuff to remember, like a book mark which stays in the car.
    Take a minute to look at it before you drive off anywhere and this will help you focus, despite being in a rush....e.g.
    • Have I got my mobile phone with me?
    • Is it charged / do I have my in-car phone charger with me?
    • Have I enough petrol?
    • Do I have contact details of everywhere I am going? Correct address, phone number, name of client (you would be surprised at the number of people going IN to the wrong house!)
    • Do I have a map or know EXACTLY where I am going, where to park? Use of Google Map/street view is really handy here.
    • Do I have change for parking meters?
    • Does someone know where I am going today? Have I left these details somewhere, in order/time of visits?
    If you can mentally tick all of the above, then off you go.
    When you get to destination, reverse into parking space if you can, for a smooth exit. After knocking/ringing bell, take a step back so you are not ‘in their face’. When asked in, try to follow the person by saying ‘you lead the way’ – that means that you can shut the door behind you and make sure it’s not being locked. You can also have a quick look at the door, to make sure you know how to get out! E.g. does the door handle work up or down, is it locked with a Yale or mortise, is there a baseball bat behind the door (joke- but not in some areas!)
    Try not to get yourself in to a compromising situation. For example, if someone (not elderly- use your sense on this one) comes to the door semi-dressed, say that you will come back in 10 minutes.
    Try to keep yourself nearest the door if you can, when inside (but this is sometimes difficult to arrange). If anything untoward happens, for example if there is someone else there who makes you feel uneasy, make an excuse (see below) and get out.
    Use your phone as an acting ‘prop’ if you don’t know the area/client. E.g. when standing on doorstep, pretend to be ‘on the phone’......saying, “ Yes, I’m just at Mr Smith’s now, I’ll give you a ring back when I have finished..... Sorry about that, Mr Smith, I’m just letting the office know where I am”. The client doesn’t know that you don’t have an office base somewhere!
    Or get a friend to give you a ring mid –visit to check if you are ok.
    Or pretend to take a call: “ Oh, sorry, my phone’s on vibrate and I’ve got to take this, my child/ my dog is ill at the moment.... oh, no I ‘ve got to go, it’s an emergency, I’m really sorry- I’ll give you a ring and will re-schedule for tomorrow”.
    Bottom line is- if it doesn’t feel right, trust your instinct and get out. Make any excuses, equipment in the car is a good one, whatever, but just go, calmly and quickly and drive off.
    There are lots of systems as well- try some links below. Remember, don’t be complacent, if in doubt get out
  12. Suzannethefoot

    Suzannethefoot Active Member

    Not all clients can get to a surgery. Simple as that!
  13. Rob Kidd

    Rob Kidd Well-Known Member

    Odd one that - all clients seem to be able to get to hospital when the need arises. Why cannot they get to a posiatry surgery? As a matter of anecdote, my Dad was a UK GP (retired 1989); for the last 10 years of his working life he had (essentially) all "home visits" delivered to the local hospital. This gave: 1) proper working conditions, and 2) shifted some emphasis of responsibility back onto the client. While I am sure he was not right in everything - I am clear about this.
  14. David Widdowson

    David Widdowson Active Member

    ALL?... Yes, its called an ambulance ... I think the NHS still has some left!

  15. Suzannethefoot

    Suzannethefoot Active Member

    As practitioners in private practice, we do not have the resources available to the NHS. Yes, I'm sure 90% of my clients could get to my surgery, but it would cause huge amounts of upheaval, cost of taxi's, or children having to take time off work to bring them, and in many cases, pain, for them to get here. Sometimes home visits are the most sensible solution. On this I am very clear. Just my opinion of course.
  16. twirly

    twirly Well-Known Member

    Hi Rob,

    I appreciate your father's ability as a GP to authorise transport to facilities in days gone by. Even as an NHS podiatrist (in days gone by) this was never something available to our service. Certainly locally this is the current picture although I would invite others to comment if the service is dealt with differently in other areas.

    If I demanded all patients attend my private clinic then I would either have fewer patients who would almost certainly find an alternative for their care or have to extend their appt. time to permit them access & if wheelchair user, transfer time etc. which would cost me time & money. I price h/v accordingly without penalising patients for being disabled. (Restricted by area). My clinic was purposely built to allow disabled/wheelchair access as many wheelchair users prefer to attend appointments. However, I prefer not to dictate to a patient that my services are restricted to those who can access transport. I feel I should add, I do not see patients who 'prefer' a visit. My housebound patients are just that. Not through choice, through disability.

    Just my thoughts. As a PS. How would you deal with a patient who is terminally ill bed bound?

    Kind regards,

  17. David Widdowson

    David Widdowson Active Member

    The original posters question seems to have got turned around somewhat into a pointless arguement of why do home visits at all.
    It is pointless because home visits are a fact of life that will not change.
    Tell my terminally ill bed ridden patients and stroke victims to get themselves into the clinic ... I think not!
    In a perfect world home visits would not be necessary ... but it's not ... so they are, period.
    It would be wise now to drop this arguement and either return to the original question or leave it alone.
    Just my humble opinion of course.

  18. Rob Kidd

    Rob Kidd Well-Known Member

    Davide W, please no offence was ever meant - or made - I am sorry if that is the manner in which I came over. I recognise totally that we do not, and never will live in a one-size-fits-all world. Of course there is, and always will be a need for some home visits, but as a routine way forwards it is my opinion that they are not in the best interests of quality health care.
    Oh - and by the way, Dad never organised transport! This was always done by family-relatives etc. I am simply saying that we should discourage the home visit mentality by those who cannot be arsed to go to the surgery.................... Not that I practice at all - now retired. Rob
  19. footdrcb

    footdrcb Active Member

    I worked as a tradesman for 15 years before becoming a podiatrist. My entire job was visiting homes. I think that there is a little too much anxiety being manifest on this thread.
    Come on guys, home visits are usually for geriatric patients who have limited mobility . As if they are going to give you a haymaker.
  20. Suzannethefoot

    Suzannethefoot Active Member

    Errr . . .what?:confused:
  21. W J Liggins

    W J Liggins Well-Known Member

    According to Chambers dictionary (slang) 'a wild swinging blow'. The Shakespearian version may also be correct (used in fencing) 'a hit, or home thrust'.

    Whichever definition takes your fancy, the suggestion is that a geriatric patient is not going to hit you. However, I believe that the OP was referring more to an attempt at a 'home thrust' by a less than gentlemanly male patient, or perhaps just inappropriate behaviour by a patient sadly affected by Alzheimer's or similar disability.

    All the best

  22. footdrcb

    footdrcb Active Member

    I tell you what bill... That less than gentlemanly male patient could give me the home thrust any day mate.

    All the best

  23. footdrcb

    footdrcb Active Member

    Yes I know Suzanne,

    I guess like bill said, if the old buggers want to grab me , Id feel quite lucky and good on them I say.

  24. Suzannethefoot

    Suzannethefoot Active Member

    Thank you Bill for your explanation. I agree footdrcb, they are hardly going to force their geriatric attentions on me. Having said that, as a woman,I have declined to visit people when I have had 'bad vibes'. No point taking chances.
  25. johntee721

    johntee721 Member

    Hi there,

    I've just started my own little practice and have done a few home visits....It is primarily with patients who are unable to get to the clinic. I just can't get my head around the trust that people place in you....A stranger with sharp objects in his/her bag strolling into their homes. You gotta love the old dears tho they do come out with some priceless stuff..lol. I remember when training I visited Swansea and we did doms with NHS staff, they said they wouldn't go to certain areas alone! I think there is a big difference for male pods, I feel confident in my abilities physically and mentally to combat any situation that may arise whilst on home visits..
  26. Kaleidoscope

    Kaleidoscope Active Member


    Ive been doing some pretty dire Home Visits recently.....I don't mind when they are not well.... its the well ones that can't be bothered to go to the clinic that get me down.... who want the earth and don't want to pay much for it (and tell you someone else will do it for £10!)

    I was speaking to my partner about this....and my daughter overheard me saying the final word on DOMS......

    "..........they are soul-destroying"

    My daughter said '! thought you only did their feet?'

    I told her she had been watching way too many Vampire stories!

  27. Lilypad

    Lilypad Member

    Good thread. Home visits can be essential to those who cannot make it to hospital or simply want to be treated in the comfort of their own home, especially where chiropody is concerned, treatmemt of older patients. I've found no cause for major concern so far in my career carrying out home visits. However, as stated above, you need to be aware of possible dangers, female podiatrists/chiropodists especially.

    My local police station gave me a free panic alarm which I take on my keyring, I always let someone know where I am address, name, number, appointment time. I also try and avoid visiting people after dark although this can be difficult. There is a risk of being attacked in clinic or hospital too sadly so I don't think it is something that one can escape, home visits can be a life line to many though.

Share This Page