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Palliative Podiatry?

Discussion in 'Introductions' started by PodFelicity22, Oct 20, 2009.

  1. PodFelicity22

    PodFelicity22 Welcome New Poster

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    The public hopsital that I work at has been allocated palliative care hours for podiatry. It's only 0.1 EFT but I would like to have an impact on these palliative care patients. The Podiatry department has a good reputation among hospital staff and I don't want to compromise this by just cutting toenails for these patients.
    Is there another hospital out there that is providing podiatry services to pall care? If so, what is your role?

  2. Tuckersm

    Tuckersm Well-Known Member

    Hi felicity,

    We provide services to our Pall care facility, and nail care is part of it. These clients often have significant peripheral oedema making ingrown nails common. We also provide information etc. on pressure relief, and treat the associated pressure ulcers, but usually less agressively.
    Not all Pall Care patients are end of life, so footwear issues (again associated with oedema) are also addressed.
  3. cwiebelt

    cwiebelt Active Member

    Hi Felicity,

    At the hospital i work in we also provide services to palliative care clients, yes a lot of this is basic nail care and callus debridmant. I provide some basic tips for the carer or nusing staff eg suggest off loading the foot if confined to bed, use of moisturiser cream if skin is dry this i know is basic but still important.
    We have tried to educate both family, doctors and nusing staff which we see also is our role so as to provide a service to the client and those providing care to the client.
    we have given brief presentations to the medical staff, which has been a useful forum.

  4. cornmerchant

    cornmerchant Well-Known Member

    Hi Felicity

    As a Pod in private practise, a large part of my work is palliative. Unlike many pods, particularly NHS based 'specialists" I consider this "cut and come again" work, as it is often described, to be equally as important as other branches of the profession.

    It is not just nail cutting- far from it! As already pointed out, education re foot wear, pressure relief, creaming of dry skin , all the problems associated with aging, may be basic but nevertheless important to maintain mobility and prevent breakdowns/pressure sores. Often we may be the ones to pick up ulcers, ischaemia, cellulitis......to name just a few examples that come to mind from my own experiences.Many of my palliative cases are in fact high risk patients who are not seen by the NHS or find appointments too infrequent or very difficult to get to owing to mobility problems.

    Hope this helps, and you are able to make a difference!

  5. admin

    admin Administrator Staff Member

    Just to clarify the original posters question:

    Are you talking about palliative care (ie the cut and come again) or are you talking about providing podiatric care to patients who are in hospital for palliative care of their medical condition?
  6. Tuckersm

    Tuckersm Well-Known Member

    From Dept of Health
  7. cornmerchant

    cornmerchant Well-Known Member

    With resoect, I think that the meaning of "pallaitive care" in relation to podiatry has a slightly different connotation-routine maintenance maybe would better describe it. Maybe Felicity actually meant care of terminally ill patients?

  8. admin

    admin Administrator Staff Member

    Thats what I was trying to clear up.

    Interestingly, the Wikipedia definition of "palliative care" does fit that of the routine 'cut and come again' podiatry: "Palliative care is any form of medical care or treatment that concentrates on reducing the severity of disease symptoms, rather than striving to halt, delay, or reverse progression of the disease itself or provide a cure."

    Palliative care

    Palliative care (derived from the Latin root palliare, or "to cloak") is an interdisciplinary medical caregiving approach aimed at optimizing quality of life and mitigating suffering among people with serious, complex illness.[1] Within the published literature, many definitions of palliative care exist. The World Health Organization (WHO) describes palliative care as "an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial, and spiritual."[2] In the past, palliative care was a disease specific approach, but today the WHO takes a more broad approach, that the principles of palliative care should be applied as early as possible to any chronic and ultimately fatal illness.[3]

    Palliative care is appropriate for individuals with serious illnesses across the age spectrum and can be provided as the main goal of care or in tandem with curative treatment. It is provided by an interdisciplinary team which can include physicians, nurses, occupational and physical therapists, psychologists, social workers, chaplains, and dietitians. Palliative care can be provided in a variety of contexts including hospitals, outpatient, skilled-nursing, and home settings. Although an important part of end-of-life care, palliative care is not limited to individuals near the end of life.[1]

    Evidence supports the efficacy of a palliative care approach in improvement of a patient's quality of life.[4][5]

    Palliative care's main focus is to improve the quality of life for those with chronic illnesses. It is commonly the case that palliative care is provided at the end of life, but it can be for a patient of any age.[6]

    1. ^ a b Zhukovsky D (2019). Primer of Palliative Care. American Association of Hospice and Palliative Medicine. ISBN 9781889296081.
    2. ^ "WHO | WHO Definition of Palliative Care". WHO. Retrieved 4 December 2019.
    3. ^ Sepulveda, Cecilia; Marlin, Amanda; Yoshida, Tokuo; Ullrich, Andreas (2 August 2002). "Palliative Care: The World Health's Global Perspective". Journal of Pain and Symptom Management. 24 (2): 91–96. doi:10.1016/S0885-3924(02)00440-2. PMID 12231124.
    4. ^ Kavalieratos D, Corbelli J, Zhang D, Dionne-Odom JN, Ernecoff NC, Hanmer J, et al. (November 2016). "Association Between Palliative Care and Patient and Caregiver Outcomes: A Systematic Review and Meta-analysis". JAMA. 316 (20): 2104–2114. doi:10.1001/jama.2016.16840. PMC 5226373. PMID 27893131.
    5. ^ Hoerger M, Wayser GR, Schwing G, Suzuki A, Perry LM (June 2019). "Impact of Interdisciplinary Outpatient Specialty Palliative Care on Survival and Quality of Life in Adults With Advanced Cancer: A Meta-Analysis of Randomized Controlled Trials". Annals of Behavioral Medicine. 53 (7): 674–685. doi:10.1093/abm/kay077. PMC 6546936. PMID 30265282.
    6. ^ "What is Palliative Care? | Definition of Palliative Care | Get Palliative Care". Retrieved 12 May 2020.
  9. PodFelicity22

    PodFelicity22 Welcome New Poster

    Thanking everyone for their input.
    I am more than happy to provide the 'cut and come again' service, but I wanted to look at podiatry as a more holistic approach to palliative care (that being pod tx for patients in palliative care of existing medical condition). Not all pall care patients are old and immobile so I am looking at being part of a medical team that is able to improve a persons quality of life. Is this something where podiatrists can offer other therapies? (acupuncture for pain relief, massage??)
    This podiatry dept has a strong representation for diabetic foot wounds, amputation management, pressure care and preventative care, all of which has been hard work to not be known as just 'the pedicurist'.

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