Working with the homeless

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Hi there

I am due to qualify (hopefully!) in July and want to work with the homeless as a volunteer in Bath for one day a month. My question is, has anybody got experience in this field and if so, do you have any advice as to what the main issues are? For example, bearing in mind the homeless spend a lot of time walking- should I be careful about debriding callus that maybe protective?

Any advice would be really welcome

thanks

Jenny Clarke

 

Hi Jenny

I have done some volunteering for Crisis at Christmas up in London. The foot conditions I treated were fairly routine, with only a few serious cases of neglected feet. By and large, any of the clients with diabetes etc have access to drop in centres and GPs and get regular foot care. The common conditions were thickened/overgrown nails, callus, corns and sometimes athletes foot. Footwear is always worthy of a look as shoes that get worn out or are too small can be responsible for a lot of their problems. By and large I was surprised that the majority of feet I saw were problem free.
However I would tend to treat conservatively especially as their access to hygiene/clean clothes/bathing, can be very limited. Advice and education is just as important as the treatment for a lot of them. If posible, go armed with clean/new socks which are always welcome, and of course any good condition shoes that are available.

I know you will enjoy the experience, you will meet a lot of interesting people and it will give you good experience in working outside the usual clinic environment.

Best of luck with your finals an I really hope you enjoy your future career in Podiatry as much as I do.

best regards

Cornmerchant

 

Hi Jenny

Admirable ambition and all the very best for the future. I write a podiatry column for Pavement magazine for the London homeless http://www.thepavement.org.uk/ and have done since it started. According to the editor it is a popular feature with the readers who show remarkable interest in the care of their feet.

Have a swizz at the latest edition http://www.thepavement.org.uk/pdfs/pavement29.pdf

If you read through the back issues you will see what homeless people have to cope with and the support mechanisms which are available to them.

Another very interesting project comes from Dr Footsie in California. Martin is a retired podiatrist who works with street kids on anti gang, smoking and drug promotions. He using cartoon characters and street theatre. He is a real hero.

http://www.drfootsie.org/ and
http://www.drfootsie.org/footsie/see_and_hear/photos/events/road_trip_2007.php

toeslayer

 

Hey Jenny,

I used to work with homeless and insecure housing people in St Kilda (Victoria), and agree about the going armed with socks, though also a number 10 blade for callus and plenty of alcohol wipes and foot files.

Try to make a deal with you local $2 shop for bulk purchases of loose top socks (I got the nice Chinese shop keepers in Carlisle St down to $1.30 a pair ) so if you give some diabetes ed you can at least show and give someone what they need.

Maybe also suss out the surrounding local shoe shops or op shops to see what shoes they have.

Maybe even find an old foot spa that may help break the ice for people that maybe a little hesitant to discuss feet, it may seem ok for pods but weird for the general population.

All the best,


Brendan.

 

Hi Jenny
The main conditions I encountered whilst working in this field were:
Severely neglected feet ie hypertrophic, long nails
Hyperkeratosis like I'd never seen before
A couple of cases of trench foot (honestly) - worth considering KMnO4 footbaths.

A really interesting group of patients - a lot of them seemed genuinely embarrased about their feet and general situation. This unfortunately led to a high DNA rate.

Good luck,
Russ.