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The Effect of Working Amongst Older Persons in Podiatry?

Discussion in 'Gerontology' started by C Bain, Oct 1, 2005.

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  1. C Bain

    C Bain Active Member


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    Hi All,

    How are we in general and the younger Podiatrists in particular affected by the continuous interaction with the elderly, and in Private Practise in the main the old and infirmed?

    Does it have an effect on younger Podiatrists or have they in their degree some form of training to deal with this, (Psychology/Sociology module perhaps?)! Has any academic approach been developed in the degree level training before practise?

    Are we still able to treat a Patient as a person or something boarding on a number through pressure of work I wonder?

    How say you?

    Regards,

    Colin.
     
  2. Craig Payne

    Craig Payne Moderator

    Articles:
    8
    Last edited by a moderator: Oct 2, 2005
  3. I think that's what growing up is all about. Some years ago when I was working in Dorset, I was asked to visit an elderly lady who was bed-bound, and who enjoyed a fearsome reputation amongst the medical and nursing fraternity for abusive behaviour. I had ample warnings from the general practitioners before my visit - and with good reason too.

    She was a desperately poor creature – existing, rather than living, in a council bed-sit, with her COPD, diabetes, rheumatoid arthritis and congestive heart failure - with no family or friends to visit or care, only the medical and social services to look after her daily needs. When I opened her front door the stench of urine was so strong it made my eyes water and my guts retch and the place was absolutely filthy. Getting old can be so much fun, huh?

    I had my work cut out. Because of her behaviour towards others who had visited, she had received no foot care for over two years and with her health deteriorating, she had multiple digital ulcerations from her toenails, which were over two inches long, broken and neglected.

    As soon as I walked in the door the verbal assault started - with language that one would normally associate from the terracing at an Old Firm derby as opposed to an old lady's home. Just what you want at 4.30pm on a Friday afternoon!

    In circumstances like these I try to focus on something the patient is familiar with - a book they are reading or a newspaper or some ornaments or photographs. Having worked in psycho-geriatric units for ten years, you quickly pick up the things that help keep the patient calm and malleable. There were some photographs on her mantle-piece; one of them, in sepia-tone,was of a beautiful young girl, who I took to be her granddaughter or great granddaughter even.

    Amidst the verbal barrage I took the photograph over to her and sat down beside her on the bed. If I am being honest now, I was hoping that this gorgeous apparition might appear during my visit, as often family members do from time to time. But alas that was not to be the case on this occasion. I asked her who it was in the photograph, and by now you'll know the answer.

    When she stopped crying she told me that she remembered the day the picture was taken - in 1939, just before the Second World War. There was broom in the background, and she said it smelt like burnt coconut in the late summer sun. And she remarked that the photographer had a nervous tic in his left eye, something she found terribly endearing, even to that day.

    The problem with getting old, she said, was that those memories and feelings were just the same as they were when she experienced them all those years ago. Often, when she was awakening from a dream, she would be right there, back in her childhood, smelling the gorse and hearing her mother scold her. But the first thing she saw when she opened her eyes was her twisted and painful fingers, and then the awful realisation came. Every day, relentlessly, she entered a living nightmare from which only oblivion offered any real escape or hope.

    I cannot begin to tell you how distraught and upset I was when I left. I realised who she was that afternoon, as soon as I had looked in her eyes. They were the same as they were in the photograph; it was just that everything else had changed, but there was something left inside which was the same as it was when she was twenty-three years of age. That is the problem with getting old. The bits on the outside do change, but inside, in our heads, we are just the same as we were when we were running around without a care in the world, when we were children.

    As you will gather by now, Colin, I am not religious in the slightest; although I can appreciate what it is that makes people believe that there is something else beyond our mortal lives. On occasions like those, life almost becomes unbearable, and it is easy to believe there is something else - some unseen force or deity - something that is going to reassure us that all is alright and everything makes perfect sense. But I don't think there is.

    Life to me is just one brief moment of glory, then nothing else. Just like there was nothing before we were born. But for those approaching the last few years, we should strive to make it as pleasant and endurable as we can - that is true humanism, as far as I am concerned. As to your question about teaching, you cannot really teach what this is about; you have to experience it for yourself - just like I did in Dorset all those years ago. Nothing else will do. What you learn from that experience, and from what you learn about yourself as a result, is what growing up and getting old is all about.

    Regards

    Mark
     
  4. Kim

    Kim Member

    You can't buy experience

    Mark,
    I don't think anyone could have put that quite as well as you did.
    As a final year student, and a mere 22 years old I feel that the constant interaction with the elderly in this profession is not what I envisaged when embarking upon podiatry.
    I quickly learnt that the elderly and infirm consititute the largest portion of our patient population. Unfortunately, after 4 years at uni I fear some of my colleagues are oblivious to this fact.
    Whilst working with the aged and infirm is not my ideal day I realise that they require a service which I can provide and some are forever greatful (the others well you know them, but it is the same if they are 2 or 82).
    I am grateful that as a 11 or 12 year old my mum worked in aged care, and before school I used to go and have breakfast with the 'oldies', it was then that I learnt how to commuincate with the older generation, when to ask them questions and when to just listen.
    Whilst at uni we are taught the medical basis of aging and the theories behind 'getting old', those mornings before school as a kid have far better equipped me with the skills to treat these people and the knowlegde of when to let go and leave work at work.The stories of some of the elderly really tug at those heart strings, if you took all of that weight home there wouldn't be much left for you or your family.
    I guess the point I'm trying to make, going back to the original question, the effect of working amongst older persons in podiatry is that you could become very burnt out very quickly if you didn't develop the neccesary coping skills. Maybe another reason many leave our profession early.
    I guess it's the same with all generations though a terminally ill child may walk through your doors you have to let that go too, a comforting fact is that many of these people have lived a great life, if you ask them they probably wouldn't change a thing, so when they have a multitude of ills I guess we just have to imagine them in the younger days and try and make them as comfortable as we can.

    Kim.
     
  5. Kim

    You raise some very important issues regarding the interaction between clinicians and the elderly; including the impact such activity has on our own outlook on life. There was a recent case here in England, where a care assistant was convicted of elderly abuse in a nursing home. Under cross-examination it was established the she harboured ill-feelings, not just to the residents under her care, but to the elderly in general, yet she could offer no explanation whatsoever why this was so. After the (guilty) verdict, her counsel mitigated that his client had a pathological fear of getting old – a fear that resulted in her targeting those who reminded her of her own fragile mortality on a daily basis.

    The psychology behind such behaviour is often neglected (or ignored) by educationalists when teaching gerontology – often, I suspect, because the subject is a difficult one for many folks to grasp and accept. There is little doubt that the elderly make up the majority of the patients we see, and when one is immersed daily in a clinical practice where we are faced with the harsh realities of life – the loss of our loved ones, debilitating illness and disease, loneliness and hardship – it can have a detrimental effect on our own outlook and well-being. How many times are we told, “don’t get old, whatever you do,” or “it’s no fun, this old age,”? We are in denial if we don’t think it has an impact on ourselves.

    Perhaps it has something to do with the way society in general has developed over the last generation, where youth, beauty and materialism take precedence over everything else. In western societies especially, the elderly are carted off to sheltered accommodation and residential homes as soon as they find it difficult to cope. ‘Out of site and out of mind,’ I suspect is the motive behind many of these cases. Compare this to the situation a few years ago, where elderly parents were taken back into the family home to be looked after and cared for, and where the younger generations could witness the natural order of life, and you begin to realise where the alienation of the elderly begins. Whatever philosophical claims we might make for ourselves, humankind is only marginal. We hardly count in the natural orders of zoology. The trouble being we are so full of our own selfish importance that we fail to see just how ordinary each and every one of us really is: we are all equal in the grand scheme of things, and to abuse or neglect anyone else is ultimately to the detriment of us all.

    One of the most profound writings on this subject comes from the pen of Jim Crace – a Birmingham author – whose book Being Dead should be required reading for everyone – but especially people whose vocation involves caring for those in their twilight years. It is the story of Joseph and Celice, a married couple, both zoologists, who return one day to the coastal dunes where, thirty years before, they had first made love. There they are attacked and beaten to death by a robber. From this starting point, the novel traces three trajectories: their married life, from their meeting as graduate students working at this beach; the course of their last day, traced backwards, or undone, until they are back in bed, asleep, that morning; and the first week of their death until they are found and taken away by the police. The changes that take place as their bodies decay are meticulously described. At the end of the novel, nine days after their death, the grass has recovered and there is no sign they were ever there.

    It is a difficult yet deeply moving and sobering book whose final words are, “These are the everending days of being dead.” Consider for a moment when these days really begin.

    What is obvious from your writing, is that you have a great understanding of life already – even at the tender age of twenty-two – and this will stand you in tremendous shape throughout your career. As Felicity pointed out on another stream, the ability to simply listen is one of the greatest tools you can ever have. Never disregard it.

    Best wishes
    Mark

    Amen to that.
     
    Last edited: Oct 2, 2005
  6. C Bain

    C Bain Active Member

    Hi Kim,

    I don't think you really need to much advice re life and death. You're moving quite happily I think for someone moving out into the real world after Uni.!

    Tunnel vision is what I used to be accused of in my other life, (Probably because I was a specialist and the powers that be wanted jack of all trades, I wonder what the NHS. wants come to think of it?), if you have no other interest than Podiatry it could easily lead to the burnt-out scenario. It is important to keep a wide vision of life whilst stepping into the environment of a lot of cases, (But must be dedicated to the vocation if that is what it still is?).

    House bound sick and elderly who value your conversation as much as your Podiatry, if not more! You have already got most of that from the old days of Age-concern. If you have trouble talking to people this is not the job for you. I have quite a few Patients who are with me because the other Shiropodist never said two words to them during his/her visit! Must remember to shut up though and always be listening, however!

    I spent a lot of my time in and about what now is Age-concern. In those days the Church of most shades of denom. were the prime moves running it. As a result Applied Religion was the call of the day! No Tunnel vision there, most helpers and even more of the oldies where committed Christians, not necessarily churchgoers, committed Christians of various iliac! The urgency brought on by age and dieing was to them a natural progression!

    Belief is the thing that keeps most of our older fraternity going, and although Nature and the NHS. may have a policy of keeping people alive well past their sell by date, better that way than the other extreme of the injection in the arm because some petty bureaucrat thinks it might be a good idea?

    To each his own, in the same way I believe I have read somewhere that the practising believer is less likely to have a heart attack than a none believer? Anybody, correct me if I'm wrong. (This is apart from some of those on this Arena of course, heart attack a new Thread perhaps?).

    Anyway Kim. Mark, your first Posts here is the right place to start from! I asked the question in the beginning to see where it would lead, I thought it was a dead duck from the beginning, (Oh yea of little faith!). I'm actually talking to Mark again, without taking the pet! Just shows you! Isn't life full of surprises?

    I expected something like the first reply from Craig re the Degree course. Academia is duty bound to go with the flow don't you think. Podiatry could be held to be one of those professions who need more mature types in it perhaps?

    A follow on question could be, WHAT IS MATURITY? (No not manure but mature, although I don't know though?).

    You sound like you've got it never mind your age. Funnily enough it's your working with the aged in your teens which gives you it, not the degree, but it will help!

    When I was trained for my other life the one thing that was paramount was to be able to disengage and still do the job! Podiatry does not even come over the horizon with regard to the degradation experienced in my other life! The case Mark cited is rare and few and far between or so I would hope. Just remember not to learn on the walls and be careful of the unwashed cup? Sitting on the carpet in some houses could be highly dangerous, too, as something unseen carries you out of the door before your time? But there we go again.

    One of the most important things that has come out of this Thread is the reminder by you that
    Quote: "Maybe another reason many leave our profession early." Coping Skills learnt or unlearnt perhaps, and not brought into Podiatry with them from outside intimated by you!


    Just maybe the University Schools Of Podiatry should be laying this and the fact that a large part of your working life will be with the elderly well and truly on the line in their first interviews? Not to sure that it is happening today? The Uni. needs customers today to survive, or does it, someone prove me wrong?

    Regards,

    Colin.

    PPS. All spelling mistakes and worse gratefully received? Tinkering will follow later!
     
    Last edited by a moderator: Oct 3, 2005
  7. admin

    admin Administrator Staff Member

    Any more comments on religon from this point forward will be deleted. A couple of messages have been removed from this thread and one has been slightly edited. Lets keep things on track.
     
    Last edited: Oct 3, 2005
  8. Some background articles on ageism and abuse of the elderly.

    http://www.manchesteronline.co.uk/n...ers_tears_over_abuse_of_elderly_patients.html

    http://news.bbc.co.uk/1/hi/uk/4051603.stm

    http://www.nottingham.ac.uk/public-...chive&code=THE-148/03&create_date=26-nov-2003

    http://www.elderabuse.org.uk/documents/general/References.htm

    and it's not just physical abuse. This from Hansard April 2004....

    Abuse of Elderly People

    3.10 p.m.


    Baroness Barker: My Lords, I beg leave to ask the Question standing in my name on the Order Paper. In doing so, I declare an interest as an employee of Age Concern England.

    The Question was as follows:


    To ask Her Majesty's Government what steps they propose to take to address the issue of abuse of older people.


    Baroness Andrews: My Lords, since 1997, the Government have done a great deal to address poor practice and to tackle the wilful abuse of elderly people. More initiatives are planned.
    The Health Select Committee's recent inquiry into elder abuse is greatly welcomed. It draws public attention to an issue of great importance and confirms the Government's long-standing approach. Over the next few weeks, Ministers will carefully study the 40 recommendations made by the Select Committee, before issuing a formal reply.


    Baroness Barker: My Lords, I thank the Minister for that reply. The Health Select Committee has accepted evidence from the National Care Standards Commission and from my honourable friend Mr Burstow that over-prescription of anti-psychotic and neuroleptic drugs is happening to vulnerable older people in care homes. Will the department, as a matter of urgency, issue regulations covering the administration of medication to vulnerable people, so that that abuse will stop? Will elder abuse feature in any future review of the National Service Framework for Older People?

    Baroness Andrews: My Lords, the Select Committee referred to the Government's good practice in trying to restrain over-medication, which is something that we cannot tolerate. We would like to see it reduced, especially as it tends to become part of the culture of management, rather than being used to meet medical needs.

    The current situation is that people who are on medication and are taking four or more medicines have their situation reviewed every six months, as opposed to the annual review for other people. Those provisions are monitored by the strategic health authorities. The NSF will come under review over the next six months, and it is likely that the issue of medication will be examined. However, the National Care Standards Commission and CHAI inspect the issue of medication robustly and in connection with national standards. We anticipate that next May the National Institute for Clinical Excellence will produce guidelines on dementia care, including the use of anti-psychotic drugs. We are keeping the situation very much under review.

    *************************
     
  9. C Bain

    C Bain Active Member

    The Effect of Working Amongst Old Persons in Podiatry?

    Hi All,

    I have read the information contained in the Websites above and knew about most of it anyway from elsewhere?

    No mention of Podiatry as far as I see here or from what I can remember reading elsewhere?

    Is the suggestion been made here that Podiatry and the Podiatrist is involved in this ABUSE?

    The question was, "The Effect of working Amongst Old Persons in Podiatry?" Kim and Craig got it, anyway! Should this Posting-reply No.8. Dated 3rd. October 2005 at 12.21am. be here?. Is it not addressing something else far more important than a Podaitrist threatening a nervous break down working amongst the elderly at the one extreme and throwing a sicky at the other, or departing into the wide blue yonder for what ever reason? A New Thread elsewhere perhaps?

    Are we to conclude by the above Post that Podiatry and Podiatrists are involved in the above mentioned abuse of the elderly? If so please produce the evidence so we may all share in this sad knowledge and state of events?

    Regards All,

    Colin. (Not ready to give up just yet perhaps!).
     
  10. javier

    javier Senior Member

    This subject was discused on the article:

    Anne Mandy and Paul Tinley
    Burnout and Occupational Stress: Comparison Between United Kingdom and Australian Podiatrists J Am Podiatr Med Assoc 2004 94: 282-291

    On this article it was stated that: "Although there are domains of specialization within podiatric medical practice, the scope of practice is
    essentially associated with the provision of care to elderly patients. It is generally accepted that elderly people carry low status" (page 287)

    I must agree with this, because from my experience the main problem among young podiatrists due to their practice is related to elderly footcare. Palliative care is usually related with routine and lack of long term improvement.

    Also, there is a lack of relation between pregratuated podiatrists expectations and their role after their graduation.
     
  11. C Bain

    C Bain Active Member

    Burnout and Occupational Stress!

    Hi Javier,

    Thank you for that piece of information. I wonder whether Admin. would be able to recover that article by Mandy and Tinley, perhaps?

    Hylton, sorry, forgetting you!

    Regards,

    Colin.

    PS. Javier, A lot of good points in there! I will not try to reproduce them, they stand alone for all to read!
     
  12. Craig Payne

    Craig Payne Moderator

    Articles:
    8
    Its a major important issue - as part of Gerontology course here with the podiatry students we devote >3 hours to the topic of elder abuse.
     
  13. C Bain

    C Bain Active Member

    Abuse of the Elderly!

    Hi Craig,

    Quote: "3 hours to the topic of elder abuse."

    I'm interested to know whether the 3 hours is involved in any known abuse directly connected to the Podiatrist or is it a background examination of society abusing the elderly as a whole?

    I find this as disgusting as child-abuse or child-murder! I would not put anything past the human-race but I must admit I haven't seen any evidence or considered the possibility until now re Podiatrists! Is there any readings referring to Podiatrists abusing the elderly?

    Apart from of course the murder of a patient/witness in the US., was she elderly I wonder?

    Regards,

    Colin,

    PS. When I put the question down Craig I was centring on the abuse caused to the Podiatrist quite possibly by the Podiatrist abusing himself rather than the Elderly? But if you or others want to widen that Field of Examination who am I to stop you!
     
    Last edited: Oct 4, 2005
  14. Hylton Menz

    Hylton Menz Guest

    Javier said:

    A couple of years back I looked at student perceptions of working with older people, and the results were better than expected. Even though few students wanted to specifically work with older people, their knowledge of ageing and their attitude towards older people was generally quite good compared to other professions:

    [​IMG]

    [​IMG]

    You can link to the abstract here.

    While I agree that some students graduate with an unrealistic expectation of what their job will involve, and that this may lead to the high levels of burnout that have been reported, I also think that the profession itself needs to raise the profile of geriatrics as a valid specialty area. We have a range of special-interest groups for sports medicine, pediatrics, diabetes and surgery, but none for geriatrics. Australian physiotherapists have an active geriatrics/gerontology interest group, so why not podiatry?

    Cheers,

    Hylton
     
  15. Craig Payne

    Craig Payne Moderator

    Articles:
    8
    I don't teach that part of the course now, but when I did, this is the handout I gave the students:
    At LTU, Gerontology is taught as part of the same subject with Paediatrics and Sports Medicine (Podiatric Specialisation). The learning outcomes for this subject are:
    (1) & (2) are very relevant to this thread. ie "Understand the disciplines of..." and "Be able to function competently in the multidisciplinary environments of..."
     
    Last edited: Oct 4, 2005
  16. Felicity Prentice

    Felicity Prentice Active Member

    This year we had a really vigorous, interesting and challenging gerontology course. Students were able to participate in a number of forums and seminars on a range of topics, including palliative care, death and dying, promoting independence, community resources, falls prevention...you name it. We also looked at the phenomenon of elder abuse. Often this is not malicious and intentional, but a failure to provide adequate and appropriate care. Either way, it is a very real and important part of our society which tends to favour the young and fit.

    As Health care professionals who have the time and training to listen, observe and assess, Podiatrists are in a privileged position to detect and address issues surrounding the care of older people.

    I believe our students really enjoyed the gerontology program. Which is pretty good for a bunch of immortal 20-somethings who can't even imagine that one day they too will be old.

    cheers

    Felicity

    PS Hylton did an outrageously good job at the Falls Prevention stuff for our students - they were lucky to have such an expert in their midst.
     
    Last edited: Oct 5, 2005
  17. C Bain

    C Bain Active Member

    A Big Thank you from one who does not really Matter HERE!

    Hi All who have contributed above,

    I for one am over the moon with the replies above, especially from Craig, Hylton and Javier for much needed contributions as far as I am concerned in this Thread!

    The main points that sprung straight to mind were,

    1. Raising awareness and going out of the way to learn to recognise the tell tale signs of abuse.

    2. The lack of corroboration when listening to the sometimes confused elderly person making in a lot of cases what amounts to criminal assault or worse against his kith-and-kin. Finding those around you who should have known better listening and shrugging it off as gaga?

    3. Sometimes the modus operandi can be lost in the confusion of say a domestic disorder, situation.


    A couple of examples,

    1. One of my Scientific Aids Officers was called to a house where a young baby had fallen down the stairs. There was something not quite right? The Woman child-minder in those days before child-minder regulations in the UK. existed had said that the one year old child had fallen down the stairs. The child had serious injuries and was in hospital. The conclusion from the second examination was that the injuries on the photographs from the hospital did not match with the stairs and the fall explanation of how it happened.

    A reasoned comment by me to my officer in ear shot of the childminder, "No these stairs could not possibly have caused these injuries!" The childminder broke down and confessed to having thrown the baby down the stairs, she could not cope with the baby crying.

    I would not expect A Podiatrist to be able to read the scene of a crime in this way but using ones eyes and listening to what is being said could be sufficient to share your suspicions with say the family doctor later perhaps!

    2. Called to a house to find a 80yr. old sitting in her chair in her bedroom of the family house with a thin plastic bag neatly placed over her head like the effect of the modern vacuum-machine today. Otherwise no sign of distress or displaced articles or furniture in the room???

    Did she commit suicide or was she murdered?

    1. It turned out that there was a suicide note found in the waste paper bin after an extensive search of the scene.

    2. Friends and family new that she was wanting to end it all!

    3. She had a terminal illness and was very weak and frail, (Once the bag was on there would be no time for her to remove it!).

    Of course, a relative could have set the scene up to get her large fortune in her will! Trouble was with that she had already given the house to her son and family and it was well known that before the terminal illness she had been a happy out going grandmother!

    Two very extreme cases, simpler ones of failing to feed the elderly relative or regular bruises not explained by steroids perhaps worthy of note.

    Not wishing to frighten the young Podiatrist off here I would point out that you must be very careful how you approach these things and who you hold conversations with,

    1. If you get it wrong it could cost you real money if whoever sues?

    2. Spreading to much information around wily nilly could get you in the UK into trouble with a breach of our ethical code?

    3. Abuse is I hope never going to come your way ref. the two examples above! But simple abuse as described in the course notes and papers above can happen under your very nose if you are not awake to it!

    Regards,

    Colin.

    PS. A last comment perhaps, in those days when I worked in Scientific Aids provided I had reasonable suspicion, if I was later proved wrong, I was still fireproof because I only needed that reasonable suspicion to perform the arrest, whether or not a crime had been committed, that was immaterial!!! You could end up in the Civil or Criminal Court if you were found to be wrong by making public allegations?

    PPS. I hope not to long winded re my personal experience of abuse and suspected abuse here!
     
  18. Erp

    Erp Member

    The positive effect of working with the elderly

    Dear Fellow Gerontologists,

    This discussion certainly took a sad turn after such positive beginnings.
    After completing a post grad in gerontology, I found working with the older clients to be the most rewarding part of my job. These people are alive with history and I have learnt more about living through wars, depression, the holocaust and what people did before TV than any books could tell me.
    In our course we learned about the concept of 'successful ageing' and many older members of society do just that. I once had a 100 yrs + client who was doing a woodwork course! He was brilliant and a huge inspiration of just what successful ageing means.

    Often media is to blame for portraying older age as negative, to be avoided. Well, I don't much like the alternative which is to die young!
    I would rather live to 100 than drive into a tree at 21. (This is my standard response to the 'don't get old' statement.)

    If nothing else, aged care is a huge growth industry and with the baby boomers on the way there will be a massive demand for health services to suit their needs - and many have the money to pay for it.
    It is simply poor business planning to ignore this market!

    Here's to the true survivors !

    Liz Perry.
     
  19. C Bain

    C Bain Active Member

    This discussion has taken a Sad turn?

    Hi Liz,

    I cannot agree with you more, 're sad turn'. I for one tried to keep off my last post because all I can see in my work with the older generation is satisfaction and the constant surprise at how resilient they are. Even when things are not going right with my patients I don't give up and walk away from them! Their problem is my bread and butter, my problem!!! I am not happy if I don't have the answer, until I do get the answer!

    I decided to specialise in the older person because in my section of the private sector that is where my practise is at! Being one of them, (No not them, them!). I have sometimes to be careful I don't appear to be a right know it all when I visit them!

    A couple of weeks ago I even was able to work on filling in a part of my Fathers family war time history, as well as a corn! That as a six year old my knowledge was not as complete as it might have been? Giving the Spitfires tail a kiss on the way out of one of my fathers places of work I remembered but the rest I was not allowed to know!

    Today it is a sign of the times again I'm afraid. Trust no one, be prepared to shop anyone, and to be oh so 'Politically Correct' that you start to look for the new Gestapo/SS. around every corner?

    Health and safety of today would have strangled the British Industrial Revolution at birth if it had existed then! Now that I've got that off my chest back to PODIATRY.

    Practise away from the 'cut and come' allows me to work like our forefathers worked with the added bonus of updated knowledge and equipment! Then we get back to where it's all at, Our Elderly Patient. Not someone to look down upon but to look up to because we owe them allot!!! This is something that should be our watch word as Podiatrists. The Elderly Patient is not a bl**dy nuisance he /she is the latest daily challenge! And if I don't stop now I will be getting my hand slapped by one of the daily challenges!

    We have aired what can go wrong in Gerontology, (If the Computer can spell it, I never can?)! Now let us get back to something positive. After all when I threw a brick at that Germany 1000lb'er parked under the railway bridge at the bottom of my street the Lord must have spared me for something useful? I missed!

    Regards,

    Colin.

    PS. I'm not old really, state of denial only?
     
  20. Craig Payne

    Craig Payne Moderator

    Articles:
    8
    I was just going throuh some stuff on the computer and came across these notes .... they are a small part of what the students were given as part of the gerontology (in addition to what I posted above on elder abuse):

     
  21. C Bain

    C Bain Active Member

    A Mark of Appreciation!

    Hi All,

    I don't know about you but I personally do appreciate the useful information and background contributed here in this Thread by all and particularly Craig with that last one above!!!

    The day I can stand up and not learn something from somebody else on any subject will be a sad day for my Patients and I?

    There are two threads flowing together in this Thread. As usual I have no difficulty in swapping backwards and forwards between them, (I hope you can too!),

    1. THE POSITIVE! All the blessings and pleasure from meeting and giving treatment to the elderly. Dare I say it, utter the forbidden word 'Healing' no matter how transient it may be as their feet recede into the distance as eyes sometimes grow dim. Or even if they can see their feet they cannot reach them anymore?

    2. THE NEGATIVE! The Second Thread here of ABUSE? I would rather it didn't exist, but it does and we as Podiatrists, with I hope some common sense must always be aware of it?

    3. There should always be a Third Way! For a human being to be effective and useful he/she must be able to stand up and be counted,

    1). Have a depth of understanding!

    2). Hold to ethical, religious, common sense knowledge and belief's! Be a whole person no matter whether they are right or wrong!

    3). Have an open mind. For if you don't the Old-one will see through you in the 'twinkling of an eye' and that respect you need to do your job properly will be straight down the plughole or should that be out of the window!

    Do you care about your Patients? Can you care personally for your Patients whilst working for a monolith of an employer? Is there any reason why you cannot care for your patient? High loss of new Podiatrists perhaps? Were not confronted with the caring element early enough in their training perhaps?

    Regards,

    Colin.

    PS. Anyway Craig and the rest of you have contributed here, I hope there maybe more to come!!!
     
  22. C Bain

    C Bain Active Member

    The Third Element?

    Hi All,

    Could this be a Third Element in observation and treatment of the Elderly?

    """MALNUTRITION."""

    In this Thread we have considered two Elements of Ageing!

    A Third Element has just been pointed out to the general public in the BBC. Health News Website that of Malnutrition,

    Quote:- Malnutrition 'time bomb' warning Europe's ageing population means many more will die of malnutrition unless action is taken, warns a charity.

    The heading, Doctors 'Often miss malnutrition.'

    http://news.bbc.co.uk/health [8 & 9 .10 .05].

    Question:- If you as a Podiatrist were to come across malnutrition, what is the set procedure for a Podiatrist? Is there one other than common sense tell someone, and who?

    Regards,

    Colin.

    PS. The definition in the article is,

    "A state of nutrition in which a deficiency, excess or imbalance of energy, protein, and other nutrients causes measurable adverse effects on tissue, function and clinical outcome."

    PPS. At the beginning of the article we have the Effects of Malnutrition listed,

    1. Impaired immune responses,

    2. Reduced muscle strength and fatigue,

    3. Increased difficulties in breathing,

    4. Impaired thermoregulation,

    5. Impaired WOUND HEALING,

    6. Apathy, depression and self-neglect,

    7. Poor libido,

    If nothing else No.5 on Wound Healing gets my attention here, anyway!
     
  23. C Bain

    C Bain Active Member

  24. Han

    Han Welcome New Poster

    My Views

    Hi Everyone,

    I thought I would post some of my views being a new grad (first year out).

    Freshly out of highschool, I went straight into studying architecture. Realising a little while down the track, this wasnt for me, I decided to do a little soul searching and ended up studying podiatry. I grew up around a family that is somehow all involved in the allied health field and so I suppose in a way I was destined to be in this area one way or another.

    I work two part time salary jobs as a podiatrist, servicing only pension aged or older clients. I work in various environments, senior citizens centres, hostels, nursing homes, providing services for independent living pensioners etc. I travel to many of these places some two hours away.

    It is only ten months of working full time and I am exhausted. I have even contemplated going back to study another profession. I dont know whether it is because my work is not varied, whether of the high turnout loads I do, whether it is primarily working alone or whether podiatry is just not for me. I know this sounds ridiculous as I am a new grad but.. :confused:

    Working with the elderly is extremely challenging and I admire anyone who works in this field. I find most clients are forever thanking you for your assistance, but i suppose like any age group, you will get the odd client who is never appreciative of what you do for them. However, at university, i feel certain areas should have been covered (which were not) ie. how to communicate with dementia patients, how to cope with the death of a patient etc. This year has been a very steep learning curve for me.

    My peers, who for the majority work in private practice, keep telling me I will feel differently about podiatry if i didnt work fulltime in this field, but for the time being, i am going to stick it out at least til the end of the year.

    Another factor which may be contributing to this exhaustion is the fact i did not have a break between university and working. I was very keen to get out of my part time fast food job that supported me for the years that i was studying! :)

    In regards to working in geriatrics, I do feel i have heavy expectations on me by clients in general. I am expected by some, even though they know very well i am on salary to visit them at home for treatment outside hours, I am repeatedly told 'my generation' owes it to them. But, like i said before this is in the minority.

    Have to go, but any thoughts or comments would be appreciated!

    Cheers for now

    Han :eek:
     
  25. CAS

    CAS Member

    For anyone that's interested,tomorrow (Monday) night the first in a new series of documentary programmes on Channel 4 television, examining society's attitude to the treatment of the elderly. The Trouble With Old People

    First is Tony Robinson:Me And My Mum (actor of Baldrick/Black Adder).

    I only popped by to check the archives for info on face masks and somehow clicked onto this subject - some of it very moving...
     
  26. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Elder abuse

    The BBC are reporting:
    Elderly abuse 'becoming common'
     
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