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Biomedical subjects

Arthur E Helfand

Publications and source records attributed to Arthur E Helfand.

9 recordsLinked to original sources
PubMed2003

Foot pain in later life: some psychosocial correlates.

What we have just described is a collection of problems that mark our aged of today and clearly indicate that primary foot care should be provided as a primary health service for the elderly, the mentally ill, the emotionally ill, the retarded, the blind, and others with chronic diseases. For if any of the primary problems were present on any other part of the body, except the foot, they would be provided as a covered service under the current Medicare regulations. One might ask if the foot is not a part of the anatomy and if perhaps we have forgotten the words of the classic song, which proclaims that the foot bone is connected to the head bone. The author might add a "footnote" ... in so many ways. To achieve the desired outcome of having podiatric services available to all aging patients, foot care must be integrated into all comprehensive forms of health care delivery, so that podiatric care becomes a primary service, thus permitting patients to maintain an optimal level of foot health and general health. The ability to walk requires a catalyst--foot health. Keeping patients walking is a goal that has been a part of the podiatric profession since its inception over a century ago. With the high prevalence of foot problems in the elderly, and especially in those with chronic disease and mental impairment, the needs for the future are significant. It has been projected that we as a nation and society cannot afford to deliver a maximum level of health care for the elderly. In truth, we cannot afford not to provide these basic and needed services. For it is our society that has prolonged life. It is now our responsibility to provide life for these precious given years and to assure dignity for those who have made life better for all of us.

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PubMed2003

Podiatric assessment of the geriatric patient.

UNLABELLED: The final report of the 1981 White House Conference on Aging stated the following: Recommendation number 148: Comprehensive foot care be provided for the elderly in a manner equal to care provided for other parts of the human body, to permit patients to remain ambulatory. IMPLEMENTATION: Remove current Medicare exclusions which preclude comprehensive foot care. Given the high prevalence of foot problems in the elderly, especially in those patients who have chronic diseases and mental health problems, foot care is essential. Keeping patients walking is a goal that needs to be met if older persons are to maintain a high degree of quality in their lives. Foot health, care, and foot health promotion should be a part of comprehensive health care for older Americans. The ability to remain active and ambulatory is one means of assuring independence, dignity, and self-esteem for the elderly. To accomplish this aim, practitioners must think comprehensively and recognize that team care is an essential part of chronic disease management in the older patient. Foot health education, such as programs developed by the Pennsylvania Diabetes Academy of Pennsylvania, is available to patients and professionals and should be employed. Adults with chronic disease and older patients are at high risk for foot-related disease and should have access to continuing foot assessment, education, surveillance, and care. For this population, the ability to prevent complications and maintain mobility and ambulation will be reflected in their quality of life and their ability to remain mentally alert and active in their communities.

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PubMed2003

Assessing onychial disorders in the older patient.

Disorders and diseases of the toenails (onychial) in the older patient are often the focus of the primary foot complaints. They may be a result of the aging process, the end result of repetitive microtrauma or historical major trauma, a complication or related clinical change associated with a multiple system disease or condition, or a localized foot problem. This article details the symptoms of and problems associated with onychial disorders in the elderly.

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PubMed2003

Assessing hyperkeratotic lesions in the older patient.

Hyperkeratotic lesions in the older patient create pain and deformity, limit ambulation, and may predispose the patient to ulceration. These lesions have multiple etiologies, particularly in the older patient, including the normal physiological changes of aging, disease, deformity, changes in balance, shoe last incompatibilities, and inappropriate footwear. This article outlines the signs, symptoms, and management of hyperkeratonic lesions.

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PubMed2003

Assessing and preventing foot problems in older patients who have diabetes mellitus.

The first component of prevention is patient education. The patient and those who provide care for the older diabetic must be fully informed of their problems, but understand the management process and be willing to make the lifestyle changes necessary to prevent complications. Evaluating patients to determine those diabetics who are at risk for foot problems, complication, ulceration, or potential amputation is the second component of prevention. This process must include continuing surveillance and management. Recognizing symptoms and signs of various systems with primary evaluative procedures permits the early identification of complications and secondary prevention of chronic disease. Because Medicare now provides footwear and orthotic coverage for at-risk diabetics as an adjunct to management, early screening, assessment, and detection are essential. The provision of significant patient education can then be added to complement professional education. We have attempted to provide a process for proper referral for care and management that can be employed by all health care providers involved in the evaluation of the patient who has diabetes.

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PubMed2003

Geriatric primary podiatric medicine.

The management of foot care for older patients, or podogeriatric care, is often provided as part of a team or interdisciplinary approach. The individual's podiatric and medical history, present problems, the effects of past illnesses and conditions, and the individual's (or their family's) ability to participate in the development of care plans should be taken into consideration. This article discusses various podogeriatric foot care issues and their effective management.

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PubMed2003

Basic considerations for geriatric footwear.

Proper and appropriate shoes that fit well can help keep elderly patients walking. Footwear is needed for protection and should permit the patient to function as normally as possible. The shoe must function as a unit with the patient and be compatible with and supportive to the patient's functional requirements and ambulatory needs. Though selecting shoes for older patients should always place comfort and function above style, patients also need to function in society, making intelligent compromise a consideration for the patient's overall welfare.

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PubMedDate not supplied

Foot problems in older patients: a focused podogeriatric assessment study in ambulatory care.

This study sought to demonstrate the prevalence of foot conditions in older individuals and their association with chronic risk diseases such as diabetes mellitus, peripheral arterial disease, and arthritis, and to develop care plans to reduce complications from local foot problems and chronic diseases. One thousand individuals older than 65 years who were ambulatory and not institutionalized underwent a standardized and validated podogeriatric examination assessment protocol or index. Overall, 74.6% of all patients had a history of pain, 57.2% were receiving current care for diabetes mellitus, 22.9% indicated current care for peripheral vascular disease, 94.2% had onychodystrophy, 64.2% had one or more foot deformities, 64.0% demonstrated some loss of protective sensation, and 81.7% had one or more symptoms and signs of peripheral arterial insufficiency. These findings demonstrate that foot problems in the older population result from disease, disability, and deformity related to multiple chronic diseases as well as changes associated with repetitive use and trauma. Older people are at a high risk of developing foot-related disease and should receive continuing foot assessment, education, surveillance, and care.

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