FACTS & QUESTIONS

Are you having difficulty taking care of your feet? You will benefit from foot care if:

• You have limited ability to reach your feet
• You have vision problems that make it difficult for you to see your feet well enough to perform your own foot care
• You have limited strength or agility in your hands
• You have thickened nails that are difficult to trim
• You have toe nail fungus
• You rely on others to trim your nails who are often unavailable
• You are diabetic and therefore at a higher risk of developing foot problems due to decreased sensation to your feet
• You have poor circulation to your feet

 

What can a client expect on a first visit and subsequent visits?

Health History

Your Foot Care Nurse will complete a health history. This incorporates, your chief concerns and expectations of foot care, which includes relevant current, past, social & family history. This assists the nurse to identify risk factors that may be relevant to the outcome of the treatment. Knowledge of previous foot care treatments and/or experience information assists with what has worked or not worked in the past. Current list of prescriptions.

 

Physical Assessment

Your Foot Care Nurse will undertake a physical examination that will include: condition of skin and nails, range of motion, bony prominences, circulation, and sensation. The nurse will want to assess your shoes.

 

Documentation and Privacy

Your Foot Care Nurse is required to keep your client file confidential, current, complete and secure. Your personal information may be shared with other health team members (e.g. physician). A client has the right to view that which is documented about them and withhold or withdraw consent to the sharing of his/her personal health information at any time.

 

Sterilization, Infection Prevention and Control

Your Foot Care Nurse must adhere to strict safety rules pertaining to their equipment use. Tools must be sterilized and pouched prior to use for each client. Hands must be washed before and after any treatment even when gloves are used. All non-reusable items must be discarded after each client. Personal protective equipment must be used to protect the client and the nurse. All Foot care equipment and treatment areas must be disinfected between each client to reduce cross-contamination. It is highly recommended that the nurse review and record her/his reprocessing policies and procedures on an on-going basis to comply with disinfection and sterilization processes.

 

How do I prepare for a home visit from a foot care nurse?

Choose a comfortable chair that you would like to sit in for the duration of the treatment.  A recliner works best as does a chair with a footstool.  If neither is available, the certified foot care nurse can improvise, creating a suitable area to place the feet.  One or two fresh towels are useful also.  There is no need to soak your feet  before or during the visit.

 

How long is a visit?

The first visit is usually a little bit longer since an initial assessment has to be obtained.  Typically, the first visit is about an hour, depending on the foot care needed.  Subesequent visits are shorter.

 

Will you teach me how to care for my feet between visits?

An important part  of quality professional nursing care  includes thorough health teaching.  A properly trained, certified foot care nurse should be able to provide appropriate guidelines for self-care of nails and skin between visits.  The RN will also be able to determine if further medical treatment is needed and advise seeing your doctor.

 

Can I claim this?

Medicare and Health insurances do not cover the cost of this service. This service is an out of pocket cost.

 

Can I have a one-time only appointment?

Certainly.

 

How much does nursing foot care cost?

Prices vary depending on how far the nurse needs to travel and on how much work needs to be done. (Feet which have been neglected for a long time often need a lot of work to get "tuned up".)  The cost is for the initial visit is usually $40 and $30 on subsequent visits.

 

Do you cut fingernails too?

Yes

 

How long is a visit?

The first visit is usually a little bit longer since an initial assessment has to be obtained.  Typically, the first visit is about an hour, depending on the foot care needed.  Subsequent visits are shorter.

 

How often should I have foot care?

Most clients require foot care about every six weeks although how quickly toenails grow is very individual and some clients may only need foot care every two months.  Individuals with calluses and corns usually require foot care every four to six weeks as calluses and corns have a tendency to return.

 

Who gets nail fungus infections?

Nail fungus infections are more common in men than women and in the elderly than the young. Additional traits or factors that raise one's risk of nail fungal infection include the following:

• Diminished blood circulation
• Slow growing nails
• A family history of fungal infection (genetics)
• Heavy perspiration
• Humid or moist work environment
• Wearing socks and shoes that prevent ventilation
• Walking barefoot in damp public places (swimming pools, gyms and shower rooms)
• Previous injury or infection to the skin or nail
• Diabetes, AIDS, circulation problems, a weakened immune system
• Tight footwear with crowding of toes
• Exercise that causes repeated minor trauma to the hyponychium
• (where the finger tip attaches to the nail)

 

What causes nail fungus infections?

Nail fungal infections are caused by microscopic organisms called fungi that do not require sunlight to survive. Most commonly, a group of fungi called dermatophytes (such as Candida) is responsible for nail fungal infections. However, some yeasts and molds also cause these infections.

 

Pathogens that cause nail fungus infection usually enter the skin through tiny cuts or small separations between the nail and nail bed. The fungi grow when the nail provides a suitably warm and moist environment.

 

What nail fungus treatments are there?

Treating nail fungus infections can be a long and expensive process. There are oral antifungal medications, topical ointments, and alternative therapies. Over-the-counter creams and ointments are available, but they have not proved very effective.

 

Oral medications for nail fungus infection include Itraconazole (Sporanox), Fluconazole (Diflucan), and Terbinafine (Lamisil), which typically take up to four months before fully replacing the infected nail with uninfected nail.

 

Topical nail fungus treatments include antifungal lacquer or nail polish such as ciclopirox (Penlac) in addition to other creams. Use of topical remedies can clear nail fungal infections, but often does not completely cure the infection.

 

Alternative medicines used to treat nail fungal infections include Australian tea tree oil and grapefruit seed extract. However, there is no scientific evidence supporting the use of these products.

 

Laser treatments for toenail fungus are also available, however their effectiveness is highly controversial.

 

The foot care nurse treats fungal toenails by filing the thickness of the nail and by removing as much of the fungal nail as possible. By reducing the thickness of the nail the nail becomes more porous and will breathe better thereby providing an unfavourable environment for fungus.  (Fungi do not like air).   After thorough debridement the nails will often grow back much cleaner depending on how advanced the fungal infection is.