Tell us a bit about yourself
I have been practising podiatry predominantly in the aged care sector since 2013. I started my podiatry in aged care journey in Melbourne where I was involved with organisations such as HammondCare, CraigCare, Estia Health, JewishCare, Baptist Care, Aurrum, Australian Unity, Arcare and Regis Aged Care. I also work in private practice and currently work within Canberra and regional NSW.
How were the early days for you, working in the aged care sector?
In my early days, there was limited training and exposure at university for students to work with the elderly population – particularly patients diagnosed with dementia in aged care. This meant I had to learn hard and fast once I joined the workforce.
Qualifications and clinical skills aside, I quickly realised that – when it came to patient-centred care and providing high quality services with integrity for our elderly citizens – there was more to learn and apply beyond podiatry.
We’ve progressed significantly since then, given the necessary and improved policy changes in the aged care industry over time.
I’m coming into my third year on the PAC SIG Committee. It has been an enriching and gratifying experience that has allowed me to contribute to the podiatry profession on a broader scale.
Our goal is to contribute for the benefit of the collective by supporting and promoting the podiatry profession in aged care, with considerations to governance and policy changes that subsequently impact the profession.
What does the PAC SIG group do?
We meet monthly after work hours (as we are a dedicated and unwavering bunch!) to discuss all things podiatry related in the aged care sector.
Though by no means exhaustive, our activities include strategic planning, sharing research findings, best practices and any industry updates that affect podiatry; both positively and negatively.
We also collaborate with other stakeholders such as DVA, Dementia Australia and Arthritis Australia to consult on the development of projects in allied health, digital health and Medicare.
Professional networking includes being invited to represent APodA at events such as the National Rural and Remote Health Awards – previously held at Parliament House and the National Press Club, and dining alongside the Governor-General of the Commonwealth of Australia.
A lot of your experience has been spent working with patients who have dementia. What advice do you have for fellow podiatrists in this regard?
I would love to share the following advice or reminders with fellow podiatrists.
- There are different types of dementia. An individual can be diagnosed with more than one type of dementia. Dementia Australia has identified 11 types of dementia: Alzheimer’s Disease, Vascular Dementia, Lewy Body Dementias, Frontotemporal Dementia, Alcohol related brain injury, HIV-associated Dementia, Chronic traumatic encephalopathy dementia; Posterior cortical atrophy (PCA); Down’s Syndrome and Alzheimer’s disease, Younger onset dementia and Childhood dementia.
- Each encounter with a patient who has dementia requires you to understand their physical and mental world. Dementia is a progressive disease that causes a decline in brain function, and this is a world that your patient is likely to find a challenge to navigate. To create a supportive clinical environment, try to find a calm, safe and quiet space with minimum distractions.
- One can’t take things personally when working with patients with dementia. Due to their declining cognitive and neurodegenerative condition, and possibly their physical well-being, it is important to be mindful that during the clinical process, the patient may do any of the following. They may utter uncontrollable and inappropriate comments; be confused and repetitive with their questions and statements; take more time than other patients to move, react and respond due to other chronic and mobility issues. Patience is virtue!
- The patient’s next-of-kin or carer is usually resourceful in providing assistance. If your patient with dementia finds it difficult to communicate or cooperate, their next-of-kin can step in to provide this assistance. There are plenty of useful resources available on how to engage the next-of-kin when working with patients who have dementia.
How can podiatrists become more involved?
There are plenty of ways, including the following:
- Reach out and connect with relevant organisations and peers. A first step should be the peak body, Dementia Australia, where you can find a vast amount of useful information and resources. Then contact other healthcare professions and fellow podiatrists in your local area and state who work with people who have dementia. You’d be surprised by the support available, and the diversity of thought; helping to expand your knowledge and networks.
- Consider joining the PAC-SIG committee for your professional development. The APodA is invariably ready to assist in connecting podiatrists with useful contacts and resources in the industry. Shout out to Steven Brown who is the ‘Walking Encyclopedia’ in the Advocacy team at APodA.
- Talk to the patients and their family members directly. Take the opportunity to learn more on how to assist them and their podiatry needs. They will also have practical advice on how to do things efficiently for the patient, given each patient will of course have different factors at work.
- Engage in self-reflection. I like to practice self-reflection; to evaluate and debrief with colleagues after a day’s work. As part of this process, I consider and identify things that can be done better and differently next time, with the goal to innovate methods and service delivery in an ethical manner. I bring these insights to the PAC-SIG meetings for shared development of professional practice.
What are three steps podiatrists can immediately take to support a patient with dementia?
The ones that come to mind are:
- Sometimes no assessment is the best course of action. What I mean by this is that the patient’s mood and behaviour changes can immediately affect the clinical process. Sometimes no podiatry assessment and treatment should take place on that particular day – simply because they are unsettled and it is safer for both patient and clinician. It is important to not only have patience but also strategies to communicate with the patient, their family members, carers, coordinators and facility staff when this happens; the purpose of this communication being to explain that this course of action on that particular day is in fact more effective in the longer term for treatment outcomes.
- Verbal and non-verbal communication are fundamental. This is not only helpful to both patient and clinician in a practical sense, but it also increases engagement and cooperation. This includes choice of words, positive body language and being at eye-level with the patient so they feel more comfortable. Maintaining eye contact and offering reassuring gestures with a smile goes a long way and builds rapport faster.
- Allow time for the patient to process questions and information. Ask one question at a time, speak slowly and clearly – with simple words to avoid confusion. Be mindful that a lot of our elderly patients are also hard of hearing and use hearing aids, which they often forget to wear! It is important to ensure patients are wearing their hearing aids. Also, seek next-of-kin, family or carer’s assistance to help with overall communication and hearing – as the patients themselves may not reach out for this help when they need it.
- Look into the patient’s overall wellbeing. Check with the patient, or their family member and carer to see if they have had their daily meals, emptied their bowels, and slept well the previous night. These variables are all good indications of how their moods will be affected, which will subsequently have an impact on the podiatry session.
Can you suggest any useful resources?
There are a considerable number of online resources, including:
How can podiatrists contact you?
If you have any questions, feel free to contact me and reach out on laura@podiatryx.com
