Helfand Arthur E
Temple University, School of Podiatric Medicine, Department of Community Health, Aging and Health Policy, Philadelphia, Pennsylvania, USA.
Clin Podiatr Med Surg. 2003 Jul;20(3):407-29. doi: 10.1016/S0891-8422(03)00033-8.
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.
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.
1981年白宫老龄问题会议的最终报告指出:建议148:应以等同于人体其他部位护理的方式为老年人提供全面的足部护理,以使患者能够保持行走能力。
取消目前医疗保险中排除全面足部护理的规定。鉴于老年人足部问题的高发生率,尤其是那些患有慢性疾病和心理健康问题的患者,足部护理至关重要。如果老年人要保持较高的生活质量,让患者能够行走是一个需要实现的目标。足部健康、护理以及足部健康促进应成为美国老年人全面医疗保健的一部分。保持活跃和能够行走是确保老年人独立、尊严和自尊的一种方式。为实现这一目标,从业者必须进行全面思考,并认识到团队护理是老年患者慢性病管理的重要组成部分。足部健康教育,如宾夕法尼亚糖尿病学会制定的项目,可供患者和专业人员使用,应予以采用。患有慢性疾病的成年人和老年患者患足部相关疾病的风险很高,应能够获得持续的足部评估、教育、监测和护理。对于这一人群,预防并发症以及保持活动能力和行走能力将体现在他们的生活质量以及他们在社区中保持精神警觉和活跃的能力上。