house shoes

[Scott Cawley]

Hi all, currently we offer our patients who require footwear two pairs of shoes to start with and another pair every two years. Are we being unrealistic, do our patient wear the footwear constantly or take them off when in the house. Should we be looking at providing some kind of house shoe? what do others provide, regards Scott

[John McCall]

Hi Scott,

We do much the same and most are fine with that. There are one or two who will wear out theirs more quickly because of their weight or gait pattern or simply because they're on their feet more, but we make exceptions for them.
We ask the patient to wear the shoes all of the time they are weightbearing. Some of them will keep one pair just for in the house.
Slippers? - No! No! NO! - but some of our patients do their own thing anyway.

[Douglas]

Hi Scott,

We provide 2 pairs of FW at a time and these are to be worn all the time. We replace them as and when needed - so if someone is heavy on FW and distorts the uppers etc then the FW is replaced. We also provide a repair service but do urge patients without sole adaptions that they can have this done at the cobblers. I have made some house shoes for people who very rarely go out and dont want to wear heavier FW, but its not something I want to promote too widely or there would be problems with allowances and having adequate FW to wear indoors and out. Also the use of Pulman shoes or Thamert shoes can be and effective way of keeping patients away from slippers - as John said some people will go and do their own thing, all we can do is give them the facts and suitable advice.

Doug

[Scott Cawley]

Hi John and Douglas,
I fully agree with both your comments and feel most patients will do their own thing as well. What happens if one pair goes back for repair that could not be dealt with by the cobblers? would they stay in this one pair at home as well then. The costs is the problem here as Douglas points out but how many of the ulcers are started when not wearing their prescribed footwear and is this likely to be when at home. Has anyone audited the usage of prescribed footwear, might give interesting results. The house shoes I meant were not slippers, I agree with your comments john but supplied light weight as Douglas indicated. Do either of your services provide information leaflets on use of their prescribed footwear? regards Scott 

[John McCall]

Hi,
Yes we use Pullmans too -forgot to mention that! - good for about the house and deep enough to put in a TCI. Not very expensive.
We've got a small leaflet 'Hospital Shoes' that we hand out after giving the verbal. There's a copy below which can be printed out but our health promotion team have turned it into a postcard size that looks better and is worded slightly differently. If I can get an 'e' copy I'll post it too.

[Douglas]

Hi Both,

I understand the point you make Scott about if one pair of shoes are in for repair then the patient will have to wear the other pair only indoors and out. I've read an article that states diabetic patients need towe ar their prescription footwear for at least 9.5 hours a day - I'll try and find this document.

The ideal option for high risk diabetic patients would be to provide 2 pairs of servicable footwear and a pair of house shoes. I've done some bespoke ones for pts who have particuarly difficult feet but don't often go out, but as i mentioned before it could end up with our department significantly increasing our spend to provide all diabetic pts with an extra pair of footwear.

I've also made up some leaflets which I'll put on here. They aren't in circulation yet but we are hoping this will occur relatively soon. They have something similar on Scotland already in practice.


Doug