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44
Chiropody in relation to old age
Mr. R.J. King, M.H.Ch,S.„ Chief Chiropodist, reports as follows
The Walthamstow Chiropody Clinic has been serving the Borough
since September, 1931. It was the first Municipal Clinic in Essex
and the second in the Country. Municipal Chiropody started in
Bermondsey in 1930, having been introduced by the late Mr. A.J.R.Bride
B.Sc.F.C. Ch.S., who was at that time the Head of the Chelsea School of
Chiropody. Mr. Bride was also consulted by the Walthamstow Health
Committee when the Chiropody service was started in this Borough. Prom
its inception the Chiropody service in Walthamstow has provided
treatment for all age groups and until 1948 all persons of pensionable
age were treated free, without an assessment of means.
Later, domiciliary treatment was provided by the Old People" s
Welfare Committee of the Borough Council and the work undertaken by a
private Chiropodist. Two years ago the County Council assumed respon
sibility for the Domiciliary Service, which, together with the Clinic
Service, is administered by the Walthamstow Health Area Sub Committee.
In Walthamstow we now provide five domiciliary sessions per week and
during 1961, 707 treatments were given to patients in their own homes.
The population over 65 years of age forms a large proportion of
our patients, (of a total of 22,784 treatments given during the year
6,992 were for patients in this age group) and in this field professional
attention of a specialised nature is called for.
Elderly patients are often troubled with poor circulation and a
condition which causes loss of sensation, (Peripheral Neuropathies)
thus minor abrasions in treatment, or from trauma, can very quickly
lead to ulceration. The degeneration of elastic and muscular tissue,
coupled with the disappearance of subcutaneous fat, and atrophy of
the fibro fatty pads, plus the fine tissue paper skin, calls for very
careful handling and often lengthy treatment time because the ary
fine skin is usually coupled with very hard corny conditions and
deformed nails. These conditions are worsened by the inability of
the patients to reach their feet, and quite often shoes are discarded
because of pain, which restricts normal social and domestic activity.
Deterioration can be rapid resulting in the patients becoming bed
ridden. With chiropody attention however these patients can in
many cases be kept ambulant, thus saving hospital beds, or daily
visits by the home nurse.
Elderly people who live on their own often bring their problems
to the chiropodist, simply because they have no one to talk to at
home and the chiropodist, because of his knowledge of the Health
Services generally, is in a position to put them in touch with the
appropriate officials. As well as hearing about the problems of our
elderly patients, we also hear of their joys, and the chiropodist
needs to be a good listener.