Commitment to Residents’ Safe Steps Forward: Individualized Shoes

Introduction.  Two leading interventions for footwear when individuals are admitted as inpatients across healthcare settings are non-skid socks and their personal shoes,  without assessment if non-skid socks or personal shoes are appropriate.  These interventions are insufficient to meet complex needs for individualized footwear and population-specific footwear necessary for safe transfer and mobility.  Two foot problem categories  associated with falls are local factors (structural foot disorders affecting load-bearing bones), systemic factors (dermatologic,  vascular,  neurologic musculoskeletal conditions).

Purpose.  Address  evidence gaps into residents’ care: knowledge about the impact of  ill-fitting footwear on fall risks; universal footwear vs. individualized footwear based on assessment/populations; residents’ access to optimal footwear - orthotics based on structural deficits, pathology due to diabetes; benefits of proper, individualized footwear on improved LE proprioception, balance and steppage.

Objectives. Gain knowledge about fall risks due to local structural and systemic factors that impair gait, balance for older adults, the growing clinical practice requirements for proper individualized, compensatory orthotic safe footwear.

Methods. Rehabilitation services  in 1 long term care facility initiated and lead by a physical therapist, specializing in LTC care for 30 years, implemented a Residents’ Shoe Clinic, showcased as a safe mobility exemplar implemented now for 4 years  partnering with a medical supply company to design and supply ambulatory and non-ambulatory residents’ shoes.   The process will be detailed whereby residents are evaluated, foot impressions are obtained, individualized specialized inserts and shoes are created and provided – 2 pairs/year.

Results. Over 4 years,  the Physical Therapy Program and Medical Supply Company have provided over 150 residents with these specialized shoes improving their gait, balance.  Other outcomes are residents’ reduced pain due to improper footwear, improved compensation for LE sensory neuropathy, proprioception, reduced pedal pressure injuries, dignity.  Over 50 non-ambulatory residents were provided with individualized slippers and safe footwear when out of bed.