Integrated Model of Foot Care for Homeless Adults:Community Initiative with a Patient Centered Approach

Objective: Millions of Americans are homeless and at risk for serious health consequences. To add to the complexity of experiencing homelessness, many of these individuals live with complications from diabetes. Yet, the homeless have poor access and low use of preventative health care services. The purpose of this project is to translate research evidence regarding the foot care needs of the homeless population including those with diabetes into developing a best practice model that will improve access and use of foot relates services.

Methods: A foot care program was designed to offer an assortment of foot related services in a local community kitchen where homeless adults frequent for meals. The goal of the program was to reduce morbidity and mortality associated with foot related problems among homeless adults including those with diabetes.

Results:  Through a collaborative efforts among a community agency, an academic institution, a local podiatrist, a county sponsored health clinic and community residents, a foot care program was established 18 months ago and has  evolved into an integrated model of foot care including diabetic foot care, foot hygiene, foot assessment, foot self-care education, onsite podiatric examination and interventions. Foot care services are offered at no cost and in a convenient location.

Conclusion:: Foot problems are a significant concern among homeless adults, particularly those with diabetes. Providing preventative foot care in a place where homeless adults congregate offers a unique opportunity for community partnership in providing innovative strategies to reduce morbidity and mortality among a very vulnerable population.