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Clinical podogeriatrics: assessment, education and prevention
Clin Podiatr Med Surg 20 (2003) xiii – xiv
Foreword
Clinical podogeriatrics: assessment, education and prevention
Vincent J. Mandracchia, DPM, MS Consulting Editor
In theory there is no difference between theory and practice. But, in practice, there is. Jan L.A. van de Snepscheut
I distinctly remember a conversation that I had with my parents, not long ago, regarding health care issues. My mother is 80 years old and my father is 81. I was very much interested in knowing how they looked at their health and, more importantly, what expectations they had for their future health care concerns. I certainly had preconceived notions about what a seasoned senior citizen would consider to be important to them regarding their health as they entered their eighties and nineties. As the conversation continued, I was suddenly struck with the realization that foot health or, more exactly, the ability to remain independently active was my parents’ biggest concern. As my mother put it, ‘‘Losing my ability to walk makes me dependent on my children, and that is my greatest concern.’’ The fear of dependency, the loss of an active lifestyle—albeit limited activity—was for her the greatest loss. Achieving and maintaining this active ambulatory quality of life is dependent on access to professional foot care. However, seniors have special concerns, and that requires special management considerations from practitioners. Many patients can live with and tolerate insidious onset maladies, seeking professional help when the problem can no longer be tolerated; however, the limitation or loss of ambulation that results from pedal concerns usually drives these patients to 0891-8422/03/$ – see front matter D 2003 Elsevier Inc. All rights reserved. doi:10.1016/S0891-8422(03)00048-X
xiv
V.J. Mandracchia / Clin Podiatr Med Surg 20 (2003) xiii–xiv
podiatric physicians more readily. Consequently, a podiatric physician’s ability to recognize and restore pain-free mobility is invaluable. The podiatric needs of the elderly are many and are, quite frankly, different than those of the younger population. This fact underscores the need for a specialization within our profession that addresses these unique and indeed challenging circumstances. Hence the birth of podogeriatrics. I had the distinct pleasure of meeting Dr. Arthur Helfand when I was a podiatric medical student in Philadelphia. Dr. Helfand was one of my professors and is an extremely well-respected practitioner and teacher. It did not take long for me to figure out why. Arthur Helfand is a visionary. He saw the need for podiatric services in many vital areas, and he fostered the development of and access to foot and ankle care in those specific areas. It only stands to reason that he would be a pioneer recognizing the need for the development of a subspecialty devoted to podogeriatrics. This issue of the Clinics in Podiatric Medicine and Surgery is dedicated to that recognition, the ultimate goal being the identification and management of pedal pathology in the elderly with a restoration of the quality of life so precious to us all. Arthur Helfand’s dedication to our profession over the years, his contribution to the educational process of our medical students and residents, and his numerous publications are appreciated by all of us. Dr. Helfand is an icon of the podiatric medical profession, a position that is well deserved. As an official card-carrying member of AARP, I for one, am grateful to Dr. Helfand and the others who recognize the need for podogeriatrics. I too want to maintain my ambulatory quality of life! Vincent J. Mandracchia, DPM, MS Broadlawns Medical Center 1801 Hickman Road Des Moines, IA 50314, USA E-mail address: [email protected]
Foreword
Clinical podogeriatrics: assessment, education and prevention
Vincent J. Mandracchia, DPM, MS Consulting Editor
In theory there is no difference between theory and practice. But, in practice, there is. Jan L.A. van de Snepscheut
I distinctly remember a conversation that I had with my parents, not long ago, regarding health care issues. My mother is 80 years old and my father is 81. I was very much interested in knowing how they looked at their health and, more importantly, what expectations they had for their future health care concerns. I certainly had preconceived notions about what a seasoned senior citizen would consider to be important to them regarding their health as they entered their eighties and nineties. As the conversation continued, I was suddenly struck with the realization that foot health or, more exactly, the ability to remain independently active was my parents’ biggest concern. As my mother put it, ‘‘Losing my ability to walk makes me dependent on my children, and that is my greatest concern.’’ The fear of dependency, the loss of an active lifestyle—albeit limited activity—was for her the greatest loss. Achieving and maintaining this active ambulatory quality of life is dependent on access to professional foot care. However, seniors have special concerns, and that requires special management considerations from practitioners. Many patients can live with and tolerate insidious onset maladies, seeking professional help when the problem can no longer be tolerated; however, the limitation or loss of ambulation that results from pedal concerns usually drives these patients to 0891-8422/03/$ – see front matter D 2003 Elsevier Inc. All rights reserved. doi:10.1016/S0891-8422(03)00048-X
xiv
V.J. Mandracchia / Clin Podiatr Med Surg 20 (2003) xiii–xiv
podiatric physicians more readily. Consequently, a podiatric physician’s ability to recognize and restore pain-free mobility is invaluable. The podiatric needs of the elderly are many and are, quite frankly, different than those of the younger population. This fact underscores the need for a specialization within our profession that addresses these unique and indeed challenging circumstances. Hence the birth of podogeriatrics. I had the distinct pleasure of meeting Dr. Arthur Helfand when I was a podiatric medical student in Philadelphia. Dr. Helfand was one of my professors and is an extremely well-respected practitioner and teacher. It did not take long for me to figure out why. Arthur Helfand is a visionary. He saw the need for podiatric services in many vital areas, and he fostered the development of and access to foot and ankle care in those specific areas. It only stands to reason that he would be a pioneer recognizing the need for the development of a subspecialty devoted to podogeriatrics. This issue of the Clinics in Podiatric Medicine and Surgery is dedicated to that recognition, the ultimate goal being the identification and management of pedal pathology in the elderly with a restoration of the quality of life so precious to us all. Arthur Helfand’s dedication to our profession over the years, his contribution to the educational process of our medical students and residents, and his numerous publications are appreciated by all of us. Dr. Helfand is an icon of the podiatric medical profession, a position that is well deserved. As an official card-carrying member of AARP, I for one, am grateful to Dr. Helfand and the others who recognize the need for podogeriatrics. I too want to maintain my ambulatory quality of life! Vincent J. Mandracchia, DPM, MS Broadlawns Medical Center 1801 Hickman Road Des Moines, IA 50314, USA E-mail address: [email protected]