My Feet Are Killing Me
One of the first things that many people do when they get home from work or an outing is take off their shoes. For some, that means immediate relief. Sigh! Even the correct size of shoe, no matter the price, cannot guarantee comfort over the long haul.
When you remove your shoes, “you feel heavenly,” says Shawn Mendes. (Not ‘the’ Shawn Mendes.) It's like “taking a hot shower or eating dinner or having a good night's sleep,” he adds. “It feels really good.”
Now realize that two out of every five people who are homeless wear shoes that are not the proper size. They spend their day walking most everywhere to access supports vital to their health, all the while negatively impacting their overall wellbeing. They develop chronic foot issues that, in many instances, are made significantly worse by diabetes. Their feet are killing them.
A three year study of 6900+ patients with diabetes uncovered a prevalence of charcot foot, diabetic foot ulcers, and lower extremity amputation. After 10 years of follow-up, over 1900 (29%) participants had died. Those who died were more likely to be older and men.
Diabetes is even more predominant in the homeless population. One study out of the States reports that diabetes among homeless people is 134 percent greater than in the general population. Adding to the problem is the ongoing struggle with proper diet, diabetes management, and barriers to health care.
In Toronto, people with diabetes were surveyed at homeless shelters. Of those who participated (82 percent were male), 72 percent reported experiencing difficulties managing their diabetes. Twelve percent of participants reported having difficulties making appointments and, of those who did see a physician, 6 percent stated that they did not feel comfortable or welcomed.
The Toronto-based study also revealed other potentially important barriers to their health care, like difficulties obtaining prescription medications or insulin syringes and, for 16 percent of the participants, difficulties storing their medications (for diabetes or other conditions) in a safe place. Toronto shelters, as an example, forbid needles onsite. One shelter resident reported, “I give myself insulin in the bathroom most mornings, but if I ever got caught, they’d give me a hard time.” That could include permanent removal from the facility.
Haven Toronto is a downtown drop-in centre that reduces barriers to health care and food security for elder homeless men age fifty-plus. Haven Toronto uses food as a gateway to other supports including access to a fulltime nurse. Clients come for a healthy meal and while they are there, they can visit with the nurse, no appointment necessary.
New to the drop-in centre is a foot clinic that provides comprehensive foot assessments for both diabetic and non-diabetic clients. This includes tests to asses foot health, including nerve function, management of skin pathologies, and education regarding footwear choices, foot hygiene, and management of chronic foot issues.
Recognizing that over 40 percent of homeless people wear shoes that are the wrong size, clients of Haven Toronto can access proper footwear for free through the centre’s Emergency Clothing Room. From items of clothing to personal hygiene, much has been donated through Haven Toronto’s online store, www.shophaventoronto.ca. Tax receipts are issued for store purchases.