Case Study 2 - Max
Max is a 48-year-old man with an intellectual disability.
Max is a very social individual who regularly attends bingo and delivers newspapers around his neighbourhood. He lives at home with his family and receives a disability support pension.
Max has poor health literacy, which makes it difficult for him to communicate health-related concerns and is reluctant to visit his general practitioner (GP).
He has broad, large feet (size 17), finds it difficult to find shoes, and often develops painful callouses. His shoes are worn and unsupportive and refuses to purchase new ones due to cost.
Max attends podiatry appointments on an ad hoc basis, depending on his pain levels and finances. He has sensory issues does not like the podiatry chair being raised and refuses to see a male podiatrist. Max struggles to articulate his pain.
During a routine review, Max was found to have a foot ulcer due to undiagnosed diabetes.
Max’s intellectual disability affects his understanding of his foot condition, his decision-making and ability to follow medical advice, resulting in poor compliance with post-treatment care.
Although Max is a NDIS participant, podiatry was not included in his plan. The process to include podiatry on Max’s NDIS plan was lengthy and time-consuming. Difficulties arose as Max hadn’t provided consent for communication between his podiatrist, GP, family or Support Coordinator.
In the meantime, Max’s foot condition deteriorated, and he developed a life-threatening complication due to his diabetes requiring hospitalisation.
Eventually, podiatry was included in his NDIS plan, which led to:
- Regular podiatry care
- Custom-made orthotics from an orthotist
- Purchase of supportive footwear
- A coordinated team approach with other professionals to reduce the risk of hospitalisation and amputation
Max was no longer able to continue delivering newspapers, but podiatry care has helped manage his foot condition reducing his pain and decreasing the risk of amputation.
