Hygiene and Its Implications in O&P Practice

Prior to beginning a career in O&P, I had minimal interaction with individuals with poor hygiene and assumed that cleanliness standards I considered normal were commonplace.

Prior to beginning a career in O&P, I had minimal interaction with individuals with poor hygiene and assumed that cleanliness standards I considered normal were commonplace. It was only after beginning residency that I realized how frequent exceptions to this were. A patient I had during my residency stands out in my memory. She was an elderly woman who wore an AFO and orthopedic shoes. In addition to other obvious signs of poor hygiene, a live insect could be seen either in the device or on her clothing during every encounter. Time was devoted during each appointment to cleaning the device, a task I expected patients to perform on their own. She exhibited several other atypical behaviors, including wearing excessive layers of clothing (regardless of the weather) that did not appear to have been cleaned regularly. She drove a vehicle that was filled from floor to roof with what appeared to be trash, with just enough free space for her and her sister to sit in the front seats. After noticing items missing from the office after her visits, the administrative staff limited access to paper cups, toilet paper, and other loose items to prevent them from being taken during her visit. She was pleasant to work with and engaged constructively in encounters. With time I came to understand, as most clinicians eventually do, that working with patients who have poor hygiene is a relatively common experience.