Printer-friendly format

New Lines of Discovery & Inquiry

Between the rigors of a rural lifestyle and an independent mindset that postpones seeking medical attention, there are few more challenging population groups to reach with diabetic education than Mississippi's farmers and ranchers.

That's been the experience of partners in the state's 11-year-old AgrAbility program, authorized by the 1990 Farm Bill to enable and equip farmers to maintain their work and lifestyle despite a disability.

In Mississippi, where nearly one in 10 people lives with diabetes, a key aspect of the program has been helping farmers continue working after an amputation — or, better, avoid it in the first place.

"They tend to be a little tougher breed than most of us," said Chris Wallace, CPO, FAAOP, director of Orthotics and Prosthetics with Methodist Rehabilitation Center in Flowood.

"They don't stop when they should to go to the doctor for general problems, and they're often less accessible to physicians or other healthcare professionals," he said. "So the challenge is breaking through that initial barrier, and teaching them that there are things they can do besides just struggle through it."

As part of a five-member team administering the AgrAbility program, Methodist Orthotics and Prosthetics works closely with the Mississippi State University Extension Service, the Mississippi Department of Rehabilitation Services, the T.K. Martin Center for Technology and Disability and Alcorn State University Extension Program.

Funding for the program as an educational service comes through the U.S. Department of Agriculture, with MDRS as the key financial source for clients in need of modifications or assistive technology.

Most of the clients who seek help through MDRS are referred by vocational rehabilitation counselors around the state, said Kris Geroux, director of assistive technology for MDRS in Starkville.

"We don't really go out to farms looking for people," he said. "Most of the people referred to us are asking for some kind of assistance. I imagine there are more out there we just don't know about."

Finding better ways to connect with the population they're trying to reach has been a central topic of discussion lately, as the AgrAbility partners propose changes and improvements to their strategy while applying for renewal of the four-year grant term.

"Preventive medicine is really a hard-sell to the general population, and that's no more or less true in agriculture," Wallace said. "Whether in orthopedics or any medical practice, people don't think about it until they need it."

That's an even greater risk among diabetics — especially among those less disposed to visit a doctor in general.

"They're unique in that especially in the long term, they tend to lose that protective sensation in the extremities," Wallace said. "Pain being the indicator that it is, people may have a sore that won't heal correctly, but they don't have the motivation to come in. They don't realize they're having problems until it's too late."

Adding to the risk for farmers and ranchers are a host of environmental factors. Those who work in agricultural settings spend a lot of time on their feet, while using tractors and farm implements adds the stress of friction and vibration to their bodies. Their feet are also subject to the hazards of weather, staying moist from rain, mud or sweat.

Among ways the AgrAbility team aims to help diabetic farmers is by connecting them with resources for special kinds of footwear or, in the event of amputation, prostheses that can enable them to continue working after the loss of a foot.

But ideally, it's education that can equip diabetics to manage their disease long before the threat of amputation becomes an issue. That's why the team sets up at places like 4-H gatherings and farm shows to both promote its educational messages and familiarize people with its offerings.

As with any health-promotion cause, getting the word out is often the greatest challenge.

"Those who live and work in a rural environment may not be as easily reached by the mainstream media, and they're not typically congregated in a forum where they're easy to get to," Wallace said. "You can't just mass-advertise at a certain time of the day."

For that reason, the AgrAbility team has been relying chiefly on a secondary education approach, making contact with the physicians and physical therapists who can refer their patients to AgrAbility's resources.

Those include a two-page information sheet, "Caring for a Diabetic Foot or Residual Limb in a Farming Environment," published in the current grant term by the MSU Extension Service. It explains the basic details of the disease and the complications it can cause, particularly how diabetic neuropathy and peripheral vascular disease set in.

Bringing medical terms down to everyday language, the information sheet includes simple, practical tips like carrying a change of socks to keep feet dry and clean, or looking each day for any cuts, sores or blisters. It also advises how to make sure one's footwear evenly distributes the pressure on feet, and how to keep blood flowing to the feet by taking breaks during long tractor rides.

The document also outlines basic-care techniques for an amputee's residual limb, focusing on cleaning the limb properly as well as washing the nylon sheaths, silicone suctions, sockets and gel inserts which come in contact with it.

Along with resources for education and prosthetics, the AgrAbility team also takes part in on-site assessments, to see whether technology solutions like solar-powered gates or tractor lifts may help a disabled farmer continue working his land despite disability or disease.

For more information about the AgrAbility project, visit www.msucares.com/safety/agrability or contact MSU Extension Service project associate Emily Knight at (601) 736-8251.

Tags:

None

Login and voice your opinion!