Pulmonary Embolism in Long-Term Care Facilities: What You Need to Know and How Podiatrists Can Help

A pulmonary embolism is a preventable crisis hiding in plain sight and can be a leading cause of sudden death in long-term care facilities—often striking without warning.

This silent threat isn’t just a clinical concern; it’s a matter of resident safety, liability, and compliance. As a podiatrist working closely with immobile and high‑risk residents, I’ve seen how early detection, proactive protocols, and interdisciplinary coordination can save lives, and how we can help equip your frontline team to recognize and respond.

What is a Pulmonary Embolism?

Pulmonary embolism (PE) is a serious and potentially fatal condition that occurs when a blood clot travels to the lungs, blocking blood flow. In nursing homes and assisted living facilities, residents are often at higher risk for developing these clots due to limited mobility, chronic illnesses, recent surgeries, and other age‑related factors.

In response to growing concerns over this issue, regulations now require assisted living facilities to provide a consumer information pamphlet about venous thromboembolism (VTE)—the umbrella term for both deep vein thrombosis (DVT) and pulmonary embolism (PE)—to all residents upon admission. This educational initiative aims to inform residents and their families about risk factors, early warning signs, and preventive measures.

As a podiatrist providing care for residents in long‑term care facilities in Florida and Illinois, I see firsthand how foot and leg health can directly impact mobility and circulation—two critical elements in reducing VTE risk. By exploring the causes and symptoms of PE and how it affects those in a long‑term care facility, your staff can proactively reduce the risks of a blood clot.

Understanding Venous Thromboembolism (VTE): Are a DVT and PE the same?

VTE includes both:

• Deep vein thrombosis (DVT): A clot that forms in a deep vein, usually in the legs.
• Pulmonary embolism (PE): When a part of the DVT breaks off and travels to the lungs, causing a blockage.

Why Are Residents in a Long‑Term Care Facility at Higher Risk?

Several factors increase the risk of VTE in older adults and residents of long‑term care facilities:

Immobility: Limited movement, resulting from prolonged bed rest or the use of wheelchairs, slows blood flow in the legs.
Recent surgery or injury: Especially hip, knee, or leg surgeries.
Chronic diseases: Such as heart disease, cancer, stroke, or kidney disease.
Age: Older adults have a naturally higher risk of blood clotting disorders.
Medications: Some medications (such as hormone therapies or specific cancer treatments) may increase clotting risk.
Dehydration: Common in older adults and can thicken the blood, making clots more likely.
History of DVT or PE: A prior episode significantly increases the risk of recurrence.

Signs and Symptoms of VTE and PE

Deep Vein Thrombosis (DVT) Symptoms:

Swelling in one leg (or arm)
Pain or tenderness not caused by injury
Skin that feels warm to the touch
Red or discolored skin

Pulmonary Embolism (PE) Symptoms:

Sudden shortness of breath
Chest pain that may worsen with deep breathing
Rapid heartbeat
Coughing (sometimes with blood)
Feeling lightheaded or faint

Early detection is crucial. If any of these signs are present, call 911.

The Role of Preventive Measures in Long-Term Care Settings

Preventing VTE in long-term care settings requires a team approach involving physicians, nurses, physical therapists—and yes, podiatrists.

Standard preventive measures include:

Encouraging frequent movement and walking, if possible
Using compression stockings or pneumatic compression devices
Keeping residents well-hydrated
Monitoring medications
Educating residents and staff about early signs of DVT and PE

The Podiatrist’s Role in Reducing PE Risk

Podiatrists are often overlooked in conversations about pulmonary embolism prevention, but we play a critical role—especially in long-term care.

Here’s how:

1. Promoting mobility

Foot pain, ulcers, nail disorders, or improperly fitted shoes can significantly limit a resident’s desire and ability to walk. In turn, reduced movement leads to stagnation of blood flow, especially in the lower extremities, which is one of the major risk factors for DVT.

The role of the podiatrist includes:

Diagnosing and treating foot conditions that may keep residents from walking
Recommending footwear and orthotics to improve comfort and gait
Collaborating with physical therapy to help residents maintain safe ambulation

By improving lower limb comfort and function, the podiatrist can help restore confidence in walking and reduce sedentary time.

2. Managing Edema and Venous Insufficiency

Chronic venous insufficiency, which is common in older adults, causes blood to pool in the legs, thereby increasing the risk of clot formation. Foot and ankle swelling can also obscure signs of DVT.

The role of the podiatrist includes:

Identifying abnormal swelling early during routine visits
Recommending or prescribing compression therapy to aid circulation
Referring patients to vascular specialists when necessary .

Podiatric care is an early line of defense against undetected venous problems that can escalate into life-threatening clots.

3. Diabetic Foot Care and Infection Control

Foot ulcers and infections are not just a local problem—they can contribute to immobility, systemic inflammation, and hospitalization, all of which increase the risk of VTE.

The role of the podiatrist includes:

Performing routine diabetic foot exams and wound care
Preventing complications that would otherwise lead to bedrest
Helping maintain resident independence and reduce hospitalization

Regular podiatric visits are an essential part of preventing hospitalizations—where immobility and surgery increase the risk of PE.

4. Education and Collaboration

As part of the care team, podiatrists also help educate:

Residents on foot care, signs of swelling, and the importance of walking.
Staff on monitoring changes in lower extremity health that may suggest venous problems.
Families on the importance of mobility, hydration, and preventive foot care.

The more eyes and ears monitoring for early warning signs, the better the outcomes.

Pulmonary embolism is a silent, deadly threat in long-term care—but it is often preventable with the proper awareness and care.

By addressing the underlying risk factors—immobility, foot discomfort, poor circulation—podiatrists help residents stay mobile, independent, and safe. In the broader care team, our work complements physical therapy, nursing, and medical treatment to reduce the incidence of life-threatening blood clots.

If you’re a resident, a family member, or a facility administrator, consider how podiatric care fits into your overall plan to reduce the risk of VTE.

Your feet are your foundation. Keep them healthy, and the rest of the body benefits.

The Quality Podiatry Group’s professionals are experts in providing comprehensive on-site care to seniors in long-term care facilities in Florida and Illinois.

For more information, please call 786‑975‑2090 (Florida) or 773‑321‑2681 (Illinois) or email swiseman@qualitypodiatry.com