I would put in a toe/foot flap. I know from the time that I spend in the oncologist's treatment room, your feet get cold, especially since most of them have to take off their shoes and end up with the footrest on the recliner up. I have made several now - the one that I use and others that I donated to the doctor's office for anyone to use when they don't have theirs, and one that was a present to a fellow patient.
When I got ready to put the binding on, I just add a double layer of fabric about 12" deep on one end of the quilt. Usually just a piece of the same backing fabric with polar fleece on the inside of the pocket. And then bind it as usual. The other thing is that I can fold the quilt and it slips into the foot pocket.
The ones that I have made have been basically 50"x60" - depending on the pattern on the front. I am working on one for a genetlemen at the office who is REALLY tall - almost 7' - and it is goingto be extra long and the pocket extra long too. HTH
EDITED to fix spelling and spacing issues. Should know not to type right after taking meds. ;-)