An amputee’s rehabilitation programme is typically headed up by a multi-disciplinary team of experts. It takes into account the whole lifestyle of the individual; at home, in the workplace, and outside in the local community.
The primary goal is to help the amputee retain their independence; to encourage them to stay active for the rest of their life, to regain or improve their mobility, to boost confidence and to enhance their general quality of life as much as possible. Enabling an amputee to return to work can also easefinancial pressure.
Rehabilitation is a gradual process, where small improvements may demand a great deal of effort from the amputee, and the level of progression made is often affected by the general health and strength of the individual before their amputation.
Types of therapy
Whilst still in hospital, the amputee will be under the primary care of a consultant. Further care will, however, be provided by such specialists as physiotherapists and occupational therapists.
Once the patient leaves hospital, they may be transferred to a designated rehabilitation facility where they will receive multi-disciplinary rehabilitation, or they may be discharged from the hospital directly to their home in order to receive support and care as an outpatient, which may involve attending various specialist centres.
Consultant and nurses
The consultant (not the amputee’s surgeon) is an expert in the field of amputation rehabilitation, prosthetics and limb-care, and is responsible for making decisions that long term should achieve the best outcome for the patient along with providing acute pain management.
Nurses will also support the immediate needs of amputees. This can range from helping patients with their self-care and mobility, through to wound care and providing advice.
The physiotherapist has one of the most crucial and vital roles in the rehabilitation process.
After the loss of a limb an amputation means that people have to learn how to use their bodies in a completely different manner. It is a monumental challenge, but physiotherapy helps people to adapt to their new situation through repetitive strength-building exercises.
As the patient’s strength, balance and coordination improves over time the physiotherapist will customise the rehabilitation process towards the amputee’s specific needs.
An occupational therapist assists the patient by helping them with their self-care needs and day-to-day activities. They may also be able to help complete an application for a care package.
Occupational therapy helps the patient to put into practice the advantages gained through physiotherapy, and in circumstances where the amputee cannot complete a task they may assess whether equipment would be helpful, or whether adaptations to the amputee’s property are needed.
Also, should the amputee later adopt the use of a prosthetic limb, the occupational therapist will help them learn how to use the appendage in day-to-day situations.
The goal is to increase the amputee’s independence, which is particularly important when it comes to matters involving the bathroom or dressing. Over time the amputee’s skills should develop and they will be able to complete the majority of these tasks to a level of efficiency not unlike their pre-injury lifestyle, although only as much as their condition will permit.
A prosthetist is somebody who cares for amputees by designing and providing the best-suited artificial limb that will help them to function in their lives in the best way possible. This can be on the NHS or if a claim is being made the cost of the prosthetic can be paid privately.
The prosthetist models the amputee’s stump (or region of the body that the assistive appendage will be fitted to) by creating a mould, either via an actual physical cast or, more commonly in recent years, through 3D digital imaging.
The thoughts and opinion of the amputee are valuable to the prosthetist, as they will discuss every single aspect in order to create a limb that is equal parts functional, safe, and visually appealing.
Various prosthetic limbs have been developed that apply to certain situations and terrains. For example, there are the high performance and lightweight prosthetic feet sometimes referred to as ‘blades’, much like those seen worn by runners at the Paralympics, whilst others are more sturdy and anatomically correct in their visual representation of feet.
Once selected, the prosthetist can demonstrate to the patient the correct way of using their new limb and the right way to look after it. Going forward, adjustments and adaptations can be made in order to refine the limb’s suitability to the amputee.
People who have undergone an amputation particularly a traumatic amputation following an accident will feel a strong emotional and psychological impact on their lives. It can also heavily affect their family and friends.
For that reason, it is often recommended that people in such situations attend counselling sessions to help them cope with any feelings of depression, sadness and despair. Talking about the situation can help people face up to their future and cope with their emotionally debilitating issues.
The needs of an amputee change over time, and in particular there are the usual elements of aging to take into account, such as arthritis.
It is important to lead as healthy a lifestyle as possible. Close attention must be paid to controlling weight, as this can have a detrimental effect on an amputee, particularly those who have lost a lower-limb.
Amputation does not get any easier, and it may mean that as time goes on the use of a prosthetic limb will have to decrease whilst a wheelchair will become the amputee’s dominant aide, particularly when travelling further afield or for extended periods of time.
If it is not possible for an amputee to return to work then they may need support in claiming DWP benefits and other financial help.
If you have a claim a case manager may be appointed to provide extra support and to oversee the provision of support and care.