Amputation

As with most catastrophic injuries, adjustment to life after an amputation can cause a significant increase in stress among the family and caregivers.

If the amputation was the result of a traumatic accident (unscheduled), the injured individual and the family members experience an enormous sense of shock. The grief for the lost limb that is experienced by the injured person may also be experienced by family members and caregivers.

With scheduled amputations—ones that result from chronic illness such as diabetes— individuals and family members typically have time to adjust to the idea of an amputation. However, the resulting functional limitations may still require quite a bit of adjustment.

While functional levels and intimacy issues often require short-term resolution, changes brought about by aging can arise later.

Functional Levels

Depending on the site and the number of limbs, there is a great deal of variation of functional levels.

With single amputations, impairments might be overcome with a prosthetic device. While using a prosthetic device takes training and patience, eventually the individual is able to lead a very active and healthy life.

With double amputations, functional limitations may be more significant. A double below or above knee amputation may require the use of a wheelchair, which limits independent mobility. Like spinal cord injury, caregivers of individuals with an amputation may be required to assist with Activities of Daily Living (ADLs) and mobility. The stress of assisting with dressing, grooming, feeding, and bathing can be burdensome, especially as you learn the routine. With time, the daily routine becomes more manageable and you should find your stress decreasing.

Aging

As an individual with an amputation ages, it is important that they address conservation of energy issues. This may mean that they have less stamina to perform household chores. This can result in added pressure on the family or caregiver to perform these duties.

Concern for safety may increase as the individual with a lower extremity (LE) amputation ages. There may be discussion about a home health attendant, or additional mobility equipment may be needed to ensure their safety. This is a stressful process and these decisions must be made on an individual basis, considering the wishes of the individual as well as the capabilities of the family support system.

Intimacy

There will be issues of intimacy and sexuality to be addressed. Loss of a limb may result in loss of self-esteem, self-consciousness, or feelings of being unattractive. In addition, the functional loss of one or both upper extremities may present a challenge to sexual activity.

Discussing these concerns with a professional counselor, preferably a therapist with training in this area, may be the most effective way to overcome these issues. Unfortunately, many individuals don't feel comfortable doing so, and a deterioration of the marital relationship may result. Remember, this is a common problem for individuals with amputations and there is assistance available to you.

As with spinal cord and brain injuries, an excellent source of support and information is a local Amputee support group. Attending these groups, with the amputee or alone, can be a great way to meet other people coping with these same issues. Often, the support group members have sought help from community resources, and will be able to refer you to individuals they found helpful.