Home Occupational Therapists (OT’s) are an integral part of care for a recent amputee. Every year, numerous individuals of all ages experience amputations of their upper and lower limbs, and sometimes both. These persons may have had an amputation as a result of a trauma, vascular disease, or malignancy. The experienced therapists at Wedell Home Therapy have seen a majority of individuals suffer an amputation as a result of vascular disease due to high blood pressure, a deep vein thrombosis, or an aneurysm, just to name a few.
Occupational therapists assist individuals of all ages, backgrounds, races, and socioeconomic statuses. As a result of an amputation in either the upper or lower extremity, a person will exhibit diminished strength, balance, range of motion, sensation, endurance, self-care skills, as well as participation in activities of daily living. Wedell Home Therapy occupational therapists can assist individuals in improving these areas of need. One goal is to focus on what aspects of daily life are important to a person so they can maximize their functional abilities. Depending on the age and functional potential and abilities of the person, a personalized plan will be established to reach goals.
Home occupational therapists help the person with an amputation to live their life as independent as possible. In many instances, a person is sent home from a hospital or short-term rehab facility before they receive a prosthetic in either the upper or lower extremity because of several factors. This may include additional time needed for the new amputation to heal. It is also possible decreased strength or stability has affected the limb. In some instances, a person may be awaiting insurance approval. Pre-prosthetic training focuses on said areas as described above to maximize strength, balance, endurance, and overall functional abilities prior to the acquisition of a prosthetic. Evaluation and intervention in the psychological well-being of the person with an amputation are equally as important as the physical deficits.
Occupational therapists focus on a holistic approach considering the person’s perspective and what is important to them, as well as how they want to be viewed by others. This is important for an OT to establish an appropriate plan for the person and help them achieve meaning in their life. In some cases, restorative therapy approaches for persons with amputations are not viable for a number of reasons. Compensatory strategies are more valuable in maximizing a patient’s functional potential. For example, a patient who had a recent amputation but also has a comorbidity of heart disease and is on oxygen, might benefit from the utilization of a wheelchair in the home for a majority of the time instead of a prosthetic.
Wedell Home Therapy can make recommendations regarding the set up of the home, limiting obstacles for a wheelchair and other adaptive devices for the patient as well as, continuing to improve strength of the patient. This would provide the patient the continued ability to propel the wheelchair in home. In addition, they could access items in the kitchen and bathroom from a seated level. In this case it is a “personal” care plan for the patient tailored to their needs to maximize functional abilities to achieve the highest level of independence.
Below are some specific areas of focus and intervention the therapist can establish based on a person’s functional needs and abilities.
- Strength of the upper body including hands to aid a person’s ability to perform activities such as self-care, transfers in an out of bed, toilet and shower as well as putting on and taking off potential prosthetic
- Sensory integration of amputated limb due to patient’s potential numbness and phantom sensations post amputation
- Potential home modification for person to perform functional mobility more easily with safety in mind throughout household
- Hygiene management of amputated limb, skin monitoring at incision site, and cleaning of potential prosthetic
- Education of medical equipment to be utilized in the home, use of them safely, as well as functional use (i.e., wheelchair, sliding boards, transfer benches, dressing equipment, hospital beds, commodes)
Contact one of the home occupational therapists at Wedell Home Therapy for more information. In-home physical therapy services are also provided to amputees by appointment. Visit the Amputee Coalition™ website for additional resources.
Written by: Joseph Chirco, MS, OTR/L, CSRS