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Amputation

Bound for Nursing Home at 49?

11/09/2009

Question:

My wife just had her second leg amputation above the knee, in 6 yrs due to PAD, and is currently in a rehab center/nursing home.. When the first amputation took place. I reluctantly quit my job to stay at home with her and help her..( We live on a fixxed income of $1094 a month)..She was using an electric wheel chair combined with a walker to make transfers..but the days of walkers are over.. She is over weight and also suffers from COPD, and i beleive not strong enough to use prostetics safely. I need financial assistance to get all the new gadgets to get her thru these transfers at home. I dont know how I will be able to get her from the truck to the wheel chair, or the wheel chair to the bathroom or bed room. I am terrified for her mental wellbeing if i cannot bring her home, and terrified if i bring her home i will fail in giving her the quality of life she needs, without going out and getting a second income. I make a 90 mile round trip to see her as often as i can afford..I talked to DSHS an was only offered food stamps... she alrady receives them and i dont need food i need financial assistance to properly take car of her.. do you know of any programs that will assist me financially for taking care of her at home?

Answer:

Although you stated you don't feel your wife is strong enough to make use of an above-knee prosthesis, this determination would best come from her physician. Even if she's not currently strong enough to use a prosthesis, she may be able to be rehabilitated to a sufficient degree to make use of a prosthesis - even if just for transfers and limited standing, rather than walking. A prosthesis would then improve her independence with these aspects of mobility. However, if she wasn't using a prosthesis prior to her second amputation, the likelihood she'd now use/benefit from one is less. If your wife is becoming or is depressed, this needs to be treated appropriately so she has the motivation to achieve her highest level of function possible.

Since you mentioned she is currently undergoing rehabilitation, a primary goal of rehabilitation is to maximize a person's levels of function and quality of life in many different areas, including self-care abilities and mobility. This includes educating care-givers/family members regarding the patient's medical conditions and needs, determining whether returning to home is realistic, and if so, identifying and providing appropriate adaptive equipment and assistive devices and training in their proper use, along with possible home modifications (for example, ramps, doorway widening, hospital bed, bed/bathroom on first floor, etc.). The financial, social, and psychological aspects of these considerations are typically addressed with the assistance and expertise of a Social Worker and Rehabilitation Psychologist, rather than having a person such as yourself try to look into all this on their own.

I would encourage you to make a list of all your questions and concerns, and then have each of these addressed by your wife's physician(s), therapists, and/or staff members at the rehabilitation facility.

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Response by:

Brian L Bowyer, MD Brian L Bowyer, MD
Clinical Associate Professor
Physical Medicine & Rehabilitation
College of Medicine
The Ohio State University