The geriatric amputee.
There are special aspects of aging with an amputation and with being elderly at the time of an amputation. Older adults who have undergone amputation have many issues to contend with, including comorbidities that affect postoperative care and rehabilitation, general deconditioning and loss of mobility (especially if the onset of rehabilitation is delayed), and lack of social support upon returning to the community. These problems are compounded by a lack of knowledge about caring for the residual limb and prosthesis, maintenance of general health, and management of comorbid conditions. People who have sustained an amputation at an early age and who are ambulatory may find increasing difficulties as they age. Acquired chronic disease occurs more frequently as people age. These conditions can adversely affect function after amputation. Prosthetic designs may need modification because certain components may become more difficult to use. The prevention of a (second) amputation results in saving a limb and preserving self-image and independent function. Considering the emotional and economic cost of amputation and lifelong management of a prosthesis, it is worth the time and effort to practice preventive measures. Should amputation become necessary, careful patient assessment, compassionate management, and communication among the team members results in a more favorable outcome. Including the physiatrist early in the clinical course makes this process easier.
Frieden
Richard A
RA
Department of Rehabilitation Medicine, Mount Sinai School of Medicine, Mount Sinai Medical Center, 5 East 98th Street, Box #1240B, New York, NY 10029, USA. richard.frieden@mssm.edu
D000368:Aged; D000671:Amputation, Surgical; D000674:Amputees; D001186:Artificial Limbs; D015897:Comorbidity; D015577:Geriatric Assessment; D006305:Health Status Indicators; D006801:Humans; D016491:Peripheral Vascular Diseases / Q000453:epidemiology / Q000601:surgery*; D011788:Quality of Life; D014481:United States / Q000453:epidemiology