Lived experience of older adults’ adjustment to amputation in the context of wheelchair use

Abstract

Amputation has a profound psychological impact on recipients. The experience of adjustment to lower limb amputation (LLA) by older adults who use wheelchairs was explored using Interpretative Phenomenological Analysis (IPA). Four men with lower limb amputations due to vascular disease who identified as wheelchair users were interviewed. Participants’ experiences of adjustment to LLA are represented by two themes: “Being an Active Agent” and “Psychosocial Adjustment as an Iterative Process”. Being an Active Agent included three elements: self-reflection, a sense of control over one’s LLA and the belief one is able to take action in decision-making in daily life. The second theme ‘Psychosocial Adjustment as an Iterative Process’ described the ongoing nature of the participants’ narratives of adjustment to LLA. This theme also encompassed participants’ experiences of adjustment to LLA as firmly linked to management of previous life events. Participants’ adjustment did not appear to be directly influenced by the mobility aid they used; rather, the mobility aid provided opportunities for adjustment to occur. Older adults’ adjustment to LLA appears to be influenced by their perception of being an active agent in their adjustment process, particularly in relation to decision-making. Adjustment also appears to be a process which older adults continue to engage in after the amputation event. The findings of this study suggest practical strategies that clinicians can use with older adults undergoing amputation