VA paradigm shift in care of veterans with limb loss

Abstract

Traumatic limb loss results in pain and discomfort in addition to the loss of an important part of the body and its function. The mental health challenges accompanying limb loss include issues of frustration and body image, role in life, and feelings of not being whole. Many servicemembers and veterans with limb loss need to prove to themselves that they can still accomplish physical feats, such as those with lower-limb loss returning to running or those with upper-limb loss working with tools. If our servicemembers and veterans let these activities go, they again feel a loss. Therefore, Department of Veterans Affairs (VA) services are available to help individuals meet their physical and recreational goals, whether they be running, walking, or mastering complex upper-limb activities. Veterans with limb loss need ongoing clinical care, prosthetic devices, and mobility assistance. As their prosthetic devices are repaired, replaced, and updated, they need corresponding education and training. Too often in the past, the VA has taken a narrow view of amputation care, focusing only on managing prosthetic devices. Prosthetic is one small but important aspect of the complex rehabilitation partnership between the veteran with limb loss and the VA. To assess the current veterans' perspective in this complex rehabilitation partnership, the VA Health Services Research and Development (HSRD rapid medical evacuation; early life-saving techniques; state-of-the-art surgery; and comprehensive, holistic rehabilitation care. DOD's specialized centers were designed to achieve the highest level of physical, psychological, and emotional function in servicemembers with limb loss. This paradigm shift is a major reason many servicemembers with limb loss elect to continue their military career. The editorial by Barbara Sigford, MD, former Director of the VA National Program for Physical Medicine and Rehabilitation, describes the Paradigm shift for VA amputation care [2]. Planning by VA clinicians to improve for those with limb loss began in 2006 and was the basis for discussion and collaboration between VA and DOD colleagues during the Expert Panel meeting. …