Multiple Amputations: Considerations for Life Care Planning

This article will explore the unique challenges that a person with multiple limb amputation faces and provide recommendations for potential items to include in a related life care plan. There have been significant advances in prosthetic technology in the past several years and the tendency is to provide someone with multiple limb amputations with the most advanced dynamic systems such as myoelectric arms for a person with bilateral upper extremity amputation; however, the authors caution that although these technologically advanced systems have their place in life care plans, sometimes body powered systems provide a greater level of functionality and comfort. This article will explore the causes of multiple amputations, types of upper and lower extremity amputations, and the impact the level of disarticulation has on prosthesis use and functional abilities. Furthermore, upper and lower extremity prosthesis options will be reviewed, inclusive of criteria that are considered by the prosthetist when determining the optimum choice, which may include both body-powered and myoelectric/microprocessor prosthetic devices. Innovations in customization will be reviewed. The authors also provide items for consideration for inclusion in a life care plan unique to an evaluee with multiple amputations that will increase independent function as much as possible while acknowledging the potentially significant limitations created by multiple limb loss. Geographical location is also considered as having the potential to impact the needs of the evaluee. Finally, prosthetic costing, frequency, and use of the L-Code HCPCS System will be reviewed.