The lived experiences of community-dwelling older persons with major lower limb amputation

Abstract

Background: A substantial proportion of lower limb amputations occur in older persons, with peripheral arterial disease representing the primary underlying cause. As the population continues to age, the prevalence of peripheral arterial disease is increasing, further contributing to the incidence of major lower limb amputations among this demographic. The impact of a major lower limb was found to be substantial, particularly among older persons. Literature revealed that older persons who underwent major lower limb amputation were confronted with a profound disruption to their daily lives and faced various emotional and practical challenges. Despite the benefits of rehabilitation, not all older persons are able to return to their previous level of functioning. Aims: This study aimed to explore the lived experiences of older persons within the community who underwent a major lower limb amputation in Malta, and looked at how a major lower limb amputation affected the older persons’ lives. Another aim was to analyse how older persons adapted to life following major lower limb amputation. Method: A qualitative approach was chosen to explore in depth the perspectives and lived experiences of older persons who had undergone amputation. The researcher selected interpretative phenomenological analysis (IPA) as the most suitable method to closely examine and interpret these lived experiences. Participants were recruited through purposive sampling based on specific inclusion and exclusion criteria. Four semi-structured face-to-face interviews with open-ended questions were carried out, consisting of 3 older males and 1 older female participant. A pilot study was carried out with 1 older male. Results: After data analysis, 4 superordinate themes emerged (a) the impact of amputation on daily life and independence (b) emotional response to amputation (c) the influence of support networks and (d) navigating life after amputation. Corresponding subordinate themes emerged. All older participants, each in their own way and with some shared experiences, encountered challenges in adjusting to life as an amputee within the community, yet all demonstrated resilience in one form or another. Conclusion: The study offered meaningful insights into the lived experiences of Maltese older persons with major lower limb amputations, highlighting the complex challenges they face and the needs that arise as amputees living in the community. Recommendations were directed toward authorities, policymakers, and healthcare professionals, emphasising the need to enhance education and support services, with particular attention to improving environmental accessibility for older persons with amputations.