A unique report, looking at the lives of limbless military veterans, has been launched by Northumbria University, Newcastle, to help inform future health and social care policy for an ageing veteran population.
The main aim of the study - the first of its kind anywhere in the UK - was to explore the physical, psychological and social needs of limbless veterans throughout their lives after leaving the armed forces.
The study, funded by the Aged Veterans Fund using Libor fines, used in-depth narrative interviews with a number of veterans, aged between 43 and 95, across the UK. The aim is to develop future service design and shape collaborative work between NHS and third sector organisations with responsibility to care for limbless veterans.
The study, led by the University’s Northern Hub for Veterans and Military Families Research and conducted in collaboration with Anglia Ruskin University, revealed that many of the veterans interviewed were struggling against bodily decline, while striving to maintain independence. They cited a deterioration in mobility and the emergence of social isolation in their personal accounts of ageing and limb-loss.
Persistent pain and discomfort are common experiences for many veterans affected by limb-loss, according to the study. Pain which is poorly managed may result in the inability to engage in physical activity or to utilise prosthetics comfortably. It could also lead to immobility, isolation within the home and a heavy reliance upon others to meet basic needs.
Many veterans also reported ongoing grief which they kept ‘bottled up’ post-amputation. Striving to be ‘normal’ in the aftermath of injury can be an important way for veterans to cope, however, this may also mask a great deal of enduring personal anguish.
Inability to secure post-injury employment also has a negative long-term impact upon veterans' quality of life, resulting in the belief that the amputee is unattractive to potential employers and is likely to be subject to ongoing disability discrimination.
Some veterans spent more time during their interviews talking in detail about their careers and other achievements. It was clear there was a strong sense in which work – whether continuing in military service or civilian work – helped participants to normalise their amputations and to minimise the impact of limb-loss.
In response to these interviews, the study calls for timely access to high quality healthcare services, starting from the time of amputation and extending throughout veterans’ lives.
Dr Matthew Kiernan, Associate Professor of Mental Health and Veteran Studies at Northumbria University and a former Lieutenant Commander in the Queen Alexandra’s Royal Naval Nursing Service, said: “The aim of this research is to lay a foundation so that limbless veterans can actually guide and direct us to what the problems are. Importantly, the veterans themselves are telling us what we should be looking at, what further research needs to be done and which policies need to be developed.
“This study illustrates that veterans who are affected by limb-loss require timely access to high quality support and specialist healthcare services. Special attention must also be paid to older veterans who suffered limb-loss before modern medical advances in prosthetic devices and prosthetic care.
“We have found that a holistic approach to pain management which includes a wide range of services is essential in order to ensure that veterans receive the care and support they need to maintain their independence and sense of self-worth following limb-loss.”
Veterans described enduring significant amounts of stump pain and phantom limb pain - pain that is localised in the region of the removed body part – throughout the course of their lives.
The study also highlights the growing care needs of limbless veterans as they get older. Participants described the impact of age related physical decline and musculoskeletal conditions such as arthritis and the way in which they compound the challenges associated with limb loss.
Dr Nick Caddick from the Veterans and Families Institute at Anglia Ruskin University, who led the analysis of veterans’ narratives for this study, said: “Limb loss is a progressive and deteriorating injury – it gets worse as veterans get older and good limbs wear out from the extra strain. The stories from our veterans reveal a mix of resilience and vulnerability in old age: resilience from old military ways of adapting and coping and vulnerability to isolation and changes in mobility.”
