Housing Needs of Ageing Veterans Who Have Experienced Limb Loss
Abstract
:1. Introduction
2. Materials and Methods
2.1. Design
2.2. Participants
2.3. Data Collection
2.4. Data Analysis
3. Results
3.1. Theme 1: Availability of Support
3.1.1. Navigating Sources of Support
“You’re in the military so who’s going to pay for me? Who’s actually going to take responsibility and say ‘We’re going to look after you?’”(P005)
“I don’t know what the options [for financial help with adaptations of home maintenance] are.”(P008)
“I don’t want just money, I… you know I’m after help and support in helping to move my life forward. Where is it? Its non-existent. Unless it… unless because of what happened to me and being so… being a peacetime injury, it’s… it has no bearing, it’s not important compared to those that are hurt through conflict.”(P002)
“A rep [from a military charity], he got me up here. And he was great, but as soon as I got up here and he was giving me the wrong advice. I said ‘How do I get reinstated to get my benefit back up?’ Because they’d cut it. He said ‘Oh you’ve got to go and see your doctor?’ So I made an appointment and went to see the doctor, the doctor said ‘No you’re not supposed to be coming to see me, you’re supposed to write a letter and then they send you to see me’. So he cost me three weeks and he was supposed to be my welfare officer.”(P008)
“I told you I come out of hospital and they… no one tells you about benefits and what you can get […] But it would help you know. Because I didn’t know about disability living allowance until six months after I could have claimed it.”(P023)
“I’ve asked for help and they’ve said basically this ‘Unless you need… can you wash yourself?’, ‘Can you dress yourself?,’ ‘Yes’, ‘Can you cook a meal?’, ‘Yes’, (umm) and ‘Can you take yourself to the toilet? Well if you can do all them four things…”(P008)
“I was in a bungalow that I could only use the back door. I couldn’t get out the front door because there was a series of steps so I could only use one. They wouldn’t adapt it for me, the housing association refused to adapt it.”(P008)
“Private houses, but not council, private… yeah they didn’t want to pay to have it adapted.”(P008)
“I went to buy my house out in [PLACE] and to get a mortgage you had to put down your last three years of where you were living. So the year previous I was in [PLACE] so I had an address, two years prior to that I was [ABROAD]. So I said it was [PO Box]. ‘Oh what about utility bills?’ ‘Never had a utility bill, came out of my wages’ ‘What about a phone?’ I said ‘No didn’t have a phone. No didn’t have a phone’. ‘Well how can you prove you lived there?’ […] I gave it to them and they wrote back to the mortgage company saying ‘Never heard of this fella!’ So I had to live in the house for a further two years so I could tell the mortgage company where I lived for the prior three!”(P013)
“I had to pay for stair lift myself.”(P020)
“We even brought a ramp, you know (umm) for to get the wheelchair up and down. (umm) We then had to get the door widened and a low threshold. (umm) Nothing from the… what do you call? Social service or whatever, no help at all, no. We paid for it because we were desperate. I’d spent weeks trapped in that lounge, I couldn’t get out of the lounge because I couldn’t get to the kitchen because it was a step down and to get to the toilet was… was down.”(P021)
3.1.2. Support from Military Charities
“I can’t imagine and not having the financial assistance that pensions and compensation have given me as a person with all these other problems with the cancer, limb loss and all this… and then two young children… I haven’t had a financial worry (umm) you know the kids went to private school, (umm) I can have my own hobbies, the house is paid for, (umm) and you know I don’t deliberately save all my money up and you know so I live well. And you know I’m very grateful to having the system that we’ve got and it is a welfare system isn’t it? Army pension, war pension and then criminal compensation.”(P005)
“Thanks to Blesma I… I’m able to apply for a grant to help me with my gardening and Blesma’s my… they’ve given me each year and it helps me to help myself and my partner to have some sort of work done in our garden. (umm) But I’ll be brutally honest, that’s the only financial help I get.”(P002)
“We didn’t know how to go about getting the council to do the extension and all the rest of it. So yeah [military charity 1 and military charity 2] helped.”(P010)
“No-one tells you about benefits and what you can get. We’ve had … [military charity 1] has been really good and [military charity 2].”(P016)
“They gave me a grant to get my (umm) stairs and landing decorated because I… again I could do it, but I’d probably fall of the ladder and… look if there are any specific needs like adaptions to house, don’t always provide them themselves. I think they’ll go through local authorities, but if I needed anything like that I’d probably… maybe phone up [Bill] who’s my (umm) welfare officer, have a quick chat or email him usually saying ‘Right’ you know if I need ‘X, Y, Z’ like… a grant I had in my bathroom which I’m going to.”(P006)
“[Military charity] have been brilliant to me. Absolutely brilliant.”(P016)
“[Military charity]—they’ve widened the doors, they’ve done the wet room.”(P027)
“So they got the [local authority, military charity 1 and military charity 2] and I think someone else all put some money in to have an extension with a wet room.”(P010)
3.1.3. Stoicism
“As long as you’re not too proud to not ask for assistance. And I think there is something in that, I’m a [military position], I am so independent, it is difficult to actually go to them and actually say (umm) ‘In need of help’ And what is more vital? Practical help, financial help, welfare assistance, you’ve got to just (umm) accept…”(P005)
“Accepting help where it’s needed. I’m more inclined to accept a little bit of help these days than I previously was. But (umm) and asking for help it… as well you think you know something you can’t do on your own.”(P012)
“Doing stuff for myself, only asking for help when I really need… well I know I need something (umm) I’ll ask. But that’s just a normal thing isn’t it so (umm) yeah independence is massively important. You know don’t ask people for money and all this sort of stuff so (umm) and… be self-supporting.”(P006)
“I’ve lost my leg and I’ve got to get on with it and you’ve got no choice!”(P004)
“The military coping at the time was don’t be a cry-baby, just go out, get [drunk] and get over with it […] get over it, soldier on.”(P001)
“If I was a civilian I don’t know if I would have coped. Being a military, it was let’s just move on and carry on.”(P005)
3.2. Theme 2: Changing Housing Needs
3.2.1. Unsuitable Housing
“It takes me all day just to keep this house going.”(P008)
“It was my responsibility to sort out food and I would end up having to phone takeaways and the takeaways got to know me so well that they would even just knock on the door and let themselves in and bring my food for me.”(P002)
“My wife at the time, she (umm) decided that my bed was going to be safer downstairs and that’s where I slept for… since having the total knee replacement and then the amputation. The settee was my bed.”(P002)
“I was living in the front room had a blow up bed, a double with me and my wife. She came down with me and I was having to have strip washes in a bowl of water for me, strip washes or clean my teeth and that and obviously couldn’t get upstairs to the toilet or through to the other one.”(P010)
“[Before having a stair lift] I used to go upstairs… I had to go upstairs on my back… on my bum.”(P033)
“I am bored being stuck at home and it allows me to ponder and think long and hard about this and it does make me angry and it does get me upset.”(P002)
“I used to arrive home and I used to have to stay in the house virtually.”(P014)
“We had some fun and game (umm) we had a terraced house (umm) they just about managed to get me in with a wheelchair.”(P021)
“While I was in this bungalow, this house. Very isolated, but… anyway I used to have to do my shopping on the internet to get anything because I couldn’t go anyway.”(P008)
3.2.2. Adapting Behaviour
“I basically learnt to adapt because it’s a case of all of a sudden ok I’m in the house, the old house…”(P001)
“Not being able to move sideways, not being able to reach things on the shelves […] you know not being able to carry the kids (umm) upstairs or you know it’s a big palaver to be… you know to hold a child, to go into the lift, to go up in a lift to go through your bedroom to their bedroom, down steps. It was not all wheelchair friendly this house isn’t wheelchair friendly for me. It’s not… it’s not wheelchair for everybody.”(P005)
“I was getting in the bath the wrong way, my leg was on the inside of the bath near the wall so… I couldn’t get out with my stump. So now I realise that I’ve got to turn around. Foot facing the taps, so this comes out first and then I’ve got the support and I just push up… and it’s so much easier.”(P027)
“I clean the oven out, alright I don’t have my leg on because I sit on my bum doing it, but you normally anyway I mean because the ovens low down. So how else are you going to do it? You’re going to have to sit down or stoop down, but it’s stupid stooping down, you’ve got to sit down.”(P012)
“My [Genium X-5] (umm) but when (umm) when it’s not working properly and when I’m in spinal pain and pelvic hip pain, I can’t wear my leg so I have to go around on elbow crutches.”(P002)
“And the deterioration side of things because of the accumulation of injuries and then the compounding effect of each against the other, means that maintaining mobility, independence is much more difficult than it was.”(P009)
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
- Stewart, C. Synopsis of Causation: Amputation of the Lower Limb; Ministry of Defence: London, UK, 2008.
- Kiernan, M.D.; Hill, M.; McGill, G.; Caddick, N.; Wilson, G.; Forster, N.; McIntyre, C.; Greaves, P.J.; Clarke, A.; Monkhouse, B.; et al. Maintaining Independence: A Study into the Health and Social Well-Being of Older Limbless Veterans; Northumbria University: Newcastle, UK, 2018. [Google Scholar]
- Caddick, N.; Cullen, H.; Clarke, A.; Fossey, M.; Hill, M.; McGill, G.; Greaves, J.; Taylor, T.; Meads, C.; Kiernan, M.D. Ageing, limb-loss and military veterans: A systematic review of the literature. Ageing Soc. 2019, 39, 1582–1610. [Google Scholar] [CrossRef] [Green Version]
- House of Commons Defence Committee. Armed Forces Covenant Annual Report 2016; Ninth Report of the Session 2016–2017; House of Commons Defence Committee: London, UK, 2017. [Google Scholar]
- Murrison, A. A better deal for military amputees. In Department of Health and Social Care; Department of Health and Social Care: London, UK, 2011. [Google Scholar]
- Hatch, S.L.; Harvey, S.B.; Dandeker, C.; Burdett, H.; Greenberg, N.; Fear, N.T.; Wessely, S. Life in and after the Armed Forces: Social networks and mental health in the UK military. Soc. Health Illn. 2013, 35, 1045–1064. [Google Scholar] [CrossRef] [PubMed]
- Marmot, M.; Allen, J.; Goldblatt, P.; Boyce, T.; McNeish, D.; Grady, M. Fair Society, Healthy Lives: The Marmot Review. Strategic Review of Health Inequalities in England Post-2010. Available online: https://www.gov.uk/dfid-research-outputs/fair-society-healthy-lives-the-marmot-review-strategic-review-of-health-inequalities-in-england-post-2010 (accessed on 14 January 2020).
- De-Rosende Celeiro, I.; Simón Sanjuán, L.; Santos-del-Riego, S. Activities of daily living in people with lower limb amputation: Outcomes of an intervention to reduce dependence in pre-prosthetic phase. Disabil. Rehabil. 2017, 39, 1799–1806. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Care and Repair England. Home Adaptations, Integration and the Care Act; Care and Repair England: Nottingham\London, UK, 2015. [Google Scholar]
- Adams, S. Disabled Facilities Grant: A System of Help with Home Adaptations for Disabled People in England—An Overview. Care and Repair England: Nottingham, UK, 2016. [Google Scholar]
- Carnemolla, P.; Bridge, C. A scoping review of home modification interventions—Mapping the evidence base. Indoor Built Environ. 2018. [Google Scholar] [CrossRef]
- Powell, J.; McIntosh, S.; Bird, E.; Ige, J.; Garrett, H.; Roys, M. The Role of Home Adaptations in Improving Later Life; Centre for Ageing Better: London, UK, 2017. [Google Scholar]
- Oldman, J. Housing in Later Life; Age: London, UK, 2014. [Google Scholar]
- Department for Communities and Local Government. English Housing Survey. In Adaptations and Accessibility Report, 2014–2015; Government DfCaL, Ed.; Department for Communities and Local Government: London, UK, 2016. [Google Scholar]
- Simpson, R.G.; Leach, J. The General Practitioner and the military veteran. J. R. Army Med. Corps 2015, 161, 106–108. [Google Scholar] [CrossRef] [PubMed]
- Finnegan, A.; Jackson, R.; Simpson, R. Finding the Forgotten: Motivating Military Veterans to Register with a Primary Healthcare Practice. Mil. Med. 2018, 183, e509–e517. [Google Scholar] [CrossRef] [PubMed]
- Braun, V.; Clarke, V. Using thematic analysis in psychology. Qual. Res. Psychol. 2006, 3, 77–101. [Google Scholar] [CrossRef] [Green Version]
- Samele, C. The Mental Health of Serving and Ex-Service Personnel: A Review of the Evidence and Perspectives of Key Stakeholders. Available online: https://www.fim-trust.org/wp-content/uploads/2015/01/20130729-FiMT-MHF-Final.pdf (accessed on 28 January 2020).
- Ashcroft, M. The Veterans’ Transition Review. Available online: http://www.veteranstransition.co.uk/vtrreport.pdf (accessed on 14 January 2020).
- Adams, S.; Hodges, M. Adapting for Ageing: Good Practice Ad Innovation in Home Adaptations; Centre for Ageing Better: London, UK, 2018. [Google Scholar]
- Royal British Legion. Funding for Aids and Adaptations. 2019. Available online: https://support.britishlegion.org.uk/app/answers/detail/a_id/628 (accessed on 14 January 2020).
- Blesma. Grants n.d. Available online: https://blesma.org/how-we-help/grants/ (accessed on 6 January 2020).
- Desmond, D.M.; MacLachlan, M. Coping strategies as predictors of psychosocial adaptation in a sample of elderly veterans with acquired lower limb amputations. Soc. Sci. Med. 2006, 62, 208–216. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Heal, J.; Crouch, L.; Halkiopoulos, S.; Fussey, V.; Kirkman, E. Applying Behavioural Insights to Successful Transition; Forces in Mind Trust: London, UK, 2019. [Google Scholar]
- Resnik, L.; Ekerholm, S.; Borgia, M.; Clark, M.A. A national study of Veterans with major upper limb amputation: Survey methods, participants, and summary findings. PLoS ONE 2019, 14, e0213578. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Bailey, C.; Hodgson, P.; Aitken, D.; Wilson, G. Primary Research with Practitioners and People with Lived Experience—To Understand the Role of Home Adaptations in Improving Later Life; Centre for Ageing Better: London, UK, 2018. [Google Scholar]
Number | Percentage | |
---|---|---|
Mechanism of Limb Loss | ||
In-Service Attributable | 11 | 34.4 |
In-Service Non-Attributable a | 2 | 6.2 |
In-Service Unclear | 1 | 3.1 |
Post-Service Accident | 9 | 28.2 |
Post-Service Attributable b | 2 | 6.2 |
Post-Service Illness | 7 | 21.9 |
Nature of limb loss | ||
Above-knee | 14 | 43.8 |
Below-Knee | 10 | 31.3 |
Arm | 1 | 3.1 |
Double amputee | 1 | 3.1 |
Quadriplegic | 4 | 12.5 |
Monoplegic | 1 | 3.1 |
Through-knee | 1 | 3.1 |
Theme | Sub-Theme |
---|---|
Availability of support | Navigating sources of support |
Support from military charities | |
Stoicism | |
Changing housing needs | Unsuitable housing |
Adapting behavior |
© 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
Share and Cite
Wilson, G.; McGill, G.; Osborne, A.; Kiernan, M.D. Housing Needs of Ageing Veterans Who Have Experienced Limb Loss. Int. J. Environ. Res. Public Health 2020, 17, 1791. https://doi.org/10.3390/ijerph17051791
Wilson G, McGill G, Osborne A, Kiernan MD. Housing Needs of Ageing Veterans Who Have Experienced Limb Loss. International Journal of Environmental Research and Public Health. 2020; 17(5):1791. https://doi.org/10.3390/ijerph17051791
Chicago/Turabian StyleWilson, Gemma, Gill McGill, Alison Osborne, and Matthew D. Kiernan. 2020. "Housing Needs of Ageing Veterans Who Have Experienced Limb Loss" International Journal of Environmental Research and Public Health 17, no. 5: 1791. https://doi.org/10.3390/ijerph17051791