Toileting self-care methods for bilateral high level upper limb amputees

One of the most important problems for the bilateral upper limb deficient patient is the inability to manage toileting activities. Dependence in this area precludes schooling or work. This paper surveys available clothing types and adaptations to facilitate doffing and donning clothing and devices for genital cleansing and menstrual care. The devices are analyzed for suitability for different types and levels of high deficiency and purposes. Independence requires intense motivation of the patient and elimination of overprotection by the parents.