Life Care Plans help provide qualitative and quantitative medical and quality of life needs for individuals involved in catastrophic and non-catastrophic injury. A life care plan can ensure that the injured, disabled or chronically-ill person has an adequate plan that addresses future care over the duration of their life expectancy.
This type of life care plan is designed for less severe cases. A non-catastrophic plan applies to individuals with long-term medical needs and serious impairments. While individuals can still work and perform activities of daily living (ADL), there is noted difficulty and loss of life quality. Examples include soft-tissue injuries, disc herniations, instability of the spine and/or chronic pain.
This type of life care plan is reserved for severe cases. If an individual has sustained a permanent injury or requires lifelong medical care, they are likely to fall into this category. Examples include spinal cord injuries, loss of limb, traumatic brain injury, severe burns, and blindness.
Additional areas include birth-related impairment, brachial plexus injuries, chronic pain, polytrauma, spinal cord injuries, thoracic/lumbar spinal cord injuries, cauda equina syndrome, traumatic brain injuries, and severe brain illness.
A Life Care Plan for the Amputee includes a review of history, past medical history, review of systems including a thorough assessment of pain and sexual function, medications, psychosocial history, activity status, vocational history, avocational history, prosthetic history, adaptive equipment used, achievement of maximum medical improvement. Future needs including prosthetic, emotional, rehabilitative, medical, surgical, equipment, architectural modifications, attendant care, vocational options, follow up plan, health maintenance and preventative care, and amputee future life goals when appropriate must also be considered. Potential complications are also assessed.
Additional areas considered when life care planning for an acquired brain Injury include medical complications that arise following injury and the impact on recovery, long-term function, and reintegration in the community; Cognitive problems that change mental function including personality. Long term functional impairment including weakness, spasticity, behavioral problems, and aging are also considered in the life care plan.
Often a Neuropsychological evaluation is required to determine the individual’s future education and work capacity. This also helps with community reintegration and vocational rehabilitation.
Chronic pain syndrome is described as pain lasting longer than 6 months, can worsen with time, and is associated with multiple comorbidities including psychological impact.
Life care planning for chronic pain management requires a plan that is tailored specific to the needs of the individual and often requires an interdisciplinary treatment team that is simultaneous including pain management, medication management, interventional therapies, physical therapy, and psychosocial therapies.
A burn injury life care plan will likely need to address future surgical or reconstruction procedures, pressure garments or splints, prosthetics, nutritional concerns, rehabilitation, transportation or other adaptive sports excursions, health and strength maintenance, supplies, massage therapy and any outpatient services as required to meet the individual’s specific care needs.
Psychiatric care including evaluation and treatment for the burn injured individual as well as spouse or family therapy must also be considered when preparing a life care plan.
Once the polytrauma patient has been stabilized from an organized approach to management the journey of an complex and extended recovery and treatment can begin.
Conditions often experienced with polytrauma include traumatic brain injury combined with one or more injuries such as burns, amputations, spinal cord injury, orthopedic conditions and/or injuries to internal organs.
The complexity of a polytraumatic injury can require lifelong medical and health care needs. A life care plan can play a pivotal role in identifying cost, needs, and increase the quality of life for the injured.
The life care plan can help outline from a qualitative and quantitative perspective the need for care, treatment, and rehabilitation of individuals with SCI.
A spinal cord injury life care plan will likely require input from medical and surgical specialties, nursing, multiple therapeutic disciplines, case managers, as well as other health professionals. Environmental modifications, adaptive devices, home and vehicle modifications, supplies and durable medical equipment must also be accounted for in a life care plan.
Brachial Plexus Injury are most commonly caused by closed brachial plexus trauma such traumatic injuries secondary to motor vehicle accidents, industrial accidents, falls, or objects falling on a shoulder. Open traumatic brachial plexus injuries may be as a result of gunshot wounds, lacerations or animal bites. Other traumatic plexopathies include high energy stretching (root avulsions), burner syndrome secondary to contact sports, or backpack palsy (cadet palsy). Nontraumatic plexopathies can be secondary to an inflammatory disorder, neoplastic and radiation induced or Iatrogenic plexopathies as a result of a medical procedure can also occur.
A life care plan can help identify future health care and medical needs of those suffering brachial plexus injury.
A life care plan for a birth related injury can provide the framework for immediate and future long-term care needs of the child. In addition to working in collaboration with treating providers, a life care plan help calculate future medical cost and care expenses. Future long term care needs can include medical, education, and/or rehabilitation.
Life care planning is a process of applying methodological analysis to formulate diagnostic conclusions and opinions regarding physical and/or mental impairment and disability for the purpose of determining care requirements for individuals with permanent or chronic medical conditions.
The International Association of Rehabilitation Professionals states the official definition of life care planning as “The life care plan is a dynamic document based upon published standards of practice, comprehensive assessment, data analysis, and research, which provides an organized, concise plan for current and future needs with associated costs for individuals who have experienced catastrophic injury or have chronic health care needs.”
Topics considered for inclusion in a life care plan include evaluations, therapies, diagnostic testing, medical and adaptive equipment, aids for independent functioning, prescription and nonprescription medications, home care/facility care, routine medical care, transportation, architectural modifications, potential complications, surgical intervention, and vocational services.
A qualified life care planner follows a consistent methodological process to establish a reliable and valid findings. Salient steps include a comprehensive review of all available records and supportive documentation, interview of injured party including family members or key persons who knew the person both before and since onset of injury, direct consultation with treating providers and/or evaluating professional to establish needs and services, reference clinical practice guidelines and relevant research literature, as needed, identify services to meet identified recommendations, research and document charges associated with recommended services specific to injured person’s location over remaining life expectancy.
Life Care Planners are comprised of Health Care Professionals such as Nurse Practitioners (APRN), Nurses, Occupational Therapist, Physical Therapist, Psychologist, Physician Assistants, Physicians, Rehabilitation Counselors, and Case Managers.
The Certified Life Care Planner (CLCP) credential is issued by International Commission on Health Care Certification (ICHCC) and was the first certifying body for life care planners and issued the first life care planner certification examination in March 1996. The Certified Nurse Life Care Planner (CNLCP) certification was formed for nurses only and is available through the Certified Nurse Life Care Planner Certification Board.
To begin the life care planning process, an Attorney must share the medical records to begin the comprehensive review process.
Any reports written by experts, depositions transcripts by plaintiff, experts, and family members should also be provided.
A life care plan can benefit anyone involved in catastrophic and non-catastrophic injury that will require ongoing medical care.
Examples of injury or chronic conditions include traumatic brain injury, spinal cord injury, chronic pain, complex regional pain syndrome, disc herniations, cervical spine instability, birth injury, amputations, and more.