Life Care Planning
What Is a Life Care Plan?
A Life Care Plan is a comprehensive, interdisciplinary document developed by a team of specialists to project the future costs of medical goods and services, medical equipment, medications, rehabilitation needs, and other necessary services for individuals who have experienced catastrophic injuries or chronic illnesses.
The professionals involved in developing a Life Care Plan may include healthcare providers, physicians, financial professionals, prosthetists, durable medical equipment providers, insurance professionals, and other qualified specialists.
A Life Care Plan is a dynamic document based on published standards of practice, comprehensive assessments, data analysis, and research. It provides organized and concise planning for an individual’s current and future healthcare needs, along with the associated costs. Each professional contributing to the plan operates within the standards of their respective discipline to ensure accuracy, accountability, and adherence to professional and ethical guidelines.
Who Needs a Life Care Plan?
Life Care Plans are created for individuals who have experienced catastrophic injuries or who have chronic healthcare needs requiring an assessment of future medical costs. Examples include:
- Stroke and brain injuries
- Amputations
- Aneurysms
- Anoxic and traumatic brain injuries
- Concussions
- Autism
- Birth injuries
- Brachial plexus injuries
- Burns
- Blindness
- Deafness
- Emphysema
- Cerebral palsy
- Medical malpractice cases
- Orthopedic injuries
- Spinal cord injuries
- Reflex Sympathetic Dystrophy
- Personal injury cases
- Chemical exposure cases
- And many other conditions
In summary, individuals facing chronic physical, medical, or psychological conditions can benefit from this type of comprehensive analysis. Life Care Plans are used in litigation, settlement planning, and long-term financial planning for individuals with significant medical needs or disabilities.
Purpose of a Life Care Plan
A Life Care Plan is developed to support the individual who is the subject of the plan. Its purpose is to assist in achieving optimal outcomes by identifying appropriate treatments, preventive measures, and long-term care needs while considering insurance and financial factors.
A Life Care Plan should provide accurate, timely cost information, detailed service recommendations, and supporting documentation that can be utilized by the individual and involved parties. This information helps determine anticipated medical needs, projected costs, and the financial resources required to support the individual’s future care.
Developing a comprehensive Life Care Plan requires extensive research and consideration of multiple factors. The process may include:
- A thorough review of all available medical records
- Data analysis to evaluate previous surgeries, hospitalizations, diagnoses, treatments, and medications
- Projection of future medical costs based on anticipated healthcare needs and services
- Vocational assessment to evaluate loss of earning capacity, transferable skills, and potential future employability
- Functional Capacity Evaluation (FCE) to assess physical abilities and projected limitations
Components of a Life Care Plan
The following is a partial list of services and needs that may be included in a Life Care Plan:
Outpatient Medical and Surgical Care
- Physician visits
- Osteopathic care
- Chiropractic care
- Rehabilitation and physical therapy
- Functional Capacity Evaluations (FCE)
Inpatient Care and Hospitalizations
- Hospitalizations for psychiatric and psychological conditions, including services provided by psychologists, psychiatrists, speech therapists, social workers, and counselors
- Hospitalizations related to treatment, surgery, diagnostic testing, and medical or surgical conditions
Laboratory Testing
- Urine testing
- Blood testing
- Tissue and pathology testing
- Body cavity fluid testing
Ancillary Testing
- Pulmonary function tests (PFT)
- Electroencephalography (EEG)
- Electromyography and nerve conduction studies (EMG/NCV)
- Electrocardiograms (EKG)
- Visual Evoked Stimuli (VES), Auditory Evoked Stimuli (AES), and other brain stem evoked responses
Imaging Studies
- X-rays
- CT scans
- MRI scans
- Nuclear medicine scans
- Ultrasound
- Exercise stress testing and other cardiac evaluations
- PET scans
Surgical Services
- Outpatient procedures
- Inpatient procedures
Prosthetics and Rehabilitation Equipment
- Fabricated devices, including ankle-foot orthoses (AFOs) and artificial limbs
- Mobility equipment, including cars, scooters, and motorized devices
- Wheelchairs
- Colostomy supplies and care
- Canes and crutches
- Specialized beds
- Home modifications, including ramps, elevators, chair lifts, bathroom safety equipment, and related adaptations
Miscellaneous Medical Devices
- Spinal cord stimulators
- Implantable defibrillators
- Pain pumps
- TENS units
Miscellaneous Procedures
- Radiofrequency ablation
- Endoscopy
- Colonoscopy
- Similar medical procedures
Equipment and Supplies
- Attendant care
- Home health aides
- Home rehabilitation aides
- Home cooking and shopping assistance
- Home RN and LPN care
Vocational Assessment and Rehabilitation
Specialized skills required for Life Care Planning include the ability to research and critically analyze data, manage and interpret large volumes of information, evaluate details, communicate clearly in written and verbal formats, and develop professional networks for information gathering and referrals.
Services may include:
- Vocational skills testing
- Vocational rehabilitation evaluations
- Retraining cost analysis
- Assessment of transferable skills and employability
Additional Professional Services
- Psychologists and psychiatrists
- Speech therapists
- Social workers
- Counselors
Financial Analysis
A Life Care Plan may also include financial analysis involving:
- Usual, customary, and reasonable (UCR) guidelines
- Medicare reimbursement tables
- Prevailing healthcare charges
Life Care Planners must have a broad understanding of the medical disciplines involved in developing comprehensive care plans. They must understand long-term care requirements and apply evidence-based medicine when presenting recommendations and supporting data. Knowledge of healthcare administration, medical billing practices, and the relationship between insurance and medical care is essential to developing an accurate and effective Life Care Plan.