What's in a Life Care Plan? Part II

In the second part of our What’s In a Life Care Plan series, we add detail to the framework we described in Part I. Discussion will be based in part on the seminal 2018 article in the Journal of Life Care Planning by Johnson and collaborators. The discussion outlines the most recently collected, generally accepted Consensus and Majority Statements derived from over ten years’ worth of professional planning summits.

Projected Evaluations: This section of the life care plan is the primary section where certified Life Care Planners (CLCP’s) are allowed to make recommendations independent of treating or consulting physicians. Johnson et al. (2018) note that “Life Care Planners may request additional data, testing, and evaluation if required.” For example, if during a clinical interview, an evaluee complains of urological symptoms with an onset after the index injury, it is within the CLCP’s purview to include a one-time urology assessment to help inform future care.

Projected Therapeutic Modalities: Inclusive of ongoing treatments, many of which are provided by allied health providers, it is essential that life care plans include the opinions of those providers. Treating and consulting physicians typically outline specific treatment protocols for therapies like physical and occupation therapy. It is sometimes useful to speak to the treating therapist to get their insight regarding some of the nuances the evaluee’s treatment may require. For example, when therapies are anticipated to be ongoing for an extended period or indefinitely. It could be useful to consult with the treating therapist to learn how that treatment may change over time.

Medications: It is no secret that medication costs vary widely and have escalated significantly over time. Although there is no clear consensus on the issue, life care plans should take into consideration the effects that generic medications can have on overall costs. There are varying points of view on this issue. For example, in some instances, life care plans include the exact medication outlined by the prescriber. If the physician recommends the brand name medication, that is what is budgeted, and if they recommend the generic, that is included. In some instances, both generic and brand are included to create a range of expected future costs. The argument for including solely brand name is that this often-higher cost will allow for the use of medications developed in the future that may work better but cost more. Regardless of how they are reported, the issue of brand vs. generic pricing should be incorporated into the plan and readily defensible.

Attendant Care: The assistance an individual needs in the home to safely complete their activities of daily living (ADLs) can be one of the most crucial and potentially most costly sections of the plan. In clearly catastrophic cases where the individual is severely physically limited, it may be easier to identify the amount and intensity of assistance required. But what about the less catastrophic cases where a patient’s wife is helping with dressing, supervising bathing, cleaning, cooking, and transporting the injured individual. These services have value, and it is often easiest to conceptualize by imaging what life would be like if the spouse were to die or leave. Is the man not entitled to the ADL assistance that he did not require pre-injury? Furthermore, do we build in the cost of private hire or agency care? Again, our Consensus statements guide our methodology by noting that “When the life care planner includes home care, both private-hire and agency procured services are options to be considered.”

These are just a few thoughts regarding the intricacies of life care planning. To discuss a potential case assignment, we offer complimentary consultations concerning "hypothetical matters."

To strategize with one of our vocational experts or life care plan experts at Stokes & Associates please call David Barrett at 504-454-5009, visit our website, www.stokes-associates.com or email dbarrett@stokes-associates.com.


Larry S. Stokes, Ph.D.
Aaron Wolfson, Ph.D.
Lacy Sapp, Ph.D.
Todd Capielano, M.Ed., LRC, CRC, LPC, CLC
Ashley Lastrapes, MHS, CRC, CCM, LPC, LRC