Language Choices in Life Care Planning

When developing life care plans by consulting with physicians and other professionals for future medical care needs, it is essential to consider words carefully to ensure that all parties communicate effectively and are "on the same page."

We use terms like "on a more probable than not basis," "more likely than not," and "more than a 50% chance of being required" when asking about future medical care needs. The Standards of Practice for Life Care Planners states that "the life care planner facilitates understanding of the life care planning process" and "provides information about the life care planning process to involved parties to elicit cooperative participation." The person we are consulting with must understand what we mean by these terms to obtain the appropriate information. It may seem clear to the life care planner what is meant by these terms; however, different professionals may interpret them differently, especially treaters with limited experience consulting with life care planners.

In a recent case, we consulted with an orthopedic surgeon, Dr. Smith, to obtain his recommendations for John Doe's future medical care due to a motor vehicle accident. When we spoke with the surgeon, we needed to clearly communicate that we were inquiring about any care required from the present through life expectancy and only future medical care specifically related to the indexed incident. The care needs to be probable and not just possible. Our review of Dr. Smith's medical records for Mr. Doe noted that Mr. Doe had a spinal fusion due to this incident two years prior.  Therefore, we asked if Mr. Doe would require an adjacent level fusion in the future due to adjacent segment disease. Dr. Smith said it was a possibility (not included in a life care plan). We went on to ask if, in Mr. Doe's remaining life expectancy, there was more than a 50% chance that Mr. Doe will require an adjacent level fusion due to the indexed incident. Dr. Smith stated that patients typically require an adjacent level fusion within 17 years from their initial fusion date.  Based on Mr. Doe's age of 47, he would require an additional surgical intervention on a more probable than not basis (included in a life care plan.)  Dr. Smith also recommended associated pre-and post-operative care. If we had not explained further and communicated effectively, Mr. Doe's life care plan would have been underfunded.

It is essential to document the information obtained in consultation and use accurate language so there is no confusion about the life care plan's recommendations.

To strategize with one of our vocational rehabilitation or life care plan experts at Stokes & Associates, please call Dave Barrett at 504-454-5009, visit our website, www.stokes-associates.com, or e-mail 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, CLCP, LPC, LRC
Brandy Bradley, MHS, CRC, LRC, CLCP
Elizabeth Peralta, M.Ed., LRC, CRC, CLCP