Life Care Plan

Three Foundations of Life Care Planning:

1. Understand the medical problem and orbiting consequential medical, emotional problems

2. ​​​​​​​What will be the medical services, therapies, medications and equipment needs for the future (understanding there will be aging)

3. What will be the costs?

What is a Physiatrist?

In 1946, the American Board of Specialists noted that orthopedic doctors lacked neurological training and that neurologists lacked orthopedic training and an understanding of long-term consequences for employment as well as long-term care and consequences of aging.
Physiatrists were defined as nerve, muscle, bone, and brain experts who focus on injury, function, and rehabilitation. (American Academy of Physical Medicine and Rehabilitation, Vol 4, 247-251, April 2012)

Physiatry Training

Physiatrists are medical school graduates who attend certified residency programs and have completed both written and oral examinations administered by the American Board of Physical Medicine and Rehabilitation. Fellowships are available for specialized study: Musculoskeletal rehabilitation, pediatrics, traumatic brain injury, spinal cord injury, and sports medicine.

Physiatry Based Life Care Planning

A Life Care Plan identifies the Medical and Functional outcomes and costs following an injury. For a Life Care Plan to appropriately provide for all the needs of an individual, the plan must have a strong medical foundation. Physicians specializing in Physical Medicine and Rehabilitation (Physiatrists) are uniquely qualified to provide a strong medical foundation for life care planning based upon their training and experience in providing medical and rehabilitative services to individuals with disabilities. Physiatrists are, by their training, experienced in dealing with individuals who have catastrophic functional problems. Additionally, physiatrists are trained to anticipate the long-term needs of their patients.” (The Life Care Planning and Case Management Handbook, 3rd Edition)

What is a Life Care Plan?

A document which identifies medical problems, what will be the required long-term care over the aging process as well as the associated costs.

A Life Care Plan addresses the following:

1. What is the subject’s condition?

2. What are the medically-related goods and services doe the patient needs?

3. How much do these needs cost?

Physiatry Treatment Approach

Physiatry uses a unique approach to treating patients, including:

1. Physical restorative programming (braces, passive and active therapy)

2. Adjustment to a disability including psychological programming for cognitive reframing, pacing, and vocational retraining

3. Pharmacological treatments including serotonin replacement, anticonvulsants, hypnotics, Cox-2’s, and Opioids

4. Procedural interventions ranging from surgeries to steroid injections.

Life Care Planning Methodology

Three Foundations of Life Care Planning

1. Understand the medical problem and orbiting consequential physical and emotional problems.

2. What will be the medical services, therapies, medications, and equipment needs for the future (understanding there will be aging)?

3. What will be the costs?

Patient and Family

A Life Care Plan provides for the patient, as well as the family. As each case is different, the global impact of injury affects all involved. At times, daycare and emotional support for children and husband or partner are required.

Why Use a Physiatrist for Life Care Planning?

​​​​​​​The physiatrists at PLCPA consider themselves to be educators in a courtroom. They are able to describe the mechanics of the injury, including shearing forces of TBI, long-term endocrine complications with brain injury, as well as cognitive and vocational losses. They are able to identify types of therapies and physicians which will be required, as well as the intensity and amounts of attendant care needed (Nursing, CNA, HHA).