A. Life care planning is a program recently established for the management of the care, resources, and services required by the catastrophically injured or the person suffering from a chronic condition.

B. Life care planning focuses on promoting the patient’s independence and empowerment, as well as the enhancement of the quality of care to ensure a meaningful life for the chronically or catastrophically ill.

C. According to the International Academy of Life Care Planners (IALCP), life care planning is defined as an advanced and collaborative transdisciplinary practice that includes the patient, family, varied care providers, and other parties who are concerned in coordinating, accessing, evaluating, and monitoring the necessary services required for the care of a catastrophically injured or chronically ill client (IALCP, 2006a).

D. Life care planning is a transdisciplinary specialty practice. Each professional, including rehabilitation specialists, nurses, case managers, physicians, social workers, and other allied health personnel, involved in life care planning brings his or her expertise and specialization to the life care planning process and to the life care plan for the ultimate benefit of the patient.

E. The standards of practice for life care planning are developed based on the standards of practice of the individual disciplines that constitute the life care planning team such as nursing, medicine, case management, and rehabilitation.

F. IALCP is the professional organization responsible for the development, maintenance, and promotion of life care planning standards.

A. Accessible—A term used to denote buildings/environments that are barrier free, thus allowing all members of society safe entry and exit.

B. Actionable tort— A legal duty imposed by statute or otherwise, owing by a defendant to the person injured.

C. Assessment—The process of collecting in-depth information about a person’s situation, family, and functioning to identify an individual’s needs in order to develop a comprehensive life care plan. Information should be gathered from all relevant sources (patient, family, caregivers, employers, medical records, etc.).

D. Clinical practice guidelines—Systematically developed statements on medical or nursing practices that assist a practitioner in making decisions about appropriate diagnostic and therapeutic health care services. Practice guidelines are usually developed by authoritative professional societies and organizations.

E. Deposition—The testimony of an individual taken under oath, but not in open court, on the subject at hand, reduced to writing and authenticated, which may be used in court.

F. Efficacy of care—The potential, capacity, or capability to produce the desired outcome through evidence-based findings.

G. Expert witness—An expert qualified to provide court testimony by virtue of knowledge, skill, experience, training, or education.

H. Exposure—The amount of money for goods, care, and services an insurance company owes, when there is liability for the injured/ill person.

I. Life care plan—A dynamic document based on published standards of practice, comprehensive assessment, research, and data analysis, 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.

J. Life care planner—A health care professional specifically educated regarding the methodology for life care planning. Professionals engaged in this specialty practice may be nurses, vocational rehabilitation counselors, rehabilitation psychologists, physicians, occupational therapists, social workers, physical therapists, and speech/language pathologists.

K. Outcome—The result and consequence of a health care process. In life care planning, an outcome is used to describe the result of the expected care or services.

A. The aims of life care planning are similar to those of case management and may include the following:

A. The life care planning process is similar to that of case management. It includes the following activities (IALCP, 2006b):

A. The case managers in a life care planning program are called life care planners. They use tools such as the life care plan to provide individualized and comprehensive life care services. In their roles, they project current and future long-term care needs that are congruent with the level of disability evident in the condition of the catastrophically injured or chronically ill individual.

B. Life care planners must possess appropriate educational and licensure requirements and knowledge as defined by their profession and its associated standards and scope of practice.

C. Life care planners must have a foundation of knowledge and appropriate experience in a specialty such as rehabilitation or nursing. According to IALCP (2006b), they:

A. The term life care plan was introduced into the health care literature in 1981 by Paul Deutsch and Fred Raffa in a legal publication entitled Damages in Tort Action. The publication described how damages could be identified in civil litigation.

B. In 1987, the life care plan was introduced into the field of rehabilitation in Guide to Rehabilitation (Deutsch and Sawyer, 1987). The life care plan was identified as part of a rehabilitation evaluation to project the impact of catastrophic injury on an individual’s future and was differentiated from a discharge plan by its specification of costs for long-term services to meet the needs of the catastrophically injured patient.

C. Communicated in 2000 and revised in 2006, the IALCP published the following definition of the life care plan: “A life care plan is a dynamic document based upon published standards of practice, comprehensive assessment, research and data analysis, 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” (2006b).

D. The life care plan has been utilized in a variety of health care settings, including the legal and ethical domains, to provide information regarding the cost of services needed for the catastrophic and long-term care of an individual. Life care plans focus mainly on rehabilitation planning, services implementation, management of health care costs and funds, transitional/discharge planning, and patient and family education (IALCP, 2006b).

E. An example of a life care plan is shown in Table 17-1.

F. A life care plan is also used as a tool in the administration and litigation of catastrophic injury claims of persons who have long-term health care needs related to a chronic illness. In this case it:

G. Characteristics that differentiate life care plans from other plans of care are: