A life care plan formally establishes the basis for future care needs and costs, particularly in cases of severe disability due to a catastrophic injury or illness. A life care plan provides a systematic and dynamic needs-based assessment of future health-care costs. The main issues from the standpoint of a physician life care planner are:
- the examinee’s clinical condition,
- the services and goods the examinee needs going forward, and
- the cost of those goods and services.
In many cases of severe disability, the physician life care planner will need to visit the examinee at home or in a long-term care facility to obtain a first-hand impression of the examinee’s daily care routines, functional ability, and available assistive technology. A televideo interview and examination can be helpful for an initial evaluation but an in-person visit may still be advisable at a later date. A televideo evaluation can be conducted from the examinee’s home, an acute-care or long-term rehabilitation facility (after institutional approval has been obtained), or the office of the examinee’s legal representative.
The presence of the examinee’s spouse or partner, parent or guardian, or legal representative is usually helpful. In some cases, photographs or video documentation of the functional ability of the examinee can help visually communicate the specific degree and severity of impairment and disability and may be integrated into or attached to the final life care plan document.
Dr. Zünkeler believes that the dignity and privacy of the examinee are of paramount importance. Therefore, to the extent necessary, the stepwise process of creating the life care plan is explained to the examinee and caregiver(s) or legal representatives. Written permission is obtained before any work is done. The life care plan is a dynamic document and may need to be updated as new information becomes available. Before completion, the life care plan is shared with the examinee and legal representative (and sometimes with the treating providers) to provide an opportunity for additional input .