Life Care Planning
01 / Definition of a Life Care Plan
As defined by the International Academy of Life Care Planners (p. 3):
The life care plan is a dynamic document based upon published standards of practice, comprehensive assessment, data analysis, and research, which provides an organized, concise plan for current and future needs with associated present-day cost for individuals who have experienced a catastrophic injury or have chronic health care needs.
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The philosophical overview of a life care plan (LCP) as provided by the International Academy of Life Care Planners (2022, p. 4-5):
The life care plan is a document that provides accurate and timely information which can be followed by the evaluee (the person who is the subject of the life care plan) and relevant parties. It is a detailed document that can serve as a lifelong guide to assist in the delivery of health care services. The life care plan reflects a collaborative effort among the various parties, when possible, and the goals that are preventative, habilitative, palliative, and rehabilitative in nature and should optimize outcomes. As a dynamic document, the life care plan may require periodic updating to accommodate change.
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A life care plan is intended to objectively detail an individual’s predictable current and future needs considering physical and mental health, wellness, as well as quality of life. To create an LCP, a systematic process is used to determine an individual’s:
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medical and functional status,
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current and future needs, and potential complications.
02 / Transdisciplinary Perspective
As per The International Academy of Life Care Planners, (p. 4), the practice of life care planning is a transdisciplinary specialty practice:
Each profession brings to the process of life care planning practice standards that must be adhered to by the individual professional, and these standards remain applicable while the life care planner engages in life care planning activities. Each professional works within their own scope of practice, standards of practice, and regulatory requirements that ensure accountability, provide direction, and describe the mandated responsibilities of their field. These standards include, but are not limited to, activities related to quality of care, qualifications, collaboration, law, ethics, advocacy, resource utilization, and research. The life care planner is responsible for following the standards of practice for life care planners
The life care planner must examine their qualifications, training, and experience as applied to each individual case. Therefore, knowledge of diagnoses, disability, and future care considerations are necessary components of the professional’s competency for the development of each life care plan.
In multidisciplinary practice, professionals are aware of, and may draw on, knowledge from other disciplines, but they do their work independently, as in silos. In interdisciplinary practice, there is sharing of information, collaborative analysis and synthesis, and coordination of activity (Mauk, 2019). In transdisciplinary practice, professionals “work jointly using a shared conceptual framework that draws together discipline-specific theories, concepts, and approaches to address a common problem” (Fuqua, 2012, p. viii). Transdisciplinary teamwork suggests that clinicians from various disciplines “regularly teach, learn, and provide care across disciplinary boundaries” (Cartmill et al., 2011, p. 8).
03 / Scope of Practice
Life care planning is a specialty practice in which a rehabilitation or health care professional may engage. To achieve the goals of creating transdisciplinary life care plans, the life care planner comprehensively identifies future care needs with associated costs. While life care planners may independently make recommendations for care items/services that are within their scope of practice, the depth and breadth of that independence depends on their professional scope of practice, their basic professional training, specialized education, practice experiences, other professional roles performed, and the populations served.
A life care plan encompasses biopsychosocial needs, the ability to participate in activity, and quality of life. The recommendations may include, but not be limited to:
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Preventive and restorative health, wellness, and medical care (e.g., professional healthcare providers, diagnostic testing, surgery, other medical interventions, specialty treatment programs, medications, disposable supplies, health maintenance).
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Equipment and adaptive aids for function (e.g., mobility devices, orthotics, prosthetics assistive technology, tools to improve functional independence).
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Community support and accessibility services (e.g., home attendant care or facility care, household services, transportation, accessibility modifications and furnishings, adaptive or therapeutic recreation, education, vocation, avocation, financial counseling, fiduciary conservator services).
To address the future care needs, the life care planner collaborates with other professionals in order to develop a transdisciplinary life care plan inclusive of recommendations outside of the individual life care planner’s professional scope of practice. No single rehabilitation or health care professional is trained to have comprehensive expertise in all areas where recommendations may be needed. Even within a profession, there are specialty and sub- specialty divisions, which may limit the life care planner’s ability to independently make all needed recommendations.