Life Care Planning after Brain Injury

Surviving Brain Injury Requires Planning

By Patricia L. Jackson, B.S., C.B.I.S. and Michael W. Davis, C.B.I.S.- C.E.T

Is it really happily ever after? 

The Life Care Plan is designed to identify long term needs through a comprehensive assessment of the client’s medical, physical, behavioral and emotional status.  Once the data is evaluated, a Life Care Plan outlines what services the client will need over the course of a lifetime to maintain physical health and emotional well being.  Contrary to popular belief, after a Life Care Plan is deemed necessary and finalized, the client, a.k.a. the subject of the Life Care Plan, is not set for life. 

In reality, it is after a Life Care Plan is finalized that the real work begins.  The Life Care Plan is a necessary map to direct the client’s way along the path of life.  If it is taken at its worth, the client will have access to the supports that were identified to facilitate successful care over the long run.  Unfortunately in a majority of cases, the Life Care Plan simply finds its way into a file cabinet and is stored along with other medical and legal documents.  

Who are the players in the plan? 

Somewhere along the way a major component is overlooked.  The medical and rehabilitation specialists do their jobs by identifying the needs of the client.  The family hires legal representation to help them do the best they can for their loved one.  The attorney’s obligation is fulfilled by presentation of a comprehensive Life Care Plan in court.  The judge (and perhaps jury) recognize the severity of the injury and find in favor of the client.  The decision is made about a financial settlement that will ensure access to whatever services had been deemed necessary for care over the client’s lifetime.  And then, everyone goes home.

Money doesn’t guarantee services 

Although life care planning focuses on caring for the needs of the injured person, a financial award in itself does nothing to guarantee client services.  There is a huge gap in the system.  The family is not always aware of the how-to’s in the rehabilitation community, yet they are most often the ones left holding the “plan” so-to-speak.  Even experts within the system find that it can be difficult to access services.  It is a grave disservice to expect that a client’s family members will know how to work through the complexities of a system, including as the maze of rehabilitation services. 

The case manager is the missing link  

A case manager who specializes in the implementation of Life Care Plans can fill that void.  Working with the family, a case manager takes charge of the Life Care Plan to access and arrange the services identified for the client.  

The role of each person involved in the Life Care Plan process is defined and is important.  Each specialist is responsible for their area of expertise.  However, the reality is that every individual involved in the case has an ethical responsibility to see that what they recommend is in fact carried out.  

It is not enough to identify, acknowledge and provide financial resources to help the client.  The care the client deserves and is entitled to should not be compromised simply because no one is identified to assume responsibility for implementing the Life Care Plan.  A case manager assures that the finances are utilized in the way that they were designated, rather than leaving follow-up client care to chance.  The Case Manager doesn’t have all the answers, but will find the resources to get the answers that the client and family deserve.

Case managers can help fulfill the intent of a life care plan

Surely it is the intent of the judge and our legal system as a whole to provide financial support by way of a settlement when they find in favor of a client.  When utilized properly, a financial award will provide support and services for the client who has sustained a serious injury.  A financial award that is misused or used improperly not only doesn’t help or support the client, but it also causes greater harm by decreasing the client’s chance for success and an improved quality of life.  Misuse will also most likely create a host of secondary problems resulting from lack of proper medical and psychological care. 

A case manager can be the critical missing link.  By monitoring the client’s status and maintaining communication amongst all the parties involved, the client’s care will remain in the forefront as the true priority.  After all, quality client care is the true intent of any financial settlement. 

Patricia Jackson is a Case Manager and Michael Davis is the President and Senior Case Manager with Neurological Case Management Associates, specializing in the field of neurological rehabilitation, in Charleston, WV.

For more information from Lash and Associates Publishing/Training, Inc., see:

Adult Mini Tool Kit on Traumatic Brain Injury for Families

This Adult Mini Tool Kit is designed for lawyers and life care planners to give to families with information on traumatic brain injury. 

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