This message has been cross posted to the following Discussions: Forensic and Life Care Planning - IALCP .
-------------------------------------------
Here's a challenge for you - I've worked through most of it in my mind but would very much welcome and appreciate your thoughts.
Life care plan. Young male (27) suffering from a most unfortunate pre-existing, (2 1/2 year duration) severe, debilitating pain from pudendal neuropathy sustains a T10-11 spinal cord injury at age 20.
Prior to the SCI, there were multiple failed treatment efforts, including a airflight in a strecther to seek treatment at a reknown center in Texas. Person had extremely low tolerance for sitting due to location and intensity of his pain, ergo, the plane on a stretcher to Texas. Other functional limitations: severely limited standing/walking - used walker for short distances and wheelchair for longer distances in the house. Required assistance with ADLs - bathing, dressing, food prep Multiple, high dose narcotics with abuse. Extreme psycho-social dysfunction ( anger and rage) with hostility to healthcare professionals and aggressive outbursts upon parents requiring police intervention ( All the aforementioned is pre-SCI, the subject injury for the LIfe CAre Plan)
One outcome of the SCI was to eliminate the debilitating pain of the pudendal neuropathy. Consequently, post-SCI there is
improved functional capabilities in some areas - sitting tolerance being a primary one, independence in bathing, dressing, food prep, driving ( hand controls), and overall psycho-social functioning ( working part-time) college(part-time). Narcotic pain medications ceased
As counter-intuitive and uncommon as it seems, the SCI has, in some areas, resulted in
improved functioning and quality of life
So... Question, for example: Pre SCI, couldn't drive and there was nothing on the horizon to suggest that he would. Post - injury he can and does, with handcontrols. Do handcontrols, and other similar items he wouldn't have needed pre-SCI because of his low functioning, get inculded in the plan ( which by the way is within the context of litigation). (If so iin one sense it doesn't seem like a "damage" that has arisen from the injury, but a sort of "gain", and I'm just not certain as towhether and how to handle these particular aspects in the plan. (Other needs arising from the SCI are more clear cut to me). Thanks for your thoughts!
-------------------------------------------
Jack Bopp
Rehabilitation Consultant
rsa@tds.net Henniker, NH United States
-------------------------------------------