Life Care Pl Deutsch And Raffa

Life Care Plan

In 1981, Paul Deutsch and Fred Raffa introduced the term life care plan (LCP) into the health care literature. Life Care Plans provide an organized plan for the current and future health needs of a patient with chronic health care needs or has experienced a catastrophic injury. Unlike plans of care, which focuses on planned interventions, the life care plan projects the patient’s needs in the future. The LCP is developed using a comprehensive assessment, data analysis, standards of practice, and research. Life care plans are used by multiple disciplines and each one must adhere to standards of practice for their individual profession. In addition, each professional must provide direction and assure accountability for the

portion of the care plan they develop. The information provided in the care plan should be easy for all parties to understand and be updated when necessary to serve as a lifelong guide for health care services (Weed & Berens, 2010). The five categories of a life care plan (LCP) assessment include: background information and assessment, physical needs, social and occupational needs, psychological well-being, and spiritual well-being and life goals (National Cancer Action Team, 2010).
Background Information and Assessment Preference
The first step in preparing a life care plan is the assessment. The life care planner should review the patient’s chart and record all pertinent information in the care plan, this will assist in identifying changes that may have occurred following the previous assessment. The background information includes pertinent patient data. The assessment preference should include the life care planners contact information, reason for the assessment, site the assessment occurred, the patients’ ability and willingness to participate, and the patients’ preference for how much information to be shared with the family/caregiver (National Cancer Action Team, 2010).
Challenges can occur when creating a life care plan using the background information from the patient’s record. Paper-based records may be illegible and fragmented. Although computer-based records provide access to all patient data, it also can have flaws, the information in both systems may not be updated or accurate. Patient information should be routinely assessed for accuracy and updated when needed, this will assist in creating a plan for the future (Wilcox, Jones, Dorr, Cannon, Burns, Radican, & Clayton, 2005).
Physical Well-being
In this domain, the life care planner will assess the patient needs to ensure they are met. Not all patients will experience the same physical symptoms associated with a specific disease or illness. In order to assure the needs are met, a self-assessment must be completed prior to meeting with the health professional. Questions included on the self-assessment will help describe the problem/symptoms, the effects on normal activity, treatment/management of the problem, results of the treatment, and physical effects (National Cancer Action Team, 2010).
The physical well-being of a patient with colorectal cancer may be determined by the background information and choice of treatment. Studies indicate that some physical functioning may be reduced following certain treatments, like surgery, and returned to normal during the healing process. In addition, the planner must take the patients age and support system into consideration when initiating the plan, which can account for a possible decline in physical functioning. The European Organization for Research and Treatment of Cancer QoL Questionnaire (EORTC QLQ) can be used to assess the physical and functional effects of colorectal cancer on the patient. Once completed, the planner can make adjustments to meet the needs of the patient in the future (Rønning, Wyller, Jordhøy, Nesbakken, Bakka, Seljeflot, & Kristjansson, 2014).
Social and Occupational Well-being
The social and occupational well-being assessment provides valuable information on how the patient is managing their condition at home, in the community, with family and friends. In addition, any issues pertaining to the work environment, finances, social and recreational activities will also be identified (National Cancer Action Team, 2010).
The social and occupational well-being of long-term cancer patients usually becomes affected as the disease progresses and/or with treatment regimens. Colorectal cancer can affect the patients’ quality of life (QoL), depending on the stage and intensity of the symptoms. The life care planner may be able to predict the future social and occupation needs of the patient based on the stage of the cancer at diagnosis and the recommended treatments. Specific side effects can be associated with the treatment of choice, therefore, a plan can be developed to accommodate the patients’ needs based on the length of the treatment. The European Organization for Research and Treatment of Cancer QoL Questionnaire (EORTC QLQ) is a widely used instrument to measure QoL (Heydarnejad, Hassanpour, & Solati, 2012).
Psychological Well-being
The purpose of this assessment is to identify any psychological needs the patient may have experienced with an illness. The psychological assessment should begin with questions that will encourage the patient to express their concerns and/or emotional problems, followed by questions that identify the patients understanding and strengths (National Cancer Action Team, 2010).
The prevalence and degree of psychological distress a patient may experience can vary based on the illness, time lapse since diagnosis, amount of physical impairment, and the prognosis. Predicting the future psychological needs of a patient dealing with colorectal cancer can be difficult. A patient may develop post-traumatic stress disorder (PTSD) at diagnosis, however, the symptoms of PTSD may not appear for several months or years. The Holistic Needs Assessment is a tool used to assess the psychological, physical, spiritual, social, and financial support for patients with cancer. It builds on past assessments and assist with future adjustments to meet the changing needs of the cancer patient (National Cancer Action Team, n.d.).
Spiritual Well-being and Life Goals
The life care planner must take precaution when introducing the subject of spiritual well-being into the assessment.

Patients may have spiritual needs to reach their life goals, but have not realized it. The planner must have knowledge of the patient’s cultural/ethnic background, which can allow for appropriate questions regarding spirituality. In order to prevent potential harm to the patient, the life care planner has to have knowledge of alternative words used to refer to spiritualty and respect the patients’ preferences. The life goals assessment explores the patients’ desires for achieving goals in their life (National Cancer Action Team,

2010).
Life care planners may have a challenge developing a plan extending over a year for spiritual needs of the patient, due to a change in the patients spiritual preference or progression of the illness. At the time of diagnosis the patient may experience a fear of dying or loss of self-identity. If the disease progresses the patient may express the need for finding the purpose and meaning of life. Therefore, creating a life care plan years in advance for an illness/disease that has several paths can be difficult. A useful tool in assessing the spiritual needs of a patient is the Spiritual Needs Questionnaire, it differentiates religious needs, the need for inner peace, existentialistic needs, and actively giving. The questionnaire can be used to make adjustments to accommodate the spiritual needs of the patient as needed (Büssing, Balzat, & Heusser, 2010).
Conclusion
Life care planners play an important role in developing a plan for current and future needs of patient’s dealing with chronic illnesses or catastrophic injuries. An appropriate life care plan has a strong medical foundation and is individualized for each patient. The life care planner must remain unbiased, respect the patients’ beliefs and preferences, and take into consideration the needs of the family and/or caregiver. Included is the cost for all recommended health care needs and equipment. Adjustments may need to be made to the plan to accommodate changes in the patients’ condition or with the progression of the illness throughout the duration of the plan.

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Rønning, B., Wyller, T. B., Jordhøy, M. S., Nesbakken, A., Bakka, A., Seljeflot, I., & Kristjansson, S. R. (2014). Frailty indicators and functional status in older patients

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