GLA is now providing services for Elder care, Dementia care and Estate Law and Estate litigations. We also continue to provide services for MVA injuries, and recently added psychiatric care on our inter-professional team!
This newsletter further discusses the benefits of having a Psychiatrist on our inter-disciplinary team, special considerations needed when planning for a person with a disability and assessing fall detection in the elderly.
Falls are a major health concern, specifically for the elderly. An Occupational Therapist (OT) comprehensive assessment can result in prevention of falls, improved functional status, reduced hospital stays, and decreased medical and care costs.
OT assessments can help in determining a client’s level of assistance needed for daily activities and determine if placing in a Long Term Care facility is required.
OTs are assessing activities of daily living (ADLs), including basic self-care functions, such as dressing, using the toilet, and walking. They also assess ability to complete instrumental ADLs (those necessary for function in the community), for example, driving, shopping, and paying bills.
The ability of older persons to perform ADLs depends on their capacity to maneuver safely and effectively. Early detection of impairments in function can identify those persons with reduced mobility, deconditioning, and risks of injury.
OTs and physiotherapist can complete a direct in person range of motion, strength, balance and ability to transfer assessment and can analyse gait.
At the end of the assessment they would recommend assistive devices to improve safety with mobility and other devices or strategies to improve independence in daily functions.
In addition, OTs are trained to assess cognition and its effect on daily function and safety. People with Dementia, who suffer cognitive decline, are more prone to delirium and inattention that can result in falls.
Moreover, when it comes to risk of falls, the elderly person’s vision and hearing can be a major factor on risk of falls. A person that is forgetful and does not wear his/her vision glasses may not be able to pay attention to obstacles in the environment and may fall. People that do not hear sounds in their environment are at high risk on missing cues around them, which can affect their safety when outdoors.
Whether or not a vulnerable elderly person is able to remain in a home setting, depends on available caregiver support and the degree of functional limitations than on the actual medical conditions that a patient may have. The OT can teach the caregiver strategies to care for the elderly in an efficient and energy conservation way.
Our OTs can complete “needs assessment” which evaluate the functional, and social status of a client in an attempt to identify care needs. This can help the family in taking decision regarding the level of care the elderly person would need, the cost of the care and the possibility of staying home vs. placement in a Long Term Care facility, which can be very expensive.
Please contact us for more information.
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Taking Special Consideration for a Person with Disability in Estate Planning/Divorce Agreement
If you are an Estate Lawyer, Financial Planner or Family Lawyer, you may be hired by clients who are dealing with disability of one of their family members. The disabled person requires special considerations.
When there is a dependent person or a person with chronic illness in a family, such as a disabled child or any family member, there might be some obligations of the advisors of the Will or a separation agreement.
Our Certified Life Care Planners and Care Plan Managers have the expertise and experience to provide a professional opinion regarding a disabled family member’s current and future needs.
A Cost of Future Care Report, also called a Life Care Plan or Future Care Cost Analysis is completed by a Canadian Certified Life Care Planner (CCLCP).
It is used to outline the medical and rehabilitation needs and associated costs for an individual who has experienced long term and chronic healthcare needs.
It is a dynamic document that is based on published standards of practice, comprehensive assessment, thorough research and interview with client and family, discussion with health care providers and rehab team, and data analysis.
Anticipating future needs involves estimating services, such as treatment, medications, assistive devices, housing needs, caregiving needs, assistance with self care tasks, assistance with housekeeping and home maintenance, transportation and other health care and non-healthcare expenses.
Life care planners can be an excellent addition to the team of advisors when planning an estate in such cases.
A Cost of Future Care Report provides the client, family, legal representatives and financial planners with a comprehensive outline and quantifies the client’s needs over a lifetime and the costs associated with accessing the treatment, services, and equipment they will require.
This can help with allocating funds when planning the estate or preparing a Will or with any need for future planning for health and medical expenses for a disabled person within the family.
We offer consulting services for companies that hold a Power of Attorney (POA) for finances for their clients, those who hold POA for personal care and those with no POA, who require our expertise to ensure that there is a future plan for health and medical care in place.
Please contact us for more information.
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The Benefit(s) of Having a Psychiatrist on a Multidisciplinary Treatment Team
Working with post trauma clients that have sustained a severe injury almost always includes mental health problems. These clients endure many losses in a matter of seconds, when involved in a car accident.
Most of these clients are diagnosed with different variations of depression, anxiety and post traumatic stress. Some of the clients are diagnosed with somatoform pain disorder.
While psychiatrists are covered by public health insurance, the wait list to see a psychiatrist can be up to a year or more, with many psychiatrists not having much experience with navigating the complexities that come with car accident related injuries.
Also, the referral process for mental health care can be complex and confusing. In many cases, a person must first see a family doctor before being referred to a psychiatrist, adding a barrier to psychiatric access, especially for the many individuals who don’t have a family doctor.
In addition, many psychiatrists have adopted a one-time consultation model in an effort to reduce the wait times, which means that even when psychiatric care is accessed, it will be limited in duration. Furthermore, typical psychiatric practices are not set up to complete accident benefit forms, provide interpretation services and provide multidisciplinary treatment.
What is reasonable in a given case, must take into account not only the wait times involved, but also the degree of the client’s psychiatric symptoms, while sitting out those wait times and the effect that these symptoms will have on the client’s function and progress in rehabilitation.
At GLA Rehab, we believe early access to a multidisciplinary approach is critical to serve our severely injured client(s). As a result, we have developed an inter-disciplinary team that works collaboratively to improve symptoms, progress a client’s function, improve their productivity level and help them to find new meanings for their days, while they are dealing with severe disability.
We have developed a treatment plan that includes three disciplines working together—psychiatry, occupational therapy and social work. We use clinicians that have extensive knowledge and experience in the accident benefit system.
GLA Rehab collaborates with PsycIME, in order to provide this service, which includes providing a joint treatment plan for clients with mental health problems.
This approach allows our rehab team to consult with a psychiatrist on a regular basis, to assist with diagnostic clarification, as well as to assist with medication and novel treatment solutions as soon as possible.
With our industry experience, the team also collaborates to assist with optimal timing of non-CAT and CAT benefit applications.
Along with our assessments, we provide robust clinical documentation from the team members, which can support client’s applications for various accident benefits they may be entitled to.
We are looking forward to the collaboration with PsycIME and in improving the outcome in our clients’ mental health.
With the upcoming Holidays and plans to meet with friends and family, we thought we would take this opportunity to focus on Dementia and Alzheimer’s disease, which are on the rise all over the world, as the population is aging.
By Galit Liffshiz MA OT Reg.(Ont) Certified Life Care Planner/Designated Capacity Assessor
Covering health care expenses for the elderly and individuals with a disability is a growing concern in Canada. This is especially relevant at present, given the increased desire of Canadians to age at home following the Covid-19 pandemic.
When it comes to home care, Canadians must figure out what level of care they require, the overall cost, and what role the family might play in providing these services.
Home care encompasses a wide range of services delivered to individuals of all ages in their home. Purposes of home care services include short-term care for recovery from surgery or acute illness, as well as longer-term care for those who are disabled or experiencing limitations because of a chronic condition, aging, or terminal illness.
Unlike hospital and physician services, home care is not an insured service under the Canada Health Act. Therefore, the provinces and territories are not required to offer it to qualify for federal transfers for health care. While Ontario provides home care services, these are very limited and there are unmet needs.
Home care services should be considered and included in estate planning and insurance coverage.
When advising clients on establishing a Will or getting insurance coverage, we need to determine if their families include any special needs member/beneficiary. When there is a dependent person or a person with chronic illness in a family, there might be some obligations of the advisors of the Will (i.e. Estate Lawyers, Life Insurers or Financial Planners) to make special considerations.
Special needs beneficiaries refer to individuals who, due to intellectual, cognitive, functional disabilities, brain diseases, mental illnesses, or injuries, are unable to effectively manage their personal or financial matters. This includes conditions such as Down syndrome, cerebral palsy, autism, Alzheimer’s disease, dementia, schizophrenia, bipolar disorders, and brain injuries.
Life Care Planners can be a good addition to the team of advisors when planning an estate in such cases.
The Life Care Plan is a structured, working document that identifies and estimates an injured or disabled person’s current and future needs in the areas of: home care, medical, rehabilitation, equipment, medication, transportation, and home/environmental accessibility.
Life care planners are certified rehabilitation professionals and educators. They maintain objectivity and base their recommendations upon research literature, the opinions of consulting team members (physicians, therapists), and patient-specific data.
Each recommendation is tied back to the data collected in the interview or history taken with the client or family, as well as review of the available medical records and information regarding client prognosis. Recommendations consider disability, individual, family, and regional factors.
The recommendations are proactive and not reactive. Life care plans are developed in a preventative manner with the goal being to minimize the frequency of occurrence, severity and duration of disability-related complications.
At GLA we are offering Life Care Plans for individuals with a disability. This can be an important tool to calculate expected future life expenses due to aging and disability, as it relates to estate planning or estate litigations.
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On the Benefit of Using a Life Care Plan Report in Estate Planning and Litigation
Reviewing the Mrs. Kollmuss and Mr. Kollmuss case law BCSC 709 (CanLll) 2012, we will examine the judge’s assessment of a matrimonial dispute regarding health and care expenses related to a child with disability when parents are divorcing.
In this case, Mrs. Kollmuss, the mother of a child with a disability, is seeking various forms of relief from her ex-husband to help support her child.
Mrs. Kollmuss and Mr. Kollmuss had two children together, Nicholas who was 19 years old, which is healthy and independent and Curtis, who is 16 years old.
Curtis requires constant supervision and care, as he is disabled.
Curtis has Bardet-Biedl syndrome, which is a rare genetic disorder, with highly variable symptoms, which may include retinal degeneration, obesity, reduced kidney function, polydactyly (extra digits of the hands or feet) among many other features).
He is legally blind and is expected to fully lose his vision by the time he is 20 years of age. He has scoliosis and epilepsy with absence seizures, Stereotypic Movement Disorder, and is functioning at the mental age of a 5-year-old. He also has problems with his hips, legs, and feet, affecting his mobility.
In 2010 Mrs. Kollmuss and Mr. Kollmuss got divorce. Following the separation, it was agreed that Curtis would reside in the family home with his mother, as both parents would like to keep him out of government facilities.
Additionally, it was agreed that Mr. Kollmuss would pay child support, spousal support, special needs summer camp, and 70% of Curtis’s day care.
It was agreed that in the instance that the house was sold, 60% of earnings would go to Mrs. Kollmuss and 40% would go to Mr. Kollmuss.
Mrs. Kollmuss disputed the agreement for the support and distribution of equity from the family home, as she claims that the cost of supporting Curtis, in a way that both parties want, is greater than what’s being provided.
When making decisions in this case, the judge considered what was known about Curtis at the time of the trial and what the parties both wish for Curtis.
The judge considered that Curtis attends school Monday to Friday, where he has full-time access to a special needs educator, but this will no longer be the case when Curtis turns 20.
Additionally, it is known that both parties would like him to remain at home with his mother and out of government facilities.
However, Due to the progressive nature of Curtis’s disability, the judge pointed out that there were several “unknowns” that are relevant to each issue being addressed.
These “unknowns” include future funding when Curtis turns 20, and the level of care that will be required of his parents in the near and distant future.
The judge highlights that Curtis’s needs may be to great and costly for his parents in the future, and questioned if Curtis will have access to programs and care that will enable him to live the life that his parents presently hope and plan for him.
Without a Cost of Future Needs report, the judged was forced to base his decision on what was known about Curtis and what the parties both wish for Curtis.
This left the high possibility that both parties will have to return to court in the future, and made it difficult for the parties to plan financially.
In this case, a Life Care Planner could help with calculating expected current and future life expenses of aging and or disability.
The Life Care Plan is a structured, working document that identifies and estimates an injured or disabled person’s current and future needs in the areas of home care, medical, rehabilitation, equipment, medication, transportation, and home/environmental accessibility.
Life care planners are certified rehabilitation professionals and educators. They maintain objectivity and base their recommendations upon research literature, the opinions of consulting team members (physicians, therapists), and patient-specific data.
Each recommendation is tied back to the data collected in the interview or history taken with the client or family, as well as review of the available medical records and information regarding client prognosis. Recommendations consider disability, individual, family, and regional factors.
At GLA we are offering Life Care Plans for individuals with a disability. This can be an important tool to calculate expected future life expenses, due to aging and disability, as it relates to estate planning or estate litigations and in case of family dispute during a divorce.
GLA is now offering a FCC report that can be used by estate planners, financial planners and estate litigations.
In this newsletter we have summarized a case law, that can reflect on the potential benefit of using a Life Care Plan report when there is a disabled person in a family that is experiencing a dispute regarding estate planning.
Hello everyone! Hope you are all embracing the blooming beauty and rejuvenating spirit of the spring season!
In this edition of our Spring Newsletter, we will be discussing the case decision of Simmons v. BelairDirect Insurance Company, 2023 CanLII 26935 (ON LAT) [1], in which the applicant was designated catastrophically impaired in criterion 8 of the Statutory Accident Benefits Schedule (SABS).
