Attendant care is a provision (the cost) for assistance in activities of daily living (“ADL”) for a person with a disability. The cost is calculated based on the daily number of hours of required assistance, either physical or supervisory.
By Joseph Caprara of CBLAW posted in Rehabilitation on Sunday, May 12, 2013.
Attendant Services
Attendant care is a provision (the cost) for assistance in activities of daily living (“ADL”) for a person with a disability. The cost is calculated based on the daily number of hours of required assistance, either physical or supervisory.
Historically, attendant care services developed with the growth of the Independent Living Movement in the 1960s and was based on the Independent Living model of service rather than the medical/ rehabilitation or charity models of service. The movement began in Berkeley with a group of students with disabilities at the University of California. The Independent Living Movement quickly spread throughout the United States and Canada.
Attendant care services evolved out of the desire and the need of persons with disabilities to lead independent lives. They are a unique form of service which enable people with disabilities to live in the community. Before the advent of attendant care services, most people with physical disabilities would have remained in chronic care hospitals, lived in institutions, or been cared for by family members long after the age when most non-disabled people would choose to live independently.
Attendant care services do NOT include: professional services such as nursing care, physiotherapy, occupational therapy or physician services; respite care; supervision or taking responsibility for the person with a disability.
Activities of daily living include:
Bathing;
Toileting (bladder and bowel requirements, bed pan routines, movement to and from the bathroom);
Tracheotomy or ventilator care,
Physical exercise,
Skin integrity care,
Mobility – transferring from a bed, chair or other structure and moving about indoors and outdoors, or assisting in moving, turning and positioning the body while in bed or in a wheelchair;
Eating, nutritional planning, and preparing meals including prescribed special diets;
Dressing and changing clothes; and
Taking medications or other remedies that are ordinarily self – administered, when ordered for the participant by a physician. (To administer medication attendants must be certified as a nursing assistant and as a medicine aide).
Type of care: Institutional, Group Home, In- home
Consideration
Adequacy of an institutional setting given the nature of the person’s disability.
Availability of institutional care in the area.
Psychological benefit with residing at home and family situation.
Positive impact a home setting will have on life expectancy.
Witnesses/Experts
Psychologist, Health Department official, rehabilitation expert, physician with experience in institutional/ group settings.
Documentation/ demonstrative evidence
Studies/ documents on life expectancy in institution versus home setting (note: the law in Canada states that where there is evidence that supported care in the home is required or available, the person should not be forced to live in an institution simply because it’s cheaper).
Level of care: who, what, where , when and how much?
Consideration
Does the proposed attendant have the necessary skill level to perform the required tasks?
Accuracy of proposed hourly rate for the attendant?
What is the premium for night-time care?
Is there a minimum charge for the attendance of the service provider?
Witnesses
Rehabilitation expert, physician, neurologist, family doctor, nursing-health care agency, community college representative to determine course curriculum for the attendant.
Documentation/ demonstrative evidence
Medical evidence to substantiate level of care and quantity of care required
Schedule from rehabilitation expert detailing level of care required, hours of care required, rates for the attendants, available agencies or private workers.
Several measures can be taken to maximize the accuracy of the attendant care required. Such measures include timeliness and a need-based assessment that is comprehensive in utilizing observation, interviewing, and knowledge of the person’s medical condition. Other measures include being able to identify extraordinary needs and recognizing some of the subtle, yet pervasive, effects of injuries such as a neurological injury.
The Trauma Lawyers at CAPRARA BARRISTERS work with appropriately qualified experts who identify the needs of injured victims that suffer from severe brain injury, burns, spinal cord injury, chronic pain, mental and/ or behavioral challenges, and furnish us with the reports required to engage the co-operation and agreement of insurance companies or defence counsel to secure funding that will adequately meet the person’s lifetime needs.
Having the right medical, rehabilitation and legal team will help reduce anxiety and smooth the road to recovery. If you have been involved in an accident, you may be eligible to receive compensation. The Trauma Lawyers at CAPRARA BARRISTERS take numerous lawsuits to trial, and have helped many persons suffering from personal injuries. If you would like to learn more, feel free to call us and speak to a member of our team.
Joseph G. Caprara