OT & Life Care Planning: An Ideal Match
An OT reached out to me earlier this month asking to chat about my experience with the life care planning certification process. We had never met or spoken before, but I was thrilled to hear from her and happy to share my thoughts and experiences.
Making the decision to pursue certification is a big commitment – of both time and money. Wisely, this OT was looking for first-hand information about what it’s like to complete the life care planning certification training and begin writing future cost of care reports (FCCs).
This conversation had me thinking more about why some OTs are so well-suited to the area of life care planning. I say some OTs because the work of life care planning is certainly not for everyone. If you live for that feeling of knowing that one of your interventions has made someone’s life a little bit easier, you probably won’t get that same feeling of satisfaction here. But, if you thrive on making sense of a complicated clinical picture and you get excited about organizing your findings in a way that others can easily understand, then life care planning may be a good fit for you.
Aside from what motivates and satisfies us as individual clinicians, there are plenty of qualities inherent to occupational therapy that make OTs an excellent fit for life care planning.
First of all, OTs are trained from the jump to understand disability from a holistic perspective. We look beyond isolated symptoms and impairments to consider the whole person. We recognize that a person's experience of disability is connected to their ability - or inability - to engage in meaningful activity, and that their ability to engage in meaningful activity is influenced by multiple factors including their environment as well as their physical, cognitive, and emotional health. As OTs, we keep the client as the centre of our focus but we use a wide lens to see the bigger picture of that person’s health and disability in the context of their home and community environments. This wide lens that we use as OTs gives us an advantage in life care planning which requires a similarly broad view to effectively evaluate the care needs of an individual.
Also, OTs are experts on function and understanding how illness or injury can alter various areas of functioning. This expertise lends itself well to life care planning which requires the evaluator to discern and explain the changes in pre/post-incident functioning that are experienced by an individual. OTs have the skills to identify a person’s baseline level of functioning and how that baseline has been disrupted by injury or illness. OTs can delve into aspects of physical, cognitive and emotional functioning in a variety of ways: we can highlight functional data that is present in the medical file; we can elicit self-report details about functioning from clients and their caregivers; we can talk to treating service providers about a client’s level of functioning; and we can use our clinical skills to incorporate functional testing into our FCC assessments and include observational data in our analyses. These OT assessment skills provide a solid foundation for understanding and explaining pre/post-injury functional changes that are integral to any good FCC report. We can then use our understanding of changes in functioning to present recommendations that support restoration of function as much as possible and maximize quality of life.
Finally, OTs are particularly well-suited to write FCCs because we are knowledgeable regarding so many of the recommendation areas that are common to life care plans. Not only can we offer valuable input regarding the need for OT assessment and treatment services, but our expertise as rehabilitation providers gives us insight into the need for other rehab services including physiotherapy, speech-language pathology, vocational services and driver rehabilitation, to name a few. Our eye for identifying barriers to occupational performance can help us to recognize the need for housing modifications and adaptive aids in the home. We also excel at understanding barriers to community-based activities like shopping, driving or using public transit, and can appreciate if there is a need for services to assist an individual with tasks outside the home. OTs are also highly skilled at evaluating the need for attendant care and housekeeping services due to our expertise on basic and instrumental activities of daily living. Ultimately, our knowledge of these multiple FCC areas enhances our ability to gauge if other’s recommendations are reasonable and necessary in order to produce a report that is reliable and defensible.
Life care planners come from a variety of professional backgrounds, particularly in the U.S. At the most recent life care planning summit which occurred earlier this year (2025) in Minneapolis, less than 10% of attendees were OTs. I was surprised to hear that the number was so low, considering how well-suited OTs obviously are to the field of life care planning, but this speaks to the differences between American and Canadian practices. A great article just came out highlighting the key differences and similarities between life care planning in the U.S. and Canada: Morrison, T., Ramos, P., & Cowitz, E. (2025). A comparison of the steps, processes and considerations involved in developing a life care plan in the United States and Canada. Journal of Life Care Planning, 23(2). International Association of Rehabilitation Professionals.
The ideal fit between life care planning and occupational therapy has been presented by other Canadian OTs, going back to the early 2000s. For more on the Canadian perspective, check out the following article: Klinger, L., Baptiste, B., & Adams, J. R. (2004). Life care plans: An emerging area for occupational therapists. Canadian Journal of Occupational Therapy, 71(1), 39–47. https://doi.org/10.1177/000841740407100108
And, if you are interested in continuing the conversation about why OTs make great life care planners, in Canada or anywhere else for that matter, feel free to send me an email at rosa@newtonOT.com