The incident of severe spinal cord injury (Grade A or B level impairment) is life changing to the patient. Not only is it unlikely that they will be able to resume pre-injury employment and income but day to day self-care is compromised. Severe SCI results in significant assistive care for the individual for the duration of their lives, which can mean expensive comprehensive medical supports for twenty five years or more on average.
There are a number of factors that complicate both the legal and the financial aspects of life after a spinal cord injury. Did you know that the average age for injured patients is from 30-40 years, impacting predominantly Caucasian males? Vehicular accidents are responsible for over 40% of the injuries where permanent spinal cord injuries occur, and most patients are single and unmarried, without provisions such as a live-in caretaker (spouse) or supplemental insurance to cover additional expenses. Minimal insurance is usually acquired with benefits paid through automotive insurers in almost half the cases.
The result of those issues contribute to a young, impaired individual with minimal social supports but dramatic reliance on healthcare services to be provided by liability insurers. Given the age of the injured the benefits required to care for their needs over a thirty year period are astronomical. Insurers do little to earn a compassionate nod for their trend toward limitations to claimants.
Sadly, families can end up in court for a year or more disputing the injury and the amount of the settlement required to care for the insured. Since 87% of individuals are released to homecare with family, the complicated process can be wrought with ethical issues including dispersing of funds and adequate supervised care.
Ethical Guardianship Rules for Caregivers
Who protects the rights of patients who have sustained significant spinal cord injury? Depending on the severity of the injury the individual may not be able to speak or communicate, which creates a concern over addressing the patients needs responsibly. Acting as a caregiver is a difficult job for a family member impacted by a SCI and there are many facets to managing care from an emotional, medical and financial perspective.
In some cases where quality of life for the patient is minimal, the decisions made by the next of kin with regards to the kind of treatment, care and the duration of efforts made create some moral and legal challenges. Laws have been written to protect the equal rights of patients regardless of their conditions while medical advances have made it clinically possible to sustain the duration of life for people with severe spinal cord injury. Medical advances have made it possible for people with severe spinal cord injury (those requiring respirators to sustain life) to live to their natural life span with the appropriate support. The financial burden of care can create ethical care issues.
The primary concern revolves around providing quality care for the injured needs. Since care is provided in the home, it can be difficult to monitor whether the injured is receiving quality care. The onus is left primarily to the care giver to decide what is essential and the best way to manage care from a comfort, needs and financial management perspective. The assumption is that the caregiver will always make the best decision for their loved one but unfortunately that is not always the case (either intentionally or unintentionally). With community assistance programs strained by ever decreasing federal budgets, home inspection and supports that monitor care in the home are virtually non-existent. Thankfully there are a number of non-profit organizations that provide education and useful advice and solutions to caregivers.
Resources for Care Providers and Families
It is life changing to be responsible for the care of a friend or family member at home in a hospice or long term disability situation. With the rising cost of professional private or assisted medical care, more families are assuming the role of home caregiver. We have provided a couple resources to help connect caregivers to ethical information and supports.
The National Association for Home Care and Hospice (NAHC) is an organization that was founded in 1985 to formulate guidelines for caring for the elderly, hospice and disabled patients in the home. Their guidelines pertain to members or medical professionals or businesses that provide support to patients in the home and are an excellent resource for evaluating the legal rights of patients in the United States.
The Family Caregiver Alliance (FCA) provides information, services and advocacy for patients and their caregivers and is a non-profit organization in the United States. They have ongoing webinars and an archive of previous topics to help educate family members on providing quality ethical care for their loved one while managing the challenges and difficulties that arise with home healthcare.
About Author:
Doreen is an experienced Spinal Cord Injury Lawyer in Tampa, who has helped many clients handle their legal requirements successfully. He loves to keep updated about the latest happenings in the legal arena to offer clients the best legal help. In his spare time, he loves to write about legal services to help those in need and also spends time with family and friends.