Revisiting Chronic Pain in the Life Care Plan

The practice of life care planning is now well into its fourth decade. At the time of life care planning’s inception, the phrase “pain management” was barely in the lexicon. During the same time period, the way in which chronic pain is perceived and treated has changed greatly. Numerous new medical techniques and procedures for treatment of pain have been introduced which were unheard of 20 years ago. There are multiple pain management associations, and volumes have been written on this subject. In addition, the topic of pain has become much more central in American public consciousness than at any time in history, and a wellchronicled crisis of the abuse of pain medication has arisen. With this heightened awareness of chronic pain, new issues have begun confronting the life care planning community. How should the treatment of chronic pain be viewed by the life care planning discipline? Is it possible to recover from chronic pain? Should opioid pain medication be included in a life care plan for extended time periods? Are we witnessing the birth of a new breed of life care plan, focusing solely on prescription pain medications for the evaluee’s lifetime? Though few life care planners can claim to be experts in the treatment of chronic pain, many are now called upon to address it in their practice. Here, we offer perspectives from life care planners, an occupational therapist, rehabilitation counselors, and a pain management specialist on this subject. This article does not purport to offer the answer to chronic pain treatment, nor does it give a road map for the manner in which a life care planner should address pain management when developing a life care plan. Instead, it is an effort to look carefully at this trend, to encourage life care planners to stay abreast of developments in the treatment of pain, and to serve as a reminder to make well-informed decisions in a life care plan where the treatment of chronic pain is central.