Key Insight

Life care planning is most effective when it reflects how an individual truly functions in daily life. Occupational therapists contribute a critical perspective by evaluating function, environment, and participation—and by taking the time to understand the full picture of how an injury impacts everyday living.

The Occupational Therapy Contribution

Occupational therapists assess how injury or illness affects an individual’s ability to function across daily activities, including:

• Activities of daily living (ADLs)
• Instrumental activities of daily living (IADLs)
• Cognitive and physical performance
• Environmental barriers and supports
• Safety, independence, and endurance

This evaluation extends beyond diagnosis to include how the individual actually lives, moves, and performs tasks over time.

As outlined in the American Occupational Therapy Association (AOTA) Scope of Practice, occupational therapists are autonomous practitioners responsible for evaluation, clinical reasoning, and intervention planning.

Within this scope, occupational therapists provide independent clinical opinions regarding:

• Therapy needs (type, frequency, duration)
• Orthotics and splinting
• Assistive technology and adaptive equipment
• Mobility devices, including wheelchairs and positioning systems
• Home health aides and attendant care
• Case management needs
• Home modifications and accessibility
• Community mobility and transportation

These opinions are grounded in functional performance, activity analysis, and environmental context.

Taking the Time to Understand the Whole Picture

A consistent theme we hear from attorneys and clients is:

“Thank you for taking the time to get to know our client.”

This reflects a core component of occupational therapy practice.

A meaningful evaluation requires more than a brief interaction. It involves:

• Observing how tasks are completed—not just whether they can be completed
• Understanding variability in performance across the day
• Identifying compensatory strategies and limitations
• Evaluating safety, efficiency, and sustainability of function
• Considering the interaction between physical, cognitive, and environmental demands

This process is grounded in time, observation, and clinical reasoning—all necessary to understand the full impact of injury on daily life.

Attorney Perspective

“The life care plan was thorough, well-supported, and easy to follow. We especially appreciated the time taken to meet with the family and understand their real-world challenges. That in-person evaluation was clearly reflected in the report, including the impact of the injury on daily functioning and family dynamics.”

— Attorney Feedback

Evaluating Function in Context

When appropriate, an in-home assessment provides direct insight into how an individual functions within their environment.

This allows for evaluation of:

• Mobility within the actual living space
• Environmental barriers to independence
• Transfer safety and fall risk
• Caregiver involvement and physical demands
• Practical use of equipment and adaptive strategies

However, even when in-home assessment is not feasible, the focus remains the same.

Through comprehensive virtual evaluation, record review, and structured interview, occupational therapists continue to assess:

how the individual functions within their real-world environment—not just in a clinical setting.

This emphasis on context aligns with the AOTA framework, which recognizes that performance is shaped by the interaction between the individual, the task, and the environment.

From Evaluation to Recommendations

Occupational therapy recommendations are derived from:

• Direct observation (when available)
• Functional assessment and activity analysis
• Clinical reasoning within scope of practice
• Consideration of long-term participation and safety

This includes recommendations related to:

• Independent living supports
• Equipment and assistive technology
• Environmental modifications
• Ongoing therapy and rehabilitation needs

These are core components of occupational therapy practice and are essential to developing a life care plan that reflects real-world needs over time.

Collaboration Within Scope

Life care planning is interdisciplinary, and occupational therapists collaborate with physicians and other providers.

Within their professional scope, occupational therapists contribute:

• Function-based analysis
• Contextual evaluation
• Independent clinical judgment regarding daily living needs

This ensures that recommendations are informed not only by diagnosis, but by how the individual functions in daily life.

Conclusion

Occupational therapy brings a distinct and essential perspective to life care planning—one grounded in function, context, and participation.

By taking the time to understand the individual and the full picture of their daily life, occupational therapists develop recommendations that are:

• Clinically supported
• Functionally accurate
• Contextually relevant
• Reflective of real-world needs

At its core, this approach ensures that the life care plan represents not just the injury—but how that injury impacts everyday living over time.

About the Author

Tracy L. Travis, OTD, OTR/L, CLCP
Occupational Therapist & Certified Life Care Planner
Founder, Turning Point Life Care Planning

Dr. Travis has experience in the development of life care plans and the application of occupational therapy principles within medical-legal contexts. Her work focuses on functional assessment, long-term care considerations, and the integration of clinical findings into structured planning frameworks.

Publications & Presentations

• Travis, T.L. Transitioning to New Areas of Practice
In Jacobs, K., & McCormack, G. (Eds.), The Occupational Therapy Manager (6th ed., AOTA Press)
• Life Care Planning: An Emerging Area for Occupational Therapists
Presented at the American Occupational Therapy Association Conference