than two thirds of SCI patients are young people involved in motor vehicle accidents and falls , but this article focuses on SCI patients in the last years of their lives . According to physician and rehabilitation expert , Craig H . Litchblau MD : “ Thanks to medical advances , SCI patients are living longer than ever before and thus require more care over a longer duration . This care is costly and must be financed if SCI patients are to remain healthy and have adequate quality of life .” 2
The adequate quality of life depends on who provides the attendant care . Studies show that about 90 percent of SCI patients experience between 8 and 14 complications each year upon returning home from the hospital after their injury . Family and friends do not have the professional licensing and bonding ( liability insurance ) to care for a SCI patient . Inexperienced attendant caregivers will not know how to deal with common complications like pain , spasticity , urinary tract infections , bowel problems , osteoporosis , respiratory difficulties , autonomic dysreflexia , and pressure ulcers . These complications can be prevented under the services of a qualified professional attendant .
As SCI patients face the last years of their lives , they grow more dependent upon professional attendant care providers . For a Registered Nurse ( RN ), the average salary in 2020 was $ 77,460 and forecasted to increase to $ 143,636 by 2030 . For a Licensed Practical Nurse ( LPN ), the average salary in 2020 was $ 48,501 and forecasted to increase to $ 55,025 by 2030 . 3 For aging SCI patients , medical advances allow them to live longer and require more professional care for longer durations . For this reason , attendant care makes up at least two thirds of the total cost of a life care plan overseen by a rehabilitation expert and computed from the cost point of view by forensic economists . The individual cost per hour for attendant care is not the main source of the expenses in life care plans ; but instead , the need for aging SCI patients to have attendant care on a 24 / 7 basis . This often results in unexpected and preventable hospital visits , which translate to significantly higher cost of any life care plan . In every case , this is unavoidable . If left unattended for extended periods of time , then the aging SCI patient risks dying from the common complications mentioned above .
Research shows that aging SCI patients near the poverty line are more likely to live shorter lives , when compared with aging SCI patients with superior financial means and access to private resources . 4 For example , the University of
2 Litchblau , Craig and Warburton , Christopher et al . “ Life Expectancy in Spinal Cord Injury : The Importance of High-Quality Care ” International Journal of Physical Medicine & Rehabilitation . Volume 10 , Issue 1 . Number 1000619 . 15 February 2022 .
3 Pettingill , Bernard F , and Federico R Tewes . “ Analysis and Forecast of Nursing Care Costs .” Pettingill Analytics , 30 Sept . 2020 , https :// www . pettingillanalytics . com / post / vaping-classactions-damages-in-the-shadow-of-tobacco .
4 Strauss D , deVivo M , Shavelle R , Brooks J , Paculdo
Alabama created a life expectancy calculator specifically for SCI patients , called “ Spinal Cord Injury Calculator .” This calculator looked at 10 factors : Age , injury date , sex , ethnicity , highest level of education , type of insurance , whether the patient has used a ventilator , the cause of their injury , their current level of SCI , and current completeness of SCI . Because the care of SCI patients is prohibitively expensive , the life expectancy results vary significantly depending on whether the patient has public versus private insurance . 5 In other words , aging SCI patients who do not receive optimal funding to finance a total life care plan , will likely not receive optimal care . Supervision by professional attendant care specialists will help prevent complications from deep vein thrombosis , pulmonary embolus , pneumonia , sepsis , urinary tract infection , cellulitis , osteomyelitis , and automatic dysreflexia , among other complications . Without question , this directly affects the patient ’ s quality of life and the patient ’ s quality of care hopefully for long durations of life .
Every SCI injury is different , and the patient ’ s mental health status is a significant factor in coping with life after the injury . Medical professionals will find ‘ quality of life ’ difficult to measure for an aging SCI patient , but they are likely to use two methods . First , the Spinal Cord Injury — Quality of Life ( SCI-QOL ) measurement system . Second , the 36-Item Short- Form Health Survey ( SF-36 ). The first is mainly a subjective measure and the second is mainly an objective measure . One particular factor that may cause depression or anxiety in many SCI patients is repeatedly comparing their lives before and after their injury , consequently affecting the patient ’ s mental health status . Studies focused on the benefits of meditation cite daily meditation and the practice of mindfulness for helping aging SCI patients become more present-minded and accepting of themselves . Another important factor in the patient ’ s mental health status is the feeling of loneliness , which is frequently reported as a source of lower quality of life after the date of injury and sometime suicide . Although an SCI affects the patient ’ s mobility and their ability to lead productive and independent lives , friends and family members want to see the patient recover both mentally and physically . For example , the use of adaptive tools if necessary . Many SCI patients request car adaptations , such as hand controls or wheelchair ramps installed , allowing the SCI patient to enjoy a change of scenery and time outside the home . Adaptive tools will help the individual perform tasks that they may not be able to perform on their own . Another example are the adaptive utensils for SCI patients , which are wrapped around the forearm and allow the patient to feed themselves independently , without relying on assistance from someone else . These changes will help
D . Economic factors and longevity in spinal cord injury : A reappraisal . Arch Phys Med Rehabil . 2008 ; 89 ( 3 ): 572-574
5 “ Spinal Cord Injury Life Expectancy Calculator .” NSCISC Application , 2013 , https :// www . nscisc . uab . edu / Public _ Pages / LifeExp .
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