Fischer, J. & Wilkins, M. Challenges and Practice Issues Faced by Canadian Life Care Planners. Journal of Life Care Planning, 2017; Vol. 15, No. 3, pp. 31-136.

Abstract: A survey was conducted to identify current issues and needs that Canadian life care planners face in their practices. Thirty-one Canadian health care professionals were asked to identify the three biggest challenges or practices they had faced in their practice in the last year. Data was analyzed using NVivo 11 to identify six essential themes among the participants. The six essential themes were found to be: (1) Collaboration for Recommendations; (2) Practice Challenges; (3) Research and Training; (4) Referral Constraints; (5) Attendant Care; and (6) Future Care Costs.  The authors further explore these themes and discuss the implications of each for life care planners.

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Kyi, M., Fischer, J. et. al. Physical Effect of Work on Healthy Individuals: Implications for FCE Testing. WORK, June 2012; Volume 42(2), pp. 233-239

Abstract: Objective: The objective of this study was to assess the effect of time of day and job type on performance of 3 functional capacity evaluation measures in healthy (asymptomatic) adults. It was queried whether or not a healthy population of adults would demonstrate a change in physical performance ability, when re-tested at the end of their work day. Setting: A convenience sample of 50 healthy adults (19-62 years, 66% male) was used from 6 work sites in an urban area. Design: Same day pre-test and post-test testing was performed, implementing use of 3 commonly used functional capacity tests; Jamar dynamometer grip strength test; Turning sub-test of the Complete Minnesota Dexterity Test; and the 50-foot walk test. Method: The study compared morning and afternoon test scores using t-tests, assessed the effect of job type (sedentary, light, medium, heavy) on performance using ANOVA. Results: All 3 measures improved from morning to afternoon; differences were statistically significant for 50-foot walk (mean=0.2 sec, p = 0.02) and manual dexterity (mean=5 sec, p<0.001). Job type had a significant effect on dexterity. Conclusions: Late day performance did not show any significant decline in this sample of healthy adults, and in fact tended to improve or stay relatively stable. Therefore, clinicians who perform functional capacity evaluations should consider alternative explanations for late-day functional declines observed in injured clients. These findings, combined with other test results, may assist clinicians with disability determination.

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Fischer, J. Determining Type and Quantity of Household Services Required for Persons with Disabilities: Using Time Use Survey Data. Journal of Life Care Planning, 2007; Vol. 6, No. 1 & 2, pp. 3-13.

Abstract: One of the most important categories in a life care plan is Home Care Services. This may include personal attendant care, facility care, and/or household services for persons with disabilities. This article focuses upon household services, which for the purpose of this article refer to all of the services required to maintain a home such as yard work, home repairs, home renovations, and housecleaning. In developing a life care plan, life care planners are faced with the challenge of determining: Which activities should be considered for inclusion in the life care plan? What amount of hired services should be allocated for assistance with household activities for individuals with disabilities? What is an appropriate age for cut-off or reduction of household services due to the effects of aging? This article provides an overview of American and Canadian Time Use Survey data and its application to life care planning in each of the three areas outlined above. In some parts of Canada, a number of life care planners are currently using time use survey data to assist with determining the amount of funding to allocate for household services. When used appropriately, such data and its activity classification systems can take the guesswork out of determining what type and amount of household services should be allocated for clients who are limited from performing such activity due to their disability. A case study also is offered.

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Makdessian, F., Friars, D., Kyi M.T., Gutteridge, L. Back on the Job. Occupational Health and Safety Magazine, December 1999.

Abstract/Overview: Untangling the complex world of a functional capacity evaluation and a physical demands analysis in helping injured workers return to work.

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Fischer, J. Reliance on Objective Functional Testing to Identify an Individual’s Needs for Home Support Services. Journal of Life Care Planning, 2007, Vol. 3, No. 1, pp. 29-34.

Abstract: One of the most common categories included in life care plans is home support services. The purpose of this article is to discuss the benefits of relying on objective functional testing and a home assessment in determining whether or not an individual requires assistance with domestic activities, and, if so, the type and extent of support required. Republished in: Rehab Matters: The Official Publication of VRA Canada, Fall 2013, pp.20-22.

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Kyi, M.T., Fischer J.A. Understanding the FCE: Objective Evaluation of Work Tolerance. OT Line, April 2001.

Abstract/Overview: Published paper outlining objective techniques used to assist in determining an individuals ability to work full time.

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Kyi, M.T. Shades of Gray: Determining return to work status isn’t always black and white. Advance for Directors in Rehabilitation, April 2001.

Abstract/Overview: Published paper outlining the importance of functional baseline and repeat testing to help determine a clients durable work tolerances, and issues pertaining to part-time versus full-time work suitability.

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Kyi, M.T. Getting Results: How to get the most out of functional capacity testing. Advance for Directors in Rehabilitation, April 2000.

Abstract/Overview: Published paper outlining key questions referral sources should ask when considering application of a Functional Capacity Evaluation, to assist in disability determination.

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Kyi, M.T., Physical Effect and Symptom Magnification: Current Issues in Work Capacity Evaluation. Occupational Therapy Now, January/February 2000.

Abstract: Work Capacity Evaluation (WCE) is used to determine an individuals physical abilities, limitations, and readiness to return to work. In the early 1980s, Dr. Leonard Matheson defined Work Capacity Evaluation as a systematic process to dependably sustain performance in response to broadly defined work demands (Matheson, 1986). As occupational therapists we are aware of the influence that symptom magnification can have on the clients perception of his or her job readiness. Therefore, in order to thoroughly assess an individuals true work capacity, it is important to separate objective findings gathered during physical effort testing, with more subjective findings gathered during symptom magnification testing.

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