- Lever Taps
1. Ms. Lancaster
¶ 545 Ms. Lancaster provided for lever taps in the cost of wheelchair accessible housing. Lever taps are required in the kitchen and in the bathroom and were priced at $99.98 for two at $49.99 each. These will require replacement every 25 years. Accordingly, I approve of the replacement cost of $99.98 every 25 years.
– Hand-Held Shower Device
1. Ms. Lancaster
¶ 546 Ms. Lancaster provided for a hand-held shower device for the wheel-in shower which facilitates showering as it brings the spray to the point of use rather than having to manoeuvre the body. The device was priced at $70.50 and must be replaced every six years (2501).
¶ 547 Dr. Geisler also recommended this item. He opined that a hand-held shower device is necessary, first if surgery affords the Plaintiff a substantial grasp she might well be able to shower herself and second, the caregivers can facilitate her bathtub washing with a hand-held shower quite nicely.
¶ 548 I approve this cost and its replacement time.
– Counselling
1. Ms. Lancaster
¶ 549 Ms. Lancaster provided for adjustment counselling at an annual sum of $5,000. Ms. Lancaster had discussed this with Dr. Geisler who originally felt that any counselling the Plaintiff required could be received from her parents or the family doctor. Ms. Lancaster opined that the Plaintiff’s parents are not trained in interpersonal relationships and family doctors, because of their busy medical practices, do not have the time to spend to discuss such issues with their patients. Ms. Lancaster was of the view that the Plaintiff may wish to speak to a counsellor on issues such as marriage and children. Ms. Lancaster testified that the Plaintiff could not discuss with her parents any problems she may have with her boyfriend, Mr. Conquest, as there is a conflict between these parties (2461). Ms. Lancaster also testified that the Plaintiff may wish to seek counselling about issues that do not fall within the parameters of the Canadian Paraplegic Association, such as marriage counselling (2509). The Psychologist Association of Alberta recommends a fee schedule of $95 per hour. Neither Ms. Lancaster nor Ms. Kirker addressed the issue of free servicing from the Alberta Paraplegic Association.
2. Ms. Kirker
¶ 550 Ms. Kirker deferred to the opinion of Dr. Geisler that counselling is not required and was of the view the Plaintiff could use her personal physician and spinal cord specialist to assist with decisions about having children.
¶ 551 Dr. Geisler cautioned against psychological counselling for the Plaintiff (2037). Dr. Geisler thought help could be best addressed by the Plaintiff’s personal physician, parents and persons with whom she had strong interpersonal relationships, or the Canadian Paraplegic Association (2038). Dr. Geisler was of the view that the Plaintiff needed to talk with somebody with specialized experience in the care of spinal cord injury. Such individuals were available at the Canadian Paraplegic Association at no cost or for a very nominal cost (2038).
¶ 552 In Dr. Rocheleau’s view, the Plaintiff did not require psychological counselling (2991).
¶ 553 I accept Ms. Lancaster’s opinion in part that because of the estrangement between the Plaintiff’s boyfriend and her parents, exacerbated because of her disability, the Plaintiff may require some counselling advice with respect to her interpersonal relationships, including marriage and children. Accordingly, I approve 20 sessions at $95 per hour for a total of $1,900.
– Wheelchair Including Sports Wheelchair
1. Ms. Lancaster
[para554] Ms. Lancaster found the Plaintiff to be an extremely informed consumer who did her own research as to the chairs which would best meet her needs. Ms. Lancaster was of the view that the Plaintiff required the following adaptations for each of her wheelchairs: push handles, caster pin locks (keeps chair from moving during transfers), padded swing-away arm rests, anti-tip tubes, high pressure tires (for less wheeling resistence), plastic coated hand rims and long tabs (for independent wheeling), grade aids (keeps chair from rolling backwards when going up hills and ramps), fabric guards and spoke guards (for protection for fingers and clothes from moving spokes).
– Primary Chair
1. Ms. Lancaster
¶ 555 The Plaintiff’s current wheelchair is an Everest & Jennings Mirage wheelchair which was purchased through Healthcare and Rehab Specialties for $3,600 (Ms. Lancaster’s July 15, 1997 report). Ms. Kirker testified that the chair cost approximately $2,600, and advised that this model is no longer made (3082). In Ms. Lancaster’s opinion, this wheelchair requires immediate replacement (2450). The Plaintiff intends to purchase the Quickie Revolution wheelchair for everyday usage, with a (16 x16) cushion, folding adjustable back, plastic side guards, standard footrests, rigid, leg strap, aluminum caster rim, caster pin locks, 1 longer fork stem, an 8 degree camber, padded swing-away arm rests, standard titanium quad release axle nuts, anti-tip tubes, 24-inch basketball wheels, plastic coated hand rims, long tabs, swing-away wheel locks, clear spoke guards, and 6-inch poly casters.
¶ 556 Ms. Lancaster described the frame of the Quickie Revolution as rigid, extremely sturdy and strong (2450). She opined that this wheelchair has the qualities to satisfy the needs of the Plaintiff as her primary everyday chair. It is available for purchase from Golden Boy Medicals for $4,395 and on the average needs to be replaced every five years. Maintenance on the Quickie Revolution chair is approximately 10 percent of its cost yearly.
2. Ms. Kirker
¶ 557 Ms. Kirker testified that the Plaintiff indicated during her interview that she would prefer a rigid frame wheelchair for her primary chair and a folding manual wheelchair for a backup chair. According to Ms. Kirker, the Plaintiff reported having some discussions with Golden Boy Medical and was considering the Kuschall Competitor for her rigid frame wheelchair (3083). Given that the Plaintiff’s current chair requires replacement, Ms. Kirker suggested that a new wheelchair be purchased now and replaced in five years. Ms. Kirker priced the Kuschall Competitor wheelchair, as the primary rigid chair, at $2,460. Ms. Kirker was advised by the supplier at Golden Boy Medical that the cost of the Quickie Revolution is between $3,000 and $3,500.
¶ 558 Ms. Kirker advised that annual maintenance costs for the primary wheelchair have been estimated at $275, based on information provided by the suppliers.
¶ 559 Recognizing the fundamental importance of a wheelchair to the Plaintiff, I approve the cost of a new wheelchair at $4,395, to be replaced every five years and with a yearly maintenance cost of $400. This wheelchair will become, after acquisition of the electric powered wheelchair, the Plaintiff’s back-up.
– Back-Up/Stand-By Chair
1. Ms. Lancaster
¶ 560 Ms. Lancaster provided for a back-up chair for use as a stand-by and folding travel wheelchair (2451). Ms. Lancaster found that the Quickie 2HP Titanium chair is most serviceable as its frame material is strong and the most lightweight. Its features are: a 70 degree fixed front frame, (16 x 16) two inch cushion, folding adjustable back, push handles, regular frame length, platform flip-up, short foot rest, extension tubes, 6-inch polyurethane aluminum caster rim, caster pin locks, padded swing-away arm rests, adjustable axle plate, STD titanium axles, quad release axle nuts, anti-tip tubes, 24-inch basketball high pressure mag pneumatic wheels, plastic-coated hand rims, long tabs, high push to lock and grade aids. Ms. Lancaster costed this chair at $7,964 with replacement every eight years. The maintenance of the Plaintiff Quickie 2HP titanium wheelchair is approximately 10 percent of its cost on a yearly basis.
2. Ms. Kirker
¶ 561 Ms. Kirker is of the view that a backup folding wheelchair should be purchased at this time, with replacement recommended every seven years.
¶ 562 Ms. Kirker advised that the Plaintiff’s preference was for a folding manual backup chair. Ms. Kirker finds the Quickie 2HP titanium chair very expensive in relation to other chairs with similar features. Ms. Kirker was advised by a supplier in Calgary that the Quickie 2HP titanium chair was discontinued April 1, 1997 because it was too expensive, not selling well, and other chairs were on the market which were meeting consumer needs just as well (3085). Ms. Kirker testified that only the side frames of the chair are titanium. The cross-braces, which constitute the folding mechanism of the chair, are made of aluminum. Therefore, the durability of the chair is in the side frames and not the folding mechanism (3085-3086).
¶ 563 Dr. Geisler was of the view that two wheelchairs would be sufficient although a backup chair was not absolutely required (2042). Dr. Geisler advised that the regular Quickie chair was collapsible and could be easily transferred into any vehicle including a car (2042). According to Dr. Geisler, the backup wheelchair could be used in the case of a breakdown of the Plaintiff’s primary wheelchair (2043). The two wheelchairs were sufficient for a combination of home and travel needs. Dr. Geisler testified that if the Plaintiff lived in an area such as Edmonton, it might be sufficient for her to have her main wheelchair and the racing chair. If the main wheelchair broke down she could use a loaner wheelchair as well as her racing chair. As the Plaintiff gets older and her shoulders start to weaken Dr. Geisler opined that she could use an electric wheelchair (2044).
¶ 564 Ms. Kirker testified that the Plaintiff would be more comfortable in her own backup manual wheelchair as opposed to a loaner wheelchair.
¶ 565 Although Dr. Geisler had recommended that possibly the Plaintiff could rely on a loaner while her primary chair was being repaired (2043), I agree with Ms. Kirker that this is not realistic nor appropriate. Ms. Kirker costed the folding manual Quickie Breezy for the backup chair in the approximate amount of $2,100 as provided by Gold Care (3088). Replacement is recommended every seven years, and the annual maintenance costs at $150.
¶ 566 I do not accept Ms. Lancaster’s recommendation for the Quickie 2HP Titanium chair. Rather, I award the Plaintiff the cost of a back-up chair in the sum of $2,100, with no replacement cost because of the acquisition of an electric powered chair in five years. The annual cost of maintenance is set at $210 (10 percent of the cost) for the five year period.
– Electric Powered Chair
1. Ms. Lancaster
¶ 567 Ms. Lancaster advises that the Plaintiff requires an electric powered chair as she cannot wheel long distances or over rough terrain (2451). To illustrate, if the Plaintiff were visiting her family, she would have great difficulty wheeling on gravel, dirt or any grassed area. Ms. Lancaster is of the view that the Action Arrow Storm Power Wheelchair is appropriate for the Plaintiff.
¶ 568 This compact powered chair, qualified by Ms. Lancaster as very sturdy, would allow the Plaintiff to access the outdoors with her friends, her sisters’ children or her own children one day. In Ms. Lancaster’s view this chair will afford the Plaintiff further independence, allow her more “up time” to be independent from weight relief, manage pressure sores when they occur and protect against pressure sores during pregnancies. According to Ms. Lancaster, without this chair, the Plaintiff would otherwise be required to spend more time in bed for relief. Ms. Lancaster advises that the Action Arrow Storm is available at Golden Boy Medical inclusive of all the above adaptations, for $11,876 with a replacement every eight years. Yearly maintenance of the Arrow Action Storm chair is in the amount of $1,187.
2. Ms. Kirker
¶ 569 Ms. Kirker opined that a wheelchair operator receives wear and tear on his or her upper extremities. Ms. Kirker often finds, even with paraplegic users who have more motor power in their arms, that as they age, they have to rely upon a power wheelchair (3090). According to Ms. Kirker, the Plaintiff reported that she anticipated the need for a power wheelchair in about five years’ time, anticipating it would be a “nicer thing” to have to enable her to keep up with her children (3091). Ms. Kirker provided for $6,500 for the power wheelchair with a recommendation for replacement of batteries every 1.5 years at $260 and yearly servicing at $250.
¶ 570 When asked if there were reasons why a power chair might not be an appropriate option for the Plaintiff at this point, Ms. Kirker opined that the Plaintiff should remain as active as possible and has indicated that fitness is high on her list of priorities (3091). In Ms. Kirker’s view, if the Plaintiff were restricted to the use of a power wheelchair, she would not have the same movement and exercise with her upper body as she would with a manual chair (3091). Ms. Kirker was also of the view that a number of spinal cord injured patients attach a stigma to the use of a power chair because it appears much more disabling than a manual wheelchair (3091). Ms. Kirker testified that the power wheelchair should be purchased in about five years (3091) although she recommended in her September 11, 1997 report that the power wheelchair be purchased at age 30 (3092).
¶ 571 Ms. Kirker assumed that the power wheelchair would serve as the Plaintiff’s primary wheelchair, so that she would only need one backup manual wheelchair (3092). Ms. Kirker would replace the less expensive folding manual backup wheelchair with a more expensive rigid wheelchair (3092). Ms. Kirker was of the view that, depending on the Plaintiff’s needs, it should be her choice whether to purchase a folding or rigid chair, but allocated funds for a more expensive rigid wheelchair (3093).
¶ 572 Ms. Kirker did not provide for a tilt mechanism in the cost of the power wheelchair as the Plaintiff did not indicate the need for a tilt mechanism at the time of the assessment. According to Ms. Kirker this feature would more often be used by individuals who are not able to weight shift independently and who are experiencing difficulty with skin breakdown. In the case of pregnancy or if the Plaintiff experiences low back pain from sitting for prolonged periods of time, the tilt mechanism could enable the Plaintiff to extend her sitting tolerance, particularly in a work environment (3093). Ms. Kirker testified that if she were to provide for the tilt mechanism the additional cost would be about $5,000. She would recommend replacement every eight years if the Plaintiff continued to use the manual wheelchair as her primary chair (3093). However, I note that in five years the electric powered chair will be her primary chair.
¶ 573 The Plaintiff is entitled to the purchase of a power wheelchair in five years from the date of the trial (November 2002) for $11,500 inclusive of the tilt mechanism, with the initial replacement eight years thereafter and subsequently every five years. The yearly maintenance will be $650. Once purchased this would constitute the Plaintiff’s primary chair and the need for the previously referred to back-up chair would therefore be eliminated.
– Racing Wheelchair
1. Ms. Lancaster
¶ 574 Ms. Lancaster found that given the Plaintiff’s disability it was very important for her to be as physically fit as possible. Dr. Geisler shared that view. One of the activities the Plaintiff enjoys, and in which she has successfully participated, is wheelchair racing. At the time of trial, the Plaintiff had been renting a wheelchair at the Rick Hansen Centre but was encouraged to acquire her own chair specifically adapted to her own requirements.
¶ 575 Ms. Lancaster advises that a racing chair can cost between $3,000 and $7,000. The cost is dependent on the model, the individual adaptations required, the size of the client and the type of racing intended. Ms. Lancaster adopts a mid-price range of $5,000, and recommends replacement every eight years. Annual maintenance of the racing chair is ten percent of the original cost.
2. Ms. Kirker
¶ 576 Ms. Kirker costed the racing wheelchair at $3,500 based on recommendations by two suppliers. The average annual maintenance costs are $225 which Ms. Kirker found more reasonable than the ten percent value of the chair as submitted by Ms. Lancaster (3108).
¶ 577 Dr. Geisler understands the Plaintiff’s request for a racing chair (2042) considering the Plaintiff’s background interest in athletics. Dr. Geisler advised that there is a great emphasis on athletics for the spinal cord injured person at the present time (2042). Dr. Geisler supports the recommendation for the racing wheelchair based on the Plaintiff’s physical as well as mental requirements.
¶ 578 Given that Dr. Geisler strongly recommends this athletic activity for the Plaintiff I am satisfied of its importance to the Plaintiff. I am persuaded a mid-range cost is reasonable. The cost of a racing wheelchair is approved at $5,000, replaceable every eight years, with annual maintenance of $500.
– Camelback Hydration System
1. Ms. Lancaster
¶ 579 Ms. Lancaster is of the view that the Plaintiff should have a Camelback hydration system that can be mounted on the chair for hands-free drinking for use while the Plaintiff wheels. Ms. Lancaster advises that these can be purchased at the Running Room at a cost of $22.95 and should be replaced yearly.
2. Ms. Kirker
¶ 580 Ms. Kirker submitted that this device may be appropriate for the described use but was of the view that the Plaintiff would have purchased a similar type of accessory had one been required in other sporting activities. I do not accept this observation.
¶ 581 This annual cost of $22.95 is approved.
– J-2 Cushion
1. Ms. Lancaster
¶ 582 Ms. Lancaster advises that the Plaintiff uses a J-2 cushion in her wheelchair and provided for an additional J-2 Cushion (2453). Ms. Lancaster advises it is available from Golden Boy Medical at $735 per cushion. According to Ms. Lancaster, the Plaintiff’s existing cushion should be replaced immediately and both cushions should be replaced every four years.
2. Ms. Kirker
¶ 583 Ms. Kirker reviewed alternate styles of cushions with the Plaintiff which provide the same amount of protection against skin breakdown. Ms. Kirker recommends the Stimulight Cushion as it is light, washable and in the event of incontinence, could be thrown into the washing machine (3090). Ms. Kirker priced the Stimulight Cushion at $594 with a replacement every four years. Ms. Kirker felt that at this time the Plaintiff’s current J-2 Cushion could be used as a back-up cushion.
¶ 584 Noting the importance of such cushions to the Plaintiff, given the frequency of her episodes of incontinence, I have determined that the Plaintiff is in need of two wheelchair cushions immediately, with one replaced every four years at a cost of $735 each.
– Replacement Cover
¶ 585 Ms. Lancaster provided for replacement covers for the gel seats at a yearly cost of $75 each, the total cost being $150 (2453). Because of the Plaintiff’s problems with incontinence, Ms. Kirker suggested that an additional cover be provided at a cost of $110 with a replacement every four years.
¶ 586 Considering the problems that the Plaintiff has encountered in the past with incontinence, I find that the Plaintiff is entitled to two replacement covers at a yearly total cost of $150.
– Ramps
1. Ms. Lancaster
¶ 587 Ms. Lancaster provides for the EZ-Access Portable Ramp which will bridge the gap over steps and curbs. It is available from Sammons at $272.95 and must be replaced every 15 years.
2. Ms. Kirker
¶ 588 Ms. Kirker provided for aluminum folding ramps which consist of two foldable and portable separate tracks allowing the Plaintiff access to a building with four or five steps. The folding ramps are about 10 or 12 feet in length. As to the difference in those suggested by Ms. Lancaster, Ms. Kirker was of the view that the ramps costed out of the Sammons catalogue had more of a flat surface which would only allow the Plaintiff to go over a curb, or two steps. According to Ms. Kirker, the ramps she suggested would provide the Plaintiff with more options because they are longer and cover more steps (3094). Ms. Kirker testified that the folding ramps are more expensive but do not require replacement (3094). Ms. Kirker costed the ramps at $518.33. I accept the recommendation of Ms. Kirker.
– Backpack
¶ 589 Ms. Lancaster and Ms. Kirker provided for a backpack. Ms. Lancaster was of the view that the Plaintiff goes through one a year. Ms. Kirker on the other hand submitted that the Plaintiff had recently purchased a leather backpack which should last for approximately ten years. Ms. Lancaster indicated that the backpack is available at Sammons at a cost of $110.95. The Plaintiff also uses the smaller fanny pack that is placed underneath the seat of the wheelchair (3089). Ms. Kirker costed the backpack at $150 as well as the fanny pack at $20 with a ten year replacement.
¶ 590 The Plaintiff is entitled to a fanny pack of $20 now with replacement in ten years and a backpack replacement of $150 commencing ten years hence.
– Ram Porch Lift
¶ 591 Ms. Lancaster advised that the Plaintiff’s parents purchased a RAM porch lift for the Plaintiff to have access into and out of their house at a cost of $6,600 (2453). The Plaintiff’s parents have been reimbursed for this cost as part of the agreed special damages. Ms. Lancaster opined that the lift should not be replaced as the Plaintiff no longer lives with her parents and plans to continue to live independently. Ms. Kirker is of the view that this is a past cost and did not provide for it in the schedule of future costs. I agree.
– Exercise Equipment
1. Ms. Lancaster
¶ 592 Ms. Lancaster provided for a Kustom Built Athletic Weight and Pulley System. In her experience patients with quadriplegia benefit from having this equipment in their homes. It could be used in the Plaintiff’s home when the weather is inclement or if the Plaintiff is unwell, such as in the case of recurring bladder infections. Ms. Lancaster’s view is that it would be a great convenience for the Plaintiff to have access to this equipment as it is crucial that the Plaintiff maintain her upper body strength to assist with her transfers and the wheeling of her wheelchair (2455). The equipment is available from Mid-Canada Medical at a cost of $5,500. No replacement is required.
¶ 593 Ms. Lancaster also advises that there is a one-year warranty on the cables, the pulleys, bearings, pushes and upholstery and a five-year warranty on the main frame and welding. According to Ms. Lancaster once these warranties expire it is estimated that maintenance of the custom built weight and pulley system would be $150 per year. Ms. Lancaster also advises that the Plaintiff currently uses special cuffs to hold weights during her exercise sessions. The total cost of the exercise equipment is $5,545.
2. Ms. Kirker
¶ 594 Ms. Kirker is of the view that the cost of the Kustom Built Weight and Pulley systems is excessive and given that it is likely designed for facility usage, the yearly maintenance fee for a home use situation will not apply. Ms. Kirker provides for a membership at a fitness facility which accommodates wheelchairs at a cost of $80 per year and recommends this as a more viable solution as it provides the Plaintiff with additional socialization. Ms. Kirker acknowledges that there will be situations when the Plaintiff will elect to stay at home. At those times the Plaintiff could use free weights and a home exercise program which would include strengthening and stretching exercises. Ms. Kirker does not provide for the cost of free weights.
¶ 595 According to Ms. Kirker the Plaintiff reported that she uses weight lifting cuffs to assist her with weight lifting activities. These are available at a cost of $25 as recommended by the suppliers with yearly replacement.
¶ 596 The Plaintiff will be allowed an annual membership fee of $80 for a fitness club, weightlifting cuffs of $25, replaced annually, and as I have been given no evidence as to the cost of free weights I will set a reasonable cost of $200 for this one time purchase.
– Attendant Care
¶ 597 Ms. Lancaster provided for several attendant care scenarios (2456):
1. 24 hour live-in care;
2. Attendant care four to five times a day;
3. 24 hour care for the occasions when the Plaintiff suffers severe bladder and kidney infections (three to four times a year) (2456);
4. Attendant care during pregnancy.
(i) 24-Hour Live-in Care Giver
1. Ms. Lancaster
¶ 598 Ms. Lancaster opined that the Plaintiff would prefer a 24 hour live-in caregiver and provided for a 24 hour caregiver to afford the Plaintiff a less regimented and more normal spontaneous lifestyle. This would avoid the necessity of the Plaintiff being tied to a caregiver at specific times (2457). The Plaintiff would prefer to have her live-in caregiver reside in a small suite contained in her home so she would be readily accessible but still provide the Plaintiff and her family with the privacy they required. Care would be provided 12 hours per day as well as two additional 15-minute work periods at night to turn the Plaintiff and deal with bladder accidents. The caregiver would have four hours downtime and eight hours sleep time. In Ms. Lancaster’s view this scenario would allow the Plaintiff to work. The annual cost would be $62,415.
2. Ms. Kirker
¶ 599 According to Ms. Kirker, the Plaintiff did not report that she had experienced any incidents to date where she required 24 hour care or that she had a preference for 24 hour care. The Plaintiff appears to have a pro-active approach to her bladder care and monitors herself for potential bladder infections on a regular basis. There may be occasions when antibiotics may not work effectively and Ms. Kirker suggests that the Plaintiff be provided with two weeks of 24 hour care throughout the year to cover such situations. Ms. Kirker advises that Ms. Lancaster reports an average cost of $200 per day for 24 hour care whereas she later reports the 24 hour rate at $171.
¶ 600 Ms. Kirker advised that the Plaintiff was asked to provide an estimate of the number of hours of care she thought would be necessary to meet her needs and Ms. Kirker used this as a basis for her cost determination for a caregiver. Ms. Kirker testified that in terms of the Plaintiff’s daily activities, she would not be accessible to the care-giver for 10 to 12 hours a day. Ms. Kirker finds the provision of a 24 hour caregiver excessive given the level of independence the Plaintiff seems to enjoy and the intermittent assistance required throughout the day.
¶ 601 Dr. Geisler indicated that if the Plaintiff were not turned at night she would be vulnerable to pressure sores. She might get away with this for up to three years but, if other circumstances prevailed or the condition worsened, the Plaintiff would become increasingly vulnerable (2039). In Dr. Geisler’s view, it would be dangerous for the Plaintiff if no one turned her at night (2038). He was mindful that the Plaintiff had not had such care since her discharge from the Glenrose or at the very least, since she started attending university (2039).
¶ 602 With regard to the attendant care, if the Plaintiff were to have involuntary bowel movements or bed-wetting during the night, she would have to wait until morning to be assisted. This would be a very unhealthy situation (2040) in light of her vulnerability to skin breakdown (2040). Dr. Geisler testified that thus far this had not happened. In his experience a situation of this nature could lull the spinal cord injured patient into believing that she would not experience skin breakdown. This can be a very dangerous assumption for the spinal cord injured patient to make (2041). Dr. Geisler testified that spinal cord injured patients have to be constantly aware of their vulnerability (2041).
¶ 603 I am mindful of Dr. Rocheleau’s testimony that the Plaintiff requires approximately six to seven hours per day of attendant care (2937). Dr. Rocheleau advised that the Plaintiff informed him that this reflected the current level of attendant care which she felt was adequate (2938). Dr. Rocheleau testified that there was no reason for the Plaintiff to receive 24 hour a day attendant care and that such level of care for a spinal cord injured person with a lesion at the Plaintiff’s level is neither standard nor common (2939).
¶ 604 Dr. Rocheleau was of the view that other models might accommodate the Plaintiff’s needs, for example, a shared unit strategy. This involves a situation where a number of people live in one dwelling such as a large apartment or home. Their needs would be cared for by one or two caregivers, dependent upon the size of the unit (2942).
¶ 605 Dr. Rocheleau also spoke to the attendant care scenario in which individuals, with medical problems requiring assistance on an intermittent basis, live in their own apartment with attendant care available on an “as-needed” basis (2942).
(ii) Attendant Care Four to Five Times a Day
1. Ms. Lancaster
¶ 606 Ms. Lancaster testified that the Plaintiff requires assistance with wheelchair transfers and standby assistance for the completion of her personal care. Furthermore, as the Plaintiff catheterizes herself four or five times daily, Ms. Lancaster recommends she have an attendant five times daily for a two hour period.
¶ 607 According to Ms. Lancaster, Edmonton Home Services Ltd. quote an average of $14.25 per hour for attendant care services which amounts to $47,025 annually for 330 days: ($14.25 x 10 hours x 330 days). 330 days represents the number of days required for personal attendant care, with the remaining 35 days covered by Ms. Lancaster under 24 hour care as it relates to bladder infections.
2. Ms. Kirker
¶ 608 Ms. Kirker is of the view that the Plaintiff catheterizes an average of four times per day, save when the Plaintiff is experiencing infections. According to Ms. Kirker’s November 1, 1997 report, the Plaintiff indicated that she is managing with her daily average of 5 1/2 hours of attendant care which provides for her meal preparation, morning routine including bathing, dressing, and catheterization, as well as her evening routine. In testimony Ms. Kirker stated that she thought that the six hours of personal care was meeting the Plaintiff’s needs (3069). According to Ms. Kirker’s September 11, 1997 report the Plaintiff is currently receiving assistance from Olsten Kimberly Qualitycare through the Capital Health Authority for six hours a day. The cost for this service is $13.55 per hour through the government program while the average cost for a personal care attendant, if paid privately, is $13.50 per hour. The weekly cost for the personal care attendant is $567, for a yearly cost of $29,484. There is some variance in the hourly rates documented. Ms. Kirker advises that the quotes for the attendant costs were provided by the agency currently providing the Plaintiff’s care and by the Capital Health Authority. Ms. Kirker testified that for the purposes of costing out care in her report, she allotted six hours of care rather than 5 1/2 (3090).
¶ 609 Ms. Kirker was of the opinion that the Plaintiff requires an attendant to assist in caring for her personal needs, home management tasks and meal preparation.
¶ 610 Ms. Lancaster does not find Ms. Kirker’s hour allocation satisfactory because in her opinion it puts the Plaintiff “seriously at risk” (3120).
¶ 611 Ms. Kirker testified she “bumped up” the personal care by a half an hour a day to six hours because the status quo appears to be meeting the Plaintiff’s needs (3119). In Ms. Kirker’s view it is unreasonable to provide for an additional four hours per day. Ms. Kirker further supplemented the personal care by providing another six hours per week of homemaking to assist with housecleaning and shopping (3119-3120). Ms. Kirker opined that other equipment could assist the Plaintiff without the need for further attendant care such as an adjustable bed to assist with the positioning of the Plaintiff. Ms. Kirker testified that the medical documents she reviewed did not indicate that the Plaintiff’s amount of personal care was inadequate. Ms. Kirker testified that the Plaintiff reported that she was satisfied with her care and did not identify a need for nighttime assistance (3275-3276).
¶ 612 The Plaintiff testified that Ms. Kirker had queried her on December 4, 1997 as to the amount of personal care she received from paid attendants and not if she were satisfied with 5 1/2 hours of attendant personal care per day (3274). When asked whether she misunderstood the Plaintiff’s answer or the Plaintiff misunderstood her question, Ms. Kirker stated she had reviewed the Plaintiff’s daily routine and that was what the Plaintiff had reported (3274).
¶ 613 At the time Ms. Kirker prepared her initial report, she was unaware that the Plaintiff was receiving regular nighttime assistance from Mr. Conquest. Ms. Kirker testified that the Plaintiff did not indicate this. Ms. Kirker testified she would have asked the Plaintiff as to the nighttime routine as that would have been a concern to her (3274-3275). According to Ms. Kirker, the Plaintiff indicated that she had no regular assistance during the night (3275). Ms. Kirker did not get the impression that Mr. Conquest was at the Plaintiff’s every night providing assistance (3069).
(iii) 24 Hour Care for the Occasions the Plaintiff Suffers Severe Infections
1. Ms. Lancaster
¶ 614 Ms. Lancaster recommends that the Plaintiff have a 24 hour attendant for her periods of severe bladder infections (three to four times per year). However, both the Plaintiff and Dr. Geisler have testified that these infections occur more frequently, every five to six weeks. Ms. Lancaster contacted Care Home Health Services in Edmonton and Edmonton Home Health Services Limited and received quotes on an average of $200 for 24 hour care. Ms. Lancaster estimates that the Plaintiff will require 35 days per year of 24 hour care which amounts to $7,000 yearly.
¶ 615 Ms. Lancaster advises that 24 hour care is based on 12 hours of paid care per day (2457).
2. Ms. Kirker
¶ 616 Ms. Kirker did not provide for this scenario in her initial report but in her rebuttal report Ms. Kirker provided for a contingency for two weeks of a 24 hour period per year.
(iv) Attendant Care During Pregnancy
1. Ms. Lancaster
¶ 617 Ms. Lancaster is of the view that the Plaintiff will require 18 months of 24 hour care during her pregnancy. The Plaintiff will gain weight, incur bladder problems and have episodes of autonomic dysreflexia, high blood pressure, decubitus ulcers, skin breakdown, and may have to stay in bed for several months. Within this context Ms. Lancaster costed $109,440 for 24 hour care during the Plaintiff’s two pregnancies (30.4 days for an average month x 9 pregnancy months x $200 = $109,440).
¶ 618 Ms. Lancaster advised that the Plaintiff is adamant about having children even though she recognizes the risk (2458), and has discussed this with her family physician.
2. Ms. Kirker
¶ 619 In Ms. Kirker’s view, it is unlikely the Plaintiff will require 24 hour care for the entire nine months of her pregnancy. Relying upon Dr. Rocheleau’s testimony Ms. Kirker was of the view that increased assistance in the order of a 50 percent increase would be needed in the second trimester and 24 hour care in the third trimester (3072). Ms. Kirker advises that Ms. Lancaster again utilized the higher 24 hour rate of $200 whereas she documents the cost at $171 for 24 hour care further in her report (3115).
(v) Determination of Attendant Care Needs
¶ 620 Given the evidence I have heard, I am not persuaded that the Plaintiff is in need of 24 hour attendant care. Because of her schooling hours and ultimately her forecasted work hours, 24 hour attendant care would have a caregiver simply available on a 24 hour call. This is a luxury, the cost of which should not be imposed upon the Defendants.
¶ 621 Accordingly, the Plaintiff is to be given costing for the following attendant care:
(1) Eight hours of care daily at $13.50 per hour and $35,640 annually ($13.50 x 8 x 330 days). The two additional hours will provide for the much needed night-time assistance of turning the Plaintiff, which Dr. Geisler insists is essential to the Plaintiff’s well-being. Also, it will provide assistance if the need arises because of night-time incontinence. I find that in the past Mr. Conquest provided this assistance but I cannot rely upon Mr. Conquest to provide such assistance in the future — it is too uncertain and speculative for me to consider.
(2) Twenty-four hour care for the occasions that the Plaintiff suffers severe bladder infections.
I accept that the Plaintiff experiences severe bladder infections every five to six weeks and that there is a real possibility that such conditions will worsen with the Plaintiff’s advancement in years. However, I acknowledge that on some occasion these infections can be effectively treated with antibiotics. I therefore accept Ms. Lancaster’s requirement of 35 days per year at $171 per day, $5,985 annually, although based upon three or four infections per year, less than the Plaintiff’s reality, it appears to consider the benefits of antibiotic treatment.
(3) Attendant Care During Pregnancy
I accept Ms. Lancaster’s forecasted two pregnancies which was supported by Dr. Rocheleau’s testimony. Further, I accept Dr. Rocheleau’s opinion that she will need 50 percent more assistance in the second trimester and 24 hour care in the third trimester. Therefore, I award 12 hour care for the second trimester at $13.50 per hour for six months (two pregnancies) (12 x $13.50 x 183 days = $ 29,646) and 24 hour care at $171 per day for six months (171 x 183 days = $31,293).
With respect to the award given in number 3 above, the appropriate deduction should be made for the standard care already awarded of eight hours daily to realize the net differential.
– Homemaker
1. Ms. Lancaster
¶ 622 Ms. Lancaster provided for the cost of a homemaker as caregivers do not perform homemaking tasks such as meal preparation (2457). By housekeeping, Ms. Lancaster meant activities such as washing, ironing, dusting, vacuuming, cleaning and wall washing. (2459). Ms. Lancaster advised that the Plaintiff cannot put the laundry away, take out the garbage, change light bulbs nor undertake major meal preparation and clean-up. A homemaker can be hired at $12.50 per hour from Para-med Health Services Ltd. or We Care Home Health Services. Ms. Lancaster advised that while the Plaintiff is living in an apartment she will require four hours per week of homemaking, (although there was a typographical error in her written report which noted three hours). This yearly cost is $2,600 ($12.50 x 4 x 52 weeks = $2,600) (2539). When the Plaintiff begins living in a home of her own Ms. Lancaster advises that she will require an additional three hours per week of homemaking. Once again her calculation is in error in her report as it was based upon four hours. The actual annual cost is $1,950 ($12.50 x 3 hours x 52 weeks = $1,950) (2539).
¶ 623 Ms. Lancaster also provides for an additional eight hours of homemaking twice per year to look after the heavy cleaning including, washing the walls; cleaning, windows, light fixtures, kitchen cupboards, and closets. Ms. Lancaster advises in her report that this service is available from We Care Home Health Services Ltd. at $17.50 per hour for heavier house cleaning chores ($17.50 x 16 hours = $280 required yearly).
2. Ms. Kirker
¶ 624 Ms. Kirker advised that the Capital Health Authority program does not provide services for homemaking (3067). Ms. Kirker was of the view that there is some duplication of job duties in those described for the homemaker and the tasks currently being performed by the personal care attendant who is responsible for meal preparation and clean-up. Ms. Kirker recommends two hours every other day for homemaking and shopping purposes (3068). Ms. Kirker opines that based on the hourly rate of $12.50 the weekly cost should be $75 for a yearly cost of $3,900.
¶ 625 Both experts agree that as the attendant caregiver does only limited housekeeping chores, the Plaintiff is in need of additional homemaking services. I accept Ms. Lancaster’s costing of four hours per week, $2,600 annually (4 x 52 x $12.50), while the Plaintiff remains in her apartment. I also agree that when the Plaintiff moves into a home, an additional three hours per week of homemaking will be required at an additional annual cost of $1,950 (3 x 52 x $12.50). This will commence when it is estimated that the Plaintiff will conclude her graduate studies, four years from January 1998 namely, January 2002. I also approve an additional eight hours of homemaking for seasonal “heavy cleaning” at $17.50 per hour twice a year to commence when the Plaintiff is anticipated to take up residency in a house for an annual sum of $280 (8 x $17.50 x 2).
– Handyman
1. Ms. Lancaster
¶ 626 Ms. Lancaster provided for the cost of a handyman not knowing whether the Plaintiff would be married or if there would be an expectation that the person with whom she was living would do work around the home (2458). In Ms. Lancaster’s view the Plaintiff would not be able to take on the responsibility for gardening and snow removal, and general outside tasks associated with a home. Ms. Lancaster provides for a handyman for four hours a week. According to Ms. Lancaster these services range from $12.50 to $20 per hour depending on the work required. Ms. Lancaster provided for an average cost of $16 per hour for a yearly cost of $3,328. I do not accept this recommendation for reasons specified below.