- Robinson #14 French Catheters and Additional
Catheterizations
¶ 731 Ms. Lancaster and Ms. Kirker provided for 4 to 5 Robinson #14 French Catheters per day. Ms. Kirker advised that the Plaintiff is currently receiving this item from Classic Health Supplies through Alberta Aids to Daily Living (”AADL”). Ms. Lancaster costed the catheters at $.98 each for a yearly cost of $1,609.65 (4.5 x 365 x .98) whereas Ms. Kirker costed the item at $.92 each as per the AADL cost, and $.98 for the retail cost. Ms. Kirker provided for a yearly cost of $1,434.72. Ms. Kirker’s calculation of the yearly cost of $1,434.72 equates to approximately 4.27 catheters a day at $.92 each.
¶ 732 Ms. Lancaster submitted that the Plaintiff averaged one to two bladder infections over the past year and thus requires two additional catheterizations daily for a two week time period each month in the event of a bladder infection. The yearly cost would be $329.28, representing two additional daily catheterizations for a two-week period each month with the occurrence of infections ($0.98 x 2 catheters x 14 days x 12 months = $329.28 / year). Once again I note that the occurrences of one to two bladder infections appears low given the testimony of the Plaintiff and Dr. Geisler. However, given that the Plaintiff did not raise this disparity I will accept this calculation.
¶ 733 According to Ms. Kirker, Ms. Lancaster provided for an additional 182 catheters per year. Ms. Kirker is of the view that the Plaintiff may require an additional catheter per day on occasion in the event of a bladder infection, but found it unlikely she would use one every other day (3073). Ms. Kirker suggests that the $329.28 should be added to the Plaintiff’s usual four catheterizations per day to arrive at a yearly cost for the catheters of $1,764.
¶ 734 I will allow the sum of $1,764 annually for catheters for daily usage and to accommodate the potential increased need because of bladder infections.
– Foley Catheter
¶ 735 Both experts agree that the Plaintiff uses the Foley Catheter when she travels. Ms. Kirker provided for 12 Foley Catheters on the basis that the Plaintiff might travel once a month. According to Ms. Kirker, the average cost of the Foley Catheter is $22.57, at a yearly cost of $270.84. Ms. Lancaster, on the other hand, costed the Foley Catheter at $5.98, and provided for 18 at a yearly cost of $107.64. With the Foley Catheter, the Plaintiff requires further supplies such as a leg bag, strapping, tubing, and a disposable catheter tray. Ms. Kirker advises that the Plaintiff would use the catheter tray with the Foley Catheter or any other in-dwelling catheter.
¶ 736 I accept the recommendation of Ms. Kirker and award $270.84 per year for Foley catheters.
– Leg Bags
1. Ms. Lancaster
¶ 737 According to Ms. Lancaster the Plaintiff uses nine-ounce leg bags for the Foley catheter system which includes connectors at a cost of $5.62 each for a yearly cost of $33.72. Ms. Lancaster advises that velcro straps attach the leg bags to the Plaintiff’s thigh at a cost of $5.95 per strap and at a usage of twice per year, at the yearly cost of $11.90. I am mindful that Ms. Lancaster provides figures for disposable bags whereas Ms. Kirker provides for a reusable bag at $55.
2. Ms. Kirker
¶ 738 Ms. Kirker was of the view that the cost for a reusable leg bag is $55, and given that it would only be used on an occasional basis, Ms. Kirker recommends replacement every five years.
¶ 739 The Plaintiff is awarded the cost of a reusable leg bag of $55, replaceable every five years. There was no evidence as to whether connectors and velcro straps are required. If such items are used in connection with the reusable bag then the annual cost recommended by Ms. Lancaster is also approved.
– Catheter Tray
¶ 740 Ms. Lancaster and Ms. Kirker provided for a catheter tray for use with the Foley catheter. Ms. Lancaster costed the tray at $8.87 from Health Care and Rehab Specialties, and advised that 2 trays are required per year. Ms. Kirker advised that a catheter tray is required each time the Foley catheter is used, and the average retail price is $5 for a yearly cost of $60.
¶ 741 I accept the recommendation of Ms. Kirker and award a yearly cost of $60.
– Chem Strips
1. Ms. Kirker
¶ 742 Ms. Kirker advises that the Plaintiff currently uses Chem Strips daily to test for bladder infections (3073). These are available from a drug store at $20 for 100 tabs. Ms. Kirker estimated that the Plaintiff uses five tabs per week at a yearly cost of $52.
2. Ms. Lancaster
¶ 743 Ms. Lancaster did not provide for Chem Strips.
¶ 744 The annual cost of Chem Strips at $52 is approved.
– Baby Powder
1. Ms. Lancaster
¶ 745 According to Ms. Lancaster, the Plaintiff uses baby powder on the seat of the commode to facilitate transfers. Ms. Lancaster advises that a 400 gm. container is required per month for $3.10, at a yearly cost of $37.20. However, earlier testimony of both experts indicated that the Plaintiff does not have a commode chair for bathing and bowel routine purposes.
2. Ms. Kirker
¶ 746 Ms. Kirker advised that the Plaintiff did not report using baby powder to assist with her transfers, but finds that in the event the Plaintiff uses this method for transferring, the cost is reasonable.
¶ 747 If the Plaintiff does use baby powder to assist in her transfers, the cost of $37.20 annually for baby powder is approved. I anticipate the parties will reach agreement on this point but once again if they cannot, they are to come back before me.
– Blue Pads/Incontinent Liners
1. Ms. Lancaster
¶ 748 According to Ms. Lancaster the Plaintiff uses 30 to 35 blue pads per month for her bowel and bladder program at $36 per box of 200. Ms. Lancaster is of the view that the Plaintiff requires two to three boxes per year at a cost of $90.
2. Ms. Kirker
¶ 749 Ms. Kirker testified that the Plaintiff uses a blue pad on her bed as well as places one on her wheelchair cushion (3072). Ms. Kirker advises that in the case of incontinence, the blue pads will “wick the moisture” away from the Plaintiff’s skin.
¶ 750 According to Ms. Kirker, the Plaintiff also uses incontinent liners from AADL. Unlike the blue pad the incontinent liner is placed in the underwear to protect the Plaintiff’s clothing from incontinence (3073).
¶ 751 According to Ms. Kirker, the supplier advised that the cost per pad is 34 [cents] through AADL and 68 [cents] per pad if purchased privately. Ms. Kirker advises that the AADL program provides for 100 pads every 2 months. Ms. Kirker provided for disposable underpads at a yearly cost of $424.32 based on the Plaintiff’s reported usage and retail cost. Ms. Kirker also provided for disposable incontinent liners and advised that AADL provides 60 liners every two months at a cost of $.68 each, and the average retail cost of $.86 each. Based on daily use of one liner, Ms. Kirker advises the yearly retail cost is $314.76.
¶ 752 I accept Ms. Kirker’s recommended annual cost for both the blue pads and the incontinent liners.
– Sterile Gloves
1. Ms. Lancaster
¶ 753 Ms. Lancaster recommended sterile gloves for catheterization as they are frequently recommended for patients with bladder infections. Ms. Lancaster advises that the Plaintiff does her own catheterizations but cannot put on these gloves. According to Ms. Lancaster, should the Plaintiff have a caregiver do her catheterizations or allow her to assist in gloving, the Plaintiff should use sterile gloves prior to starting catheterization. According to Ms. Lancaster, the sterile gloves are available at $16.95 per box of 100, or $.17 each. At an average use of 4 to 5 per day, the yearly cost of the sterile gloves is $496.40.
2. Ms. Kirker
¶ 754 According to Ms. Kirker, the Plaintiff had advised that sterile gloves were not used as part of her bowel and bladder routine. Ms. Kirker opined that it is not reasonable to provide for sterile gloves when they are not used. Ms. Kirker submitted there could be a contingency for this type of situation, but in her view an annual cost of $500 for supplies not presently utilized is unrealistic.
¶ 755 Although, the Plaintiff in the past has not used sterile gloves as part of her bowel and bladder routine because of the increased incidences of bladder infections, it is appropriate to provide for such a contingency to accommodate the sterilized method of catheterization. According, I allow $350 annually for this purpose.
– Non-sterile Gloves
1. Ms. Lancaster
¶ 756 Ms. Lancaster provided for non-sterile gloves for the bowel program and was of the view that the Plaintiff uses one box per month, at $10.95 per box of 100, for a yearly cost of $131.40.
2. Ms. Kirker
¶ 757 According to Ms. Kirker, the Plaintiff did not report using non-sterile gloves.
¶ 758 I disallow this expenditure given my earlier award for sterile gloves.
– Stainless Steel Slipper Bed Pan
¶ 759 Ms. Lancaster provided for a stainless steel slipper bed pan which is available from Health and Rehab Specialties at $74.95. Ms. Lancaster recommends replacement every 25 years.
¶ 760 I allow this cost of $74.95 with replacement every 25 years.
– Basin
¶ 761 Ms. Kirker advises that the Plaintiff indicated she uses a basin for her personal care routine items. According to Ms. Kirker, the estimated cost for this item is $8, with a five year replacement.
¶ 762 I allow this cost of $8 with a five year replacement.
– Mirror
1. Ms. Lancaster
¶ 763 According to Ms. Lancaster, the Plaintiff uses a mirror designed for self-catheterization which is available from Sammons at a cost of $62.50. Ms. Lancaster recommended yearly replacement as the Plaintiff has had to replace five or six mirrors because they have been stepped on or fallen off the bed.
2. Ms. Kirker
¶ 764 Ms. Kirker advised that the Plaintiff uses a hand-held mirror to assist her in performing her routines and for skin inspections. Ms. Kirker priced the mirror at $27.70, with replacement recommended every 5 years. Ms. Kirker found the cost as suggested by Ms. Lancaster to be high. According to Ms. Kirker, the replacement time for the mirror was based on discussions with the Plaintiff, and in Ms. Kirker’s view, yearly replacement seems excessive given that this has not been a necessity in the past.
¶ 765 I will allow the cost of $27.70 for the mirror, with replacement every second year.
– Digital Bowel Stimulator
¶ 766 Ms. Lancaster advises that a digital bowel stimulator is necessary for the Plaintiff’s bowel routine, and is available from Sammons at a cost of $85.50 and must be replaced yearly. Ms. Kirker costed this item at $65.75, and recommends a 5-year replacement. Ms. Kirker advises that the Plaintiff provided the estimated replacement of five years based on her usage and experience.
¶ 767 I will allow the cost of $85.50 with replacement every three years.
– Lotion
¶ 768 According to Ms. Kirker, the Plaintiff reported that she uses Neutraderm lotion as a moisturizer on a daily basis and uses a 480 ml container on a monthly basis at an estimated cost of $13.50, for a yearly cost of $162.
¶ 769 I will allow the annual cost of the lotion at $162.
– Digital Thermometer
1. Ms. Lancaster
¶ 770 Ms. Lancaster advises that the Plaintiff requires a digital thermometer as she cannot shake a regular thermometer. According to Ms. Lancaster, it is available at a cost of $14.98 and is replaceable every five years.
2. Ms. Kirker
¶ 771 Ms. Kirker was of the view that a thermometer is a common household item and it is not reasonable, in her view, to assume the Plaintiff’s need for the thermometer as being solely related to her disability.
¶ 772 Relying on the medical evidence adduced at trial, an abnormal temperature is a serious concern for the Plaintiff and is definitely tied to the risks related to her disability. The Plaintiff must monitor her temperature regularly and as she cannot shake a regular thermometer this clearly appears to be a reasonable expenditure and is approved at $14.98, replaceable every five years.
– Padding
1. Ms. Lancaster
¶ 773 Ms. Lancaster opined that the Plaintiff had been extremely lucky to date in that she had not developed a decubitus ulcer, but has experienced a problem with her heels becoming very sore and red. Ms. Lancaster opined that the Plaintiff should be using padding in her shoes such as lamb wool padding to reduce the pressure (2442). Ms. Lancaster opines that the Plaintiff will require six packages a year at a cost of $2.88 (London Drugs) per package for a yearly cost of $17.28.
2. Ms. Kirker
¶ 774 Ms. Kirker advised that the Plaintiff did not report using this type of padding but was of the view that the cost and potential benefit is reasonable in the event the Plaintiff experiences any reddened areas.
¶ 775 I accept the recommendation of Ms. Lancaster and award the yearly cost of $17.28.
– Debrison, Pharmacia, 60mg.
1. Ms. Lancaster
¶ 776 Ms. Lancaster is of the view that the Plaintiff requires Debrison, Pharmacia, 60mg., which is a wound cleaning agent. Ms. Lancaster advises that the Plaintiff uses one container yearly at a cost of $69, available from Blaine-McLean Surgical.
2. Ms. Kirker
¶ 777 Ms. Kirker advised that the Plaintiff did not report using this type of cleansing agent but “likely would have required some type of first aid supplies.” Ms. Kirker notes that Dr. Geisler’s report of June 2, 1995 states that one container of Debrison would be sufficient for the year.
¶ 778 By virtue of the need for the Plaintiff to be scrupulous with her skin care, I allow this expenditure of $69 annually.
– Kenacomb Cream
1. Ms. Lancaster
¶ 779 Ms. Lancaster advises that the Plaintiff requires Kenacomb Cream for rashes and uses approximately one tube per year at $16.08, available from Blain-MacLean Surgical.
2. Ms. Kirker
¶ 780 Dr. Geisler reported that the Plaintiff would only require Kenacomb Cream in special circumstances such as a fungal infection. According to Ms. Kirker, it is unlikely the cream would be required on a yearly basis although in her view some allowance could be provided for this item.
¶ 781 No evidence was provided to the Court as to the shelf life of this cream. Therefore, an annual replacement appears reasonable. I allow the cost of $16.08 annually.
– Xylocaine Gelee, 2%
1. Ms. Lancaster
¶ 782 According to Ms. Lancaster, the Plaintiff requires Xylocaine Gelee 2% for bladder infections. Ms. Lancaster advises that a 30 ml. tube costs $10.69 from Blain-Maclean Surgical. The Plaintiff uses four tubes yearly at a cost of $42.76.
2. Ms. Kirker
¶ 783 Ms. Kirker is of the view that this cost is reasonable, even though the Plaintiff did not specifically report using this item.
¶ 784 I accept Ms. Lancaster’s recommendation and allow the annual cost of $42.76.
– Bactrigras Antiseptic Dressing
1. Ms. Lancaster
¶ 785 Ms. Lancaster advises that the Plaintiff requires Bactrigras Antiseptic Dressing for burns or skin breakdown from decubitus ulcers at $1.19 each, and requires 20 packages per year at a yearly cost of $23.80.
2. Ms. Kirker
¶ 786 Ms. Kirker advises that, according to Dr. Geisler’s report, the Bactrigras Antiseptic Dressing should be used in only special circumstances and suggests 2 packages per year would be sufficient. She agrees with Dr. Geisler on this point.
¶ 787 I accept Ms. Kirker’s and Dr. Geisler’s recommendation and award $2.38 annually.
– Hair Brush With an Attached Velcro Handle
¶ 788 According to Ms. Lancaster the Plaintiff uses a hairbrush with an attached Velcro handle which is available from Sammons at $17.50 yearly and must be replaced annually. Ms. Kirker advises that the Plaintiff uses a universal cuff with her hairbrush. The universal cuff, with rigid wrist support, is available for $29 and replacement is recommended every three years.
¶ 789 Given that the experts were unable to agree on what in fact the Plaintiff currently uses, I have averaged the cost and award the Plaintiff $13.60 annually for this item.
– Sliding Shelves
1. Ms. Lancaster
¶ 790 According to Ms. Lancaster, the Plaintiff requires sliding shelves for the lower shelves of the kitchen and bathroom. Ms. Lancaster advises that pull-out baskets on runners are available from European Closet Company for approximately $50 each. Ms. Lancaster advises that baskets will be required for an estimated eight lower cupboards, two baskets per cupboard, which would amount to a cost of $800. Ms. Lancaster advises that the initial cost is included in the cost of wheelchair housing and replacement is recommended every 20 years. Ms. Lancaster advises that the installation of the baskets takes approximately three hours at $25 an hour which equates to a cost of $75 and is required every 20 years. Ms. Kirker advises that she finds the replacement time to be reasonable for this item.
¶ 791 I allow the replacement cost of $800 and installation cost of $75 every 20 years after the initial installation.
– Adjustable Bed
1. Ms. Kirker
¶ 792 Ms. Kirker advised that the Plaintiff currently has a standard size double bed and is able to turn herself to the side when she is on top of the sheets. The Plaintiff has more difficulty turning at night. To assist the Plaintiff with providing a more independent means of adjusting her position in bed as well as sitting up to perform the catheterizations with greater ease, Ms. Kirker recommends the purchase of an adjustable bed where the foot and head of the bed can be adjusted independently (3095).
¶ 793 Ms. Kirker costed the item at $1,888 and recommends replacement every 20 years. The additional cost for the mattress is estimated at $500 and replacement is recommended every ten years. The maintenance cost for the bed is estimated at $50 per year.
2. Ms. Lancaster
¶ 794 Ms. Lancaster did not make allowance for an adjustable bed.
¶ 795 I accept the recommendation of Ms. Kirker in its entirety.
– Intercom System
1. Ms. Lancaster
¶ 796 Ms. Lancaster is of the view that the Plaintiff requires an intercom system between the Plaintiff’s bedroom and other rooms in the house. According to Ms. Lancaster, this item is priced at $199.99 at Radio Shack, and must be replaced every five years.
2. Ms. Kirker
¶ 797 Ms. Kirker is of the view that this item should be considered as part of the initial cost for wheelchair housing, however, she finds the replacement time to be short and recommends that it be increased to ten years.
¶ 798 I will not allow the cost of the intercom system as I agree that it should be part of the initial cost of the wheelchair accessible housing; but I do allow a replacement cost of $200 every five years.
– Zim Jar Opener
1. Ms. Lancaster
¶ 799 Ms. Lancaster advises that the Plaintiff requires a Zim Jar Opener because of her poor grip, which is available from Sammons at a cost of $14.50, and must be replaced every five years.
2. Ms. Kirker
¶ 800 Ms. Kirker finds this item reasonable. Given that this item is made of steel, Ms. Kirker recommends that the replacement time be increased to 10 years.
¶ 801 I allow the cost of $14.50 with replacement every ten years.
– Electric Can Opener
¶ 802 Ms. Kirker advises that the Plaintiff presently has an electric can opener although she finds it difficult to hold heavy cans in order to use the opener. Ms. Kirker recommends a one-handed can opener. This item is available for an average cost of $51.50 and replacement is recommended every ten years. I accept this recommendation.
– Swedish Knives
1. Ms. Lancaster
¶ 803 Ms. Lancaster recommends Swedish Knives made with an angled handle which give the arm, wrist and hand a natural relaxed working position. Ms. Lancaster advises that the angled handle would be helpful to the Plaintiff in that she will not have to put a lot of pressure on her hand to cut. The total cost of the knives is $106 and must be replaced every five years. Ms. Lancaster provides for a straight knife ($41.25), a fork knife ($31.25), and a serrated knife ($33.95), all from Sammons.
2. Ms. Kirker
¶ 804 Ms. Kirker thought it “good” for the Plaintiff to have a knife that she can use, but reduced the number and increased the replacement time (3113). In Ms. Kirker’s view, these items would not be used on a frequent basis given the Plaintiff’s level of dependency in kitchen activities. Ms. Kirker suggests two of the knives at a cost of $75.20 with replacement every 15 years.
¶ 805 I approve the cost of all three knives at $106 total, replaceable every ten years because of the Plaintiff’s level of dependency with respect to kitchen activities.
– Gordon Peeler
1. Ms. Lancaster
¶ 806 According to Ms. Lancaster the Plaintiff requires a Gordon Peeler which clamps to a kitchen counter and is easier to use than a vegetable peeler. Ms. Lancaster costed this item at $33.25 from Sammons, and recommended a five-year replacement.
2. Ms. Kirker
¶ 807 According to Mrs. Kirker, the most recent pricing from Sammons is $29.95. Ms. Kirker advises that this peeler is an item designed for one-handed use for an individual with good dexterity and control of the one hand. Ms. Kirker is of the view that as the Plaintiff’s hand does not have good dexterity it would be a difficult item for the Plaintiff to use (3113).
¶ 808 I disallow this cost.
– Extended Reacher
1. Ms. Lancaster
¶ 809 According to Ms. Lancaster, the Plaintiff requires a quad-reacher to enable the Plaintiff to pick-up pins and hold heavier objects. Ms. Lancaster advised that the reachers are available from Sammons at $220.25 and should be replaced in three years and every five years thereafter.
2. Ms. Kirker
¶ 810 Ms. Kirker advises that the quad-reacher described by Ms. Lancaster is designed to move by wrist action as finger movement is not required. In Ms. Kirker’s view, this is different from the current reacher model the Plaintiff is able to use which is equipped with a forearm support. Ms. Kirker advises that the Plaintiff has used an extended reacher with forearm support for two years (3114). Ms. Kirker recommends that the Plaintiff continue to use the reacher with which she has been successful in the past at an average retail cost of $40, with recommended replacement every four years.
¶ 811 I approve the expenditure recommended by Ms. Kirker of $40 with replacement every four years.
– Food Processor
¶ 812 According to Ms. Lancaster the Plaintiff requires a food processor to assist with various kitchen tasks. Ms. Lancaster priced the kitchen food processor at $299 from The Bay, and advised that it should be replaced every 20 years. According to Ms. Kirker, the Plaintiff purchased a food processor for approximately $80 last year. In Ms. Kirker’s view, given the lower cost of the processor, the replacement time of 10 years is reasonable.
¶ 813 I approve a replacement cost for the food processor in ten years at $300 and thereafter every 20 years.
– Food Preparation Board
¶ 814 Ms. Kirker provided for a food preparation board with raised edges which would help the Plaintiff prepare light meals such as sandwiches. According to Ms. Kirker, it is available for a cost of $15.95, and replacement is recommended every five years. I accept this recommendation.
– Kitchen Roll-About
1. Ms. Lancaster
¶ 815 Ms. Lancaster provided for a kitchen roll-about which is a wheeled stand for moving hot pans and dishes on counters or tables. Ms. Lancaster costed the item at $35.95 from Sammons, and recommended replacement every seven years.
2. Ms. Kirker
¶ 816 Ms. Kirker was of the view that the Plaintiff cannot use the kitchen roll-out for the manipulation of hot pans or dishes as it would be unsafe considering her limited dexterity (3113).
¶ 817 I disallow this cost because of the safety concerns raised by Ms. Kirker.
– Adjustable Fold-Away Cart With Casters
1. Ms. Lancaster
¶ 818 Ms. Lancaster provided for an adjustable fold-away cart with casters for kitchen use to transfer heavy items, for example, from the refrigerator to the counter. According to Ms. Lancaster, this item is available for $83.25 from Sammons and must be replaced every ten years.
2. Ms. Kirker
¶ 819 Ms. Kirker advises that this item is not listed in the current Sammons catalogue and, as described, the item would be difficult for the Plaintiff to manipulate.
¶ 820 This cost is not allowed.
– Quad-Quip Meat Cutter Knife
1. Ms. Lancaster
¶ 821 Ms. Lancaster is of the view that the Plaintiff requires a Quad-Quip meat cutter knife which would allow her to cut food in a rocker action. This is available from Sammons at a cost of $10.50. In Ms. Lancaster’s view, two knives are required yearly at a cost of $21.
2. Ms. Kirker
¶ 822 Ms. Kirker agrees that a rocker knife would be beneficial for the Plaintiff. Ms. Kirker costs the knife at $27.85 and recommends a 5-year replacement. Ms. Kirker is of the view that the cost provided by Ms. Lancaster is unreasonable.
¶ 823 I accept the recommendation of Ms. Kirker and approve of the cost of $27.85 with replacement every five years.
– Leather Wheelchair Pushing Gloves
1. Ms. Lancaster
¶ 824 According to Ms. Lancaster the Plaintiff requires 12 sets of leather wheelchair pushing gloves involving three different types of gloves, namely cycling, long-fingered, and winter gloves. Ms. Lancaster testified that the Plaintiff requires four pairs of cycling gloves at an annual cost of $144, four pairs of long-fingered gloves at an annual cost of $108, and four pairs of winter gloves at an annual cost of $180 for a total yearly cost of $432.
2. Ms. Kirker
¶ 825 According to Ms. Kirker, the Plaintiff reported that she uses six to seven pairs of gloves per year at an average cost of $30 for a total of $195, based on 6.5 pairs per year.
¶ 826 The Plaintiff is allowed two pairs of cycling gloves at an annual cost of $72 ($36 per pair); two pairs of long-fingered gloves at a cost of $54 annually ($27 x 2 = $54) and two pairs of winter gloves at $90 annually ($45 x 2 = $90) for a total annual cost of $216.
– Pen Splint
1. Ms. Lancaster
¶ 827 According to Ms. Lancaster, the Plaintiff uses a pen splint for writing which is available from Sammons at $45 and must be replaced yearly.
2. Ms. Kirker
¶ 828 According to Ms. Kirker, the pen splint recommended by Ms. Lancaster is more elaborate than the writing splint that was fabricated at the Glenrose. Ms. Kirker advises that the current cost of the item is $62.50 whereas the cost of the splint that is similar to the Plaintiff’s splint is available at $37.50. Ms. Kirker recommends a 3-year replacement.
¶ 829 I accept the recommendation of Ms. Kirker at a cost of $37.50, replaceable every three years.
– Heart II Chair
1. Ms. Lancaster
¶ 830 According to Ms. Lancaster the Plaintiff requires a chair other than her wheelchair in which she can sit comfortably but which will provide sufficient support given her ongoing problems of scoliosis. Ms. Lancaster recommends a Heart II Chair over an ordinary recliner chair due to the protection it affords the back. It provides “excellent” support for the spinal column in addition to the reclining benefit. Ms. Lancaster advises that the Heart II Chair is available from Medi-Chair for $1,395. Ms. Lancaster deducts $625 for the cost of an average recliner. Therefore, the total cost claimed is $770, with replacement every 15 years.
2. Ms. Kirker
¶ 831 Ms. Kirker is of the view that it is unlikely that the Plaintiff would use this chair on a regular basis as she would require assistance to transfer in and out of the chair. Ms. Kirker opines that the tilt mechanism on the power wheelchair suggested by Ms. Lancaster would also provide the Plaintiff with a means of changing her position without having to lose her independent mobility.
¶ 832 I accept the need for the Plaintiff to have an alternative to her wheelchair. Therefore, I accept Ms. Lancaster’s recommendation of $770 with replacement every 15 years.
– Two Extra Pillows
1. Ms. Lancaster
¶ 833 According to Ms. Lancaster, the Plaintiff requires two extra pillows for positioning while she is sitting in her Leisure lift chair and also when she is positioned in bed. Ms. Lancaster advises that these are available from Sears at $39.99 for two and that the Plaintiff requires two sets at a total cost of $79.98 which must be replaced yearly.
2. Ms. Kirker
¶ 834 Ms. Kirker advises that the Plaintiff did not report using additional pillows for positioning; however, in the event that the pillows are used for this purpose, Ms. Kirker suggests that one set of pillows be provided every five years.
¶ 835 I will allow two pillows at a cost of $39.99, replaceable every five years.
– Dycem Matting
1. Ms. Lancaster
¶ 836 Ms. Lancaster provides for Dycem matting which is available from Sammons at $239.25 per 10 yard square roll and must be replaced every second year. I am advised that the Dycem matting prevents items from sliding as it steadies them (2446).
2. Ms. Lancaster
¶ 837 According to Ms. Kirker, Dycem matting is reusable and can be easily wiped off if it starts to lose some of its non-slip functioning. Ms. Kirker opines that an allowance of 20 feet of this material is excessive.
¶ 838 Although Ms. Kirker indicated that 20 feet of this material was excessive, she did not provide the Court with what would be reasonable in her opinion, nor how often it need be replaced. Also I have no indication if there exists a minimum quantity that must be ordered. Accordingly, I accept Ms. Lancaster’s recommendation of $239.25 with replacement every two years.
– Transfer Board
1. Ms. Lancaster
¶ 839 According to Ms. Lancaster the Plaintiff requires two transfer boards (2446) which are available from Sammons at $61.50 each and must be replaced every two years at a total annual cost of $123.
2. Ms. Kirker
¶ 840 Ms. Kirker advises that the price of a transfer board, on average, is $42. In Ms. Kirker’s view, purchasing another transfer board at this time would allow the Plaintiff to use her current one as a backup. Ms. Kirker opines that it does not seem necessary to replace these boards every two years given the manner in which the Plaintiff is transferred.
¶ 841 I allow the cost of one transfer board at $50 replaceable every three years.
– Over-the-Bed Table Tray
1. Ms. Lancaster
¶ 842 Ms. Lancaster provided for an over-the-bed table tray at a cost of $179.95 which is needed for holding supplies. It should be, in her opinion, replaced every ten years. The Plaintiff currently has a lap board for her wheelchair for house use. Ms. Lancaster advises that this item should be replaced in three years and every six years thereafter. It is available from Sammons for $163.75.
2. Ms. Kirker
¶ 843 According to Ms. Kirker, a table tray is unnecessary. It could create additional problems in so far as trying to position items close to the Plaintiff given the manner in which she currently performs her catheterizations.
¶ 844 Ms. Kirker advises that the Plaintiff had a bean bag lap tray at the time of the assessment; however, she indicated that this item is not particularly useful and that she hardly uses it. Ms. Kirker is of the view that the cost, as submitted by Ms. Lancaster, is high given that this item is available at a significantly lower cost in local retail outlets. However, Ms. Kirker gave no advice as to what that price would be.
¶ 845 I will approve a lap board table for her wheelchair for home use at $163.75, replaceable every six years but deny the claim for an over-the-bed tray for the reasons provided by Ms. Kirker.
– Cordless Speaker Phone
1. Ms. Lancaster
¶ 846 According to Ms. Lancaster the Plaintiff requires a cordless speaker phone which is available at a cost of $199.98 at London Drugs. Ms. Lancaster advises that the cost of an average phone is $29.98 and that there is a disability related cost of $170. According to Ms. Lancaster this item should be replaced in three years and every six years thereafter.
2. Ms. Kirker
¶ 847 Ms. Kirker advised that the cost of this item was found to be $65. In Ms. Kirker’s opinion there is a large variety of cordless telephones available for well under $200.
¶ 848 Clearly there is a wide range of cordless speaker phones. I am cognizant that in certain instances the telephone will be the Plaintiff’s life-line to the outside world. Also I am continually placed in the position by these experts where I must ascertain whether I am assessing the cost of a “deluxe”, “standard” or” bargain basement” model. I approve the cost of this item at $125 as the disability related cost with replacement every three years. I make this award given the advancements in technology we have seen in recent years, and given the fact that hereafter I have denied the claim for a Life Call of Canada System.
– Large Size Bath Sheets
1. Ms. Lancaster
¶ 849 According to Ms. Lancaster the Plaintiff requires large size bath sheets for use after bathing or showering. Ms. Lancaster advises that the Plaintiff requires four towels (each at $39.99) at an annual cost of $159.98, which must be replaced yearly. Ms. Lancaster advises that the Plaintiff should not be chilled after a bath.
2. Ms. Kirker
¶ 850 Ms. Kirker opines that there is no specific rationale for this item. Ms. Kirker finds the provision of four towels to be excessive and that there is no consideration for the cost of towels that would normally have been incurred. In Ms. Kirker’s view, it is unclear whether this item should be considered disability-related.
¶ 851 I am again cognizant of the fact that the Plaintiff must maintain a stable body temperature. Large bath sheets because of her immobility do not appear unreasonable. However, I agree with Ms. Kirker that there was no consideration for the cost of towels one would normally incur. I allow an annual cost of $80.
– Additional Television Set
1. Ms. Lancaster
¶ 852 According to Ms. Lancaster the Plaintiff requires an additional television set in her bedroom which would be connected to the environmental control system. Ms. Lancaster provided for this item because, in her view, there will be times when the Plaintiff will be waiting in bed for her care or must remain in bed due to illness. Ms. Lancaster submits that the cost is $359.99 and must be replaced every ten years.
2. Ms. Kirker
¶ 853 Ms. Kirker opines that the Plaintiff does not spend a lot of time in her bedroom apart from when she is sleeping. Ms. Kirker finds the Plaintiff to be an active person, interested in maintaining a level of fitness when not confined to a bed. Ms. Kirker is of the view that the need for an additional television is unclear.
¶ 854 I am not persuaded that this item is disability-related.
– Two Extra Sets of Sheets
1. Ms. Lancaster
¶ 855 Ms. Lancaster advises that the Plaintiff requires two extra sets of sheets per year over and above the normal usage at a cost of $59.99 per set for a yearly cost of $119.98. Ms. Lancaster is of the view that these sheets are required yearly.
2. Ms. Kirker
¶ 856 Ms. Kirker advised that the Plaintiff reported that her bed linen tends to wear out more quickly as they are often washed because of problems of incontinence. The Plaintiff estimated she replaced an additional set of sheets per year at an estimated cost of $60 for a double sheet with a fitted bottom and flat top.
¶ 857 I accept Ms. Lancaster’s recommendation that two extra sets of sheets are required because of the Plaintiff’s incontinence problem. An annual cost of $119.98 is approved.
– Lever Key Holder
1. Ms. Lancaster
¶ 858 According to Ms. Lancaster the Plaintiff requires a lever key holder which is available from Sammons at $19.75. Ms. Lancaster advises that the Plaintiff cannot start her car without it (2447) and it must be replaced yearly. Ms. Lancaster testifies that the Plaintiff already has a lever key holder.
2. Ms. Kirker
¶ 859 Ms. Kirker opines that the Plaintiff has been able to manage keys without an assistive device to date and did not indicate a need for this type of equipment.
¶ 860 I accept Ms. Lancaster’s testimony. This annual cost of $19.75 is approved.
– Life Call of Canada System
1. Ms. Lancaster
¶ 861 According to Ms. Lancaster, there will be times when the Plaintiff will be at home alone and in the case of a medical, police or fire problem, might rely upon Life Call of Canada System for assistance. According to Ms. Lancaster this system includes a smoke detector for response from the fire department. A priority jack is also recommended which would allow the use of the Life Call System if the phone is being used or is off the hook. Ms. Lancaster advises that there is a one-time installation cost of $49 for the Life Call System and a monthly monitoring cost of $26.75. The total cost is $370.
2. Ms. Kirker
¶ 862 In Ms. Kirker’s view, the medical necessity of this item is not clear as the Plaintiff could have access to both her telephone and cellular phone in the event of an emergency. Ms. Kirker opines that if the Plaintiff were expressing some concern as to her safety when alone, this item would be something to consider.
¶ 863 I am not persuaded that such a system is necessary given the Plaintiff’s access to a cellular phone and cordless speaker phone.
– Medication
1. Ms. Lancaster
¶ 864 Ms. Lancaster advises that the Plaintiff is currently using Urispas and Lioresal on a regular basis. The Plaintiff also takes the antibiotic, Ciproflox, approximately twice daily for five days when she has a bladder infection which is approximately every six weeks (2430 – 2431). Ms. Lancaster anticipates that the Plaintiff will find it necessary to take other medications in the future. The Plaintiff also takes a contraceptive and Extra Strength Tylenol for pain relief. Ms. Lancaster advised that the Plaintiff has to be careful with the Tylenol as it causes constipation. Ms. Lancaster provides for $150 per month to cover the cost of medication at a yearly cost of $1,800.
2. Ms. Kirker
¶ 865 Ms. Kirker submits that according to the costs of current usage as provided by the pharmacy, the yearly estimate for medications is $1,730 (3081).
¶ 866 Relying on the evidence of current usage, I allow an annual amount of $1,730.
– Computer Equipment
1. Ms. Lancaster
¶ 867 The Plaintiff currently has a computer and printer which is on loan to her through a vocational rehabilitation centre for disabled persons. In Ms. Lancaster’s view the Plaintiff should have a computer and printer of her own. Ms. Lancaster advises that the Plaintiff has researched the marketplace for what would best be suited to her needs given her disability and believes she requires a voice-activated computer system with special training on the system and software. According to Ms. Lancaster, it should be noted that although the Plaintiff uses a normal keyboard with a typing device, this is not a practical solution as it takes her an inordinate amount of time to produce one typed page. According to Ms. Lancaster if the Plaintiff were employed and was required, due to certain health problems, to work from her home, a computer system would be an invaluable tool for her. This would allow her to continue to be competitive in the workplace.
¶ 868 Ms. Lancaster advises that although this is not her area of expertise and she defers to the experts in this technical field of computer and specialized software, it has been her experience that this equipment is individualized for each client and cannot be purchased as software in the normal manner. According to Ms. Lancaster the assessment, purchase, set up and training should be done through a technical resource centre with staff who are experienced in working with quadriplegic patients. In Ms. Lancaster’s view a suitable computer and printer can be purchased for approximately $3,500 and must be replaced every six years given the obsolescence factor.