Reasonableness of Care & Assistance Claims: Stewart v Metro North

At the time of trial, the Plaintiff had resided in a residential care facility for a number of years. The Plaintiff alleged at trial that he was entitled to recover damages for future care and assistance assessed on the basis that he be transferred from this facility to his own home, allowing him to live in the community, supported by his own carers. It was submitted on the Plaintiff’s behalf that it was reasonable for his damages to be assessed on this basis by virtue of: –

• It being the Plaintiff’s wish to live in his own home;
• The Plaintiff’s quality of life being substantially improved in his own home, as it would allow him to spend more time with his family and allow him to keep a dog;
• An improvement in the Plaintiff’s quality of life leading to improvements in his psychological health, which would in turn lead him to engage in therapeutic and recreational activities; and
• The arrangement allowing the Plaintiff to receive more dedicated therapy, from which the Plaintiff would derive significant physical health benefits.

In response, the Defendant submitted that it could not be satisfied as to the Plaintiff’s intentions or wishes due to his impaired cognitive functioning. Further, it asserted that the evidence before the Court did not support a conclusion that home-living would result in the functional and cognitive improvements alleged by the Plaintiff.

The Court considered a range of factors in deciding whether it was reasonably necessary for the Plaintiff to be cared for in his own home, and therefore for damages to be awarded on that basis, namely: –

• The relevant benefits the Plaintiff would derive from home based care;
• Whether the Plaintiff continued residence at a residential care facility would be a suitable alternative to home based care;
• The comparative costs of the two options; and
• If the more expensive approach was to be adopted, whether the likely benefits would be commensurate to the extra cost.

The Court was satisfied that the provision of care and therapy to the Plaintiff within his own home would result in health benefits that could not be considered “slight or speculative” and were more than mere amenity. The Court did, however, consider the provision of therapy and care within a residential care facility to be a viable alternative model, particularly if additional services were made available to him.

Ultimately, the Court opined that the Plaintiff’s damages for future care and assistance ought to be assessed on the basis that the Plaintiff remain at a residential care facility. Of note to the Court was the considerable difference between the cost of providing care to the Plaintiff within his home own compared with a residential care facility, being $3,828,446.96. In the Court’s view, the potential benefits derived from in home care would not be significantly better than those likely to be achieved through an enhanced program provided within the environment of a residential care facility. For this reason, Cooper J opined that it was not reasonable for the Defendant to pay the “significant additional cost” that would accompany a transition to home-based care. As such, damages were assessed on the basis that the Plaintiff would continue to reside at a residential care facility, albeit with the Plaintiff receiving enhanced care arrangements.