There’s an important relationship between ADLs (Activities of Daily Living) and LTC Insurance in that ADLs are benefit triggers. When a person needs supervision or help with ADLs, this is reason enough to activate LTC Insurance benefits. A qualified doctor or medical professional will need to certify this need for LTC services though. Most companies start paying out benefits when a policy holder is unable to effectively perform at least 2 out of six ADLs, of if they suffer from a form of cognitive impairment.
ADLs and LTC Insurance Benefits
Top providers of Long Term Care Insurance services (e.g. Genworth Financial, Mutual of Omaha, John Hancock, Mass Mutual, New York Life) usually provide benefits for both standby and physical assistance. Usually, physical assistance is when someone needs actual help with ADLs. On the other hand, standby assistance is when an individual needs supervision to ensure that they safety perform ADLs. For instance, if an individual needs help bathing or dressing each morning, that is physical assistance. But if they need a caregiver standing within arm’s reach just to be safe if they might fall, that’s categorized as standby assistance.
About Cognitive Impairment
Alzheimer’s, Dementia and other similar conditions are a trigger for LTC Insurance benefits. Any form of cognitive impairment means that the affected person will need supervision for their own health and safety. For instance, if you leave the door open, a dementia sufferer might get out, start roaming and eventually get lost in the neighborhood. Thus, they need near-constant supervision.
All tax-Qualified Long Term Care policies that are available in the market today don’t necessitate prior hospitalization in order for benefits to start streaming in. Well, with annual care costs going up to over 60,000, what asset do you have to liquidate first so you can cover this bill before the insurance company sets in? Policies are activated any time the holder needs is diagnosed with cognitive impairment (e.g. Alzheimer’s), or needs help with at least 2 out of 6 ADLs.
The standardized listing of the 6 types of ADLs is:
- Maintaining Continence
When we are all young and healthy, ADLs are something we take for granted. We are able to hop out of bed in the morning, shower, get dressed quick and move around as we wish. But for our aging parents and loved ones, they can be quite a hustle.
ADLs and LTC Insurance Research
Long Term Care Insurance cover is smart planning if you don’t ever want to liquidate family assets or ever have your family relying on Medicaid. Our passionate team at LTC Key pulls the strings with top carriers in the market, and delivers to you side-by-side comparisons for cover. This way, you are more informed, and have more options to choose from. So you really have no excuse not to buy a plan that best serves your needs. You also get to save a lot of time since you don’t have to convene with any sales agent and suffer through the hard sell.
Definition of ADLs and LTC Insurance Policies
- Eating – simply the procedure of putting food into your body. This might via a receptacle (plate or cup), feeding tube, or intravenously.
- Bathing – washing yourself in a shower or bathtub. Also entails a person’s ability to get in or out of the tub/shower.
- Dressing – ability to put on or take off items of artificial limbs, braces or fasteners.
- Toileting – getting to and from the toilet, getting on and off the toilet, as well as performing the corresponding personal hygiene.
- Transferring – moving in or out of a bed, chair or wheelchair.
- Continence – a person’s capacity to control his/her bladder and bowel functions. The ability to effectively perform the corresponding personal hygiene, including caring for a colostomy or catheter bag when an individual has incapacity to control bladder and bowel functions.
All Insurance firms that we represent offer tax-qualified LTC plans. One of the main requirements for benefits to be activated for Long Term Care Insurance, Medicare and Medicaid is that a policy holder is unable to perform at least 2 ADLs. Everyone ought to be aware of this fact before they start shopping for LTC Insurance.
Instrumental Activities of Daily Living (IADLs)
Together with illness, aging can significantly impede a person’s ability to conduct daily tasks that are necessary for independent living. Certain assessments are conducted to determine a person’s baseline for functionality. Based on the outcome of this assessment, the subject might be deemed to be in need of medical treatment or additional resources. IADLs (Instrumental Activities of Daily Living) are often used when measuring one’s functionality. The point is to establish whether someone can adequately perform IADLs, or whether they need some help. In some cases, people might become completely dependent on help for IADLs. IADLs usually have a lot to do with how a person interacts with their environment, whether at home or in the community.
Examples of tasks considered to be IADLs
- Shopping – is the person able to choose and purchase food, clothing and other item all by themselves? Are they completely not able to shop?
- Traveling (either locally or afar) – are they able to safely drive or independently travel on taxis or buses? Or are they totally not able to travel?
- Managing finances – is the individual able to perform money management tasks such as balance a checkbook and pay bills? Can they handle everyday purchases but need help with paying bills, or are they totally unable to manage money?
- Housework and chores – is the person able to handle significant housework that needs to be done, maybe cleaning floors and getting rid of trash? Can they address simple housework but need assistance with bulkier chores, or are they totally unable to handle any household tasks?
- Food preparation – is the person able to plan and cool full meals by themselves? Are they only able to do light meals, or totally unable to prepare food?
- Use of the phone – is the person able to receive and make calls without any help? Can they dial 911 or answer their phone, or do they need help to find numbers before dialing? Or is the person totally unable to use the phone?
- Taking medicine – Is the individual able to safely take medication at the right times daily, or are they totally not able to take medicine without supervision?
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