Activities Of Daily Living (ADL)

Activities of daily living (ADL) refers to basic activities that an individual has to perform in order to take car of oneself, which is a key criteria for long term care(LTC)  benefit payouts.

Because insurance policies for long term care are meant to provide cover people who are unable to care for themselves, activities of daily living is used to measure whether a sufferer meets the condition for payouts to occur.

Some people might find it repulsive to be so specific in the type of disability a person suffers from. But this is how insurance as a business works.

While there is no legal descriptions of what ADL should consist of, most insurers usually design their LTC policies around 6 types of ADLs.

  • Mobility (walking or moving around)
  • Washing (bathing)
  • Dressing
  • Feeding (eating)
  • Toileting
  • Transferring

Benefits of long term care insurance plans usually payout depending on the number of ADLs that a victim is suffering from.

Basic ElderShield for example, commences payout when a person is unable to perform at least 3 ADLs.

It should be noted that ADL requirements can be just one criteria for payouts. Other criteria such as a deferred period can also come into play.

Other types of private insurance policies can have a requirement as low as 2 ADLs.

It is sometimes referred to as a severe disability when a person is unable to perform two or more of these functions.

Mobility

Mobility describes the ability to move from a space indoors to another space.

When a wheelchair is part of the equation, then the ability to move from room to room from a seated position on a level surface.

Some insurers might require that a person is unable to walk independently for a specified distance before being considered as immobile.

This implies that if the minimum distance 8 meters, a person who is able to cover that distance but not beyond might be considered mobile.

While there is no standard distance, 8 meters is often a figure that is thrown about.

Washing

Washing describes the ability of one to bath and/or shower oneself.

It includes the ability to get in and out of the bathroom or washing area.

And also the functions of rinsing and drying the body without a helper too.

It would make no sense for someone to be considered as able to take on this activity if he is able to bath with soap but unable to wash it off and dry himself after.

Dressing

Dressing is the ability of oneself to take off and put on clothing independently for the upper and lower torso.

This include the ability to secure and remove any other medical appliances or physical aids.

Sometimes using aids to dress up can be seen as an ability to dress up.

Feeding

Feeding is the ability to eat food without needing assistance after food has been prepared for consumption and made available to the sufferer.

This does not include the ability to cook.

When cooked food is placed within reach, then a person must be able to consume it himself or herself.

Consumption would include micro tasks like cutting up the food, bring the food to the mouth, chewing, etc.

Should eating be administered via a nasogastric tube, then the person should be able to to it independently.

Toileting

Toileting is the ability to use the lavatory, including being able to manage bowel movement and bladder function.

If a sufferer is using special undergarments or surgical appliances, then the toileting ability includes the ability to manage them too.

It is important to note that performing this particular ADL might require functions from other ADLs.

For example,  the ability to undress for bowel activity would be categorized under the dressing ADL. And the ability to get to a toilet and sit on the bowl would be under the ADL of transferring.

Transferring

Being able to transfer from a bed to a chair or wheelchair, and back to bed again, without requiring assistance from a helper or care giver.

This is actually physically very challenging for a person who is suffering from some type of disability, maybe through injury, weakness or chronic pain.

Someone who has an inability to do this can easily further injure himself or herself when attempting to do so.

When a wheelchair is involved, then being able to manage it like locking the brakes can be a concern.

Claim Limit

Factual Expectation

Benefits

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