Activities of Daily Living
Some of the stats on this page are courtesy of CMS, the Centers for Medicare and Medicaid Services.
Fact:
 "Most Long Term Care is to assist people with support services such as activities of daily living like dressing, bathing, and using the bathroom.”
Activities of Daily Living (ADLs)
All Tax-Qualified LTC policies are activated once the policy holder needs assistance either with two of six ADLs or with a cognitive impairment (Alzheimer's Disease, for example). ADLs are things we all take for granted in our younger, healthier years. When we wake up in the morning, hop out of bed, and get dressed, we are performing ADLs.
The standard definition of the six types of Activities of Daily Living are:
- Eating
- Bathing
- Dressing
- Toileting
- Transferring
- Maintaining Continence
While a specific definition of these activities varies from one Long Term Care Insurance Company to another, following are their general definitions.
Eating is defined as the process of putting food into the body...
- From some receptacle, such as a cup or plate.
- By means of a feeding tube.
- intravenously
Bathing is defined as the act of washing oneself in a bathtub or shower, or by sponge bath. It also includes the individual's ability to get into and out of a shower or tub.
Dressing is defined as the individual’s ability to put on and take off.
• all items of clothing
• any needed braces, fasteners or artificial limbs
Toileting is defined as
• getting to and from the toilet
• getting on and off the toilet
• performing associated personal hygiene
Transferring is defined as moving into or out of a
• chair
• bed
• wheelchair
Continence is defined as the individual’s ability to
• control his or her bowel or bladder functions
• adequately perform needed personal hygiene, including taking care of a catheter or colostomy bag, when unable to control bowel or bladder functions
All of the companies LTC Tree represents sell Tax-Qualified Long Term Care Insurance policies. One of the requirements in order for an insurance policy to be tax qualified is that it must be activated when one needs assistance with any two ADLs. This is something to be aware of when you are shopping.
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Instrumental Activities of Daily Living (IADLs)
The process of normal aging combined with illness can impede one's ability to perform the tasks of normal daily living necessary in order to live independently. Thus, the individual's functional levels must be assessed in order to plan for specific services or for rehabilitation of injuries. These assessments help establish baseline for the person's functionality, and changes may the precursors for the need for additional resources or medical treatment. When measuring a person's levels of functioning, instrumental activities of daily living (or IADLs) are used to help find solutions. Patients are scored as to whether or not they can perform these IADLs independently; or if they require some help; or if they are completely dependent on assistance with IADLs. IADLs typically involve interaction with a person’s environment. This interaction may be in the home or in their community.
The following tasks are the main examples that are considered IADLs:
- Shopping- Can the person select and buy food and clothing by themselves, or are they unable to shop at all?
- Traveling locally and afar—Is the person able to drive safely or travel independently on buses or taxis either by themselves or with a companion; or are they simply unable to travel at all?
- Managing their money - Is the person able to manage their finances, such as paying bills or balancing their checkbook? Can the person manage their daily purchases, but needs help paying bills; or are they simply unable to handle money at all?
- Housework and chores - Can the person do heavy housework that must be done, such as cleaning the floors and taking out the trash; or can they perform light housework but may need help with heavy chores; or are they unable to perform any household duties at all?
- Preparing food - Can the person plan and cook full meals; or are they able to prepare only light meals by themselves; or are they unable to prepare any food by themselves?
- Using the phone - Can the person independently dial and receive calls with no help? Can the person answer the phone or dial 911 in emergencies, or do they require a special telephone to assist with finding the number and dialing? Is the person unable to use the telephone at all?
- Taking medicine - Can the person take medications safely at the correct time of day or they unable to take medications without supervision at all?
The main benefit triggers of Medicare, Medicaid, and Long Term Care Insurance is if the person needs help with two or more Activities of Daily Living or (ADLs) which can be found at the top of this page.
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