Today’s blog post continues the series about buying long term care insurance as a strategy for planning ahead for long term care. My post of May 22, 2014 discussed whether to buy long term care insurance at all. My post of May 29, 2014 suggested looking for a stable, proven insurer. My post of June 5, 2014 described how to identify a proven, stable Long Term Care insurance company. My post of June 12, 2014 discussed the importance of protection against inflation. My post of June 19, 2014 suggested planning to use insurance to pay for four or five years of long term care. My post of June 22, 2014 suggested a daily rate to choose when purchasing long term care insurance. The introductory post in the series on planning ahead for long term care costs appeared on May 15, 2014.
Now that we’ve outlined the financial parameters of our long term care insurance policy, we will look at the conditions that will trigger coverage. Most policies now use a loss of the insured person’s ability to carry out Activities of Daily Living (“ADLs”) to trigger coverage. Usually, the policy will start to pay out when the person has trouble with two of these ADLs. Policies differ in the list of ADLs that they examine.
Most policies (and, for that matter, most geriatric care managers) consider seven primary Activities of Daily Living when determining whether a person needs assistance or supervision: Bathing (personal hygiene or grooming,) dressing and undressing, feeding oneself (does not include cooking,) transferring (getting in and out of bed and/or a chair,) ambulation (walking or otherwise getting around,) continence (controlling one’s bladder and bowel movements,) and toileting (including cleaning oneself.)
Some policies do not include bathing as one of the Activities of Daily Living. Because of the slick surfaces in tubs and showers and because the tub or shower usually requires a step in and out, bathing is frequently the first ADL for which a senior will need help. Before buying a long term care insurance policy that uses ADLs to determine whether to pay a claim, make sure that the policy includes bathing in the list.
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