What are the “Activities of Daily Living” ADL under TSGLI ?
“Activities of Daily Living” (ADL) are referred to in the TSGLI Loss Standards. Activities of Daily Living (ADL) are routine self-care activities that a person normally performs every day without needing assistance.
There are six basic ADL: eating, bathing, dressing, toileting, transferring (moving in and out of bed or chair). And continence (managing or controlling bladder and bowel functions).
Determining if you have a loss of ADL
You are considered to have a loss of ADL if you require assistance to perform at least two of the six activities of daily living. If you are able to perform the activity by using accommodating equipment (such as a cane, walker, commode, etc.), you are considered able to independently perform the activity.
Claims may be filed for loss of ability to do Activities of Daily Living (ADL) if you are unable to independently perform any two (2) of the following (6) activities on a day-by-day basis for 30 days or more (15 days or more in the case of Traumatic Brain Injuries).
Examples for the six ADL
1. You require assistance in Eating.
You are unable to get food from dish to mouth, or cannot grip or lift fork, or cannot lift or hold plate, glass, or cup or cannot shake the salt, etc.
2. Do you require assistance in Dressing?
You cannot pull a shirt overhead, button a shirt, put your foot into pants, or put on or fasten a belt. You are unable to put on socks or shoes or tie shoes or boots without assistance.
3. Is there a need for assistance in Bathing.
You cannot get in and out of a shower or bathtub, or cannot wash without help from another person.
4. Do you need assistance in Transferring?
You need help from another person to get in and out of bed or a chair or a car
5. You require assistance in Toileting.
You need help to go to and from the toilet and/or while using the toilet.
6. Is there a need for assistance in maintaining independent Continence.
You need help to manage a catheter or colostomy bag. You are unable to maintain continence independently if you are partially or totally unable to control bowel and bladder function.
The TSGLI Procedural Guide
The TSGLI Procedural Guide defines “requires assistance”:
– Physical assistance – when a patient requires hands-on assistance from another person
– Stand-by assistance – when a patient requires someone to be within arm’s reach because the patient’s ability fluctuates and physical or verbal assistance may be needed
– Verbal assistance – when a patient requires verbal instruction in order to complete the ADL due to cognitive impairment. Without these verbal reminders, the patient would not remember to perform the ADL.
Without this physical, stand-by, or verbal assistance, the patient would be incapable of performing the task.
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