What does it mean to be dependent?
The need for assistance to perform activities of daily living
Any person, regardless of their age, who requires significant and regular assistance from another person – e.g. a healthcare professional, a relative or another private individual – to perform ADLs (activities of daily living), owing to a physical, mental or psychiatric disorder or deficiency, shall be considered a dependent person.
ADLs are categorised as follows:
- Hygiene: bodily and oral hygiene; shaving and facial hair removal; menstrual hygiene.
- Elimination: eliminating bodily waste; changing colostomy bags or emptying urinary drainage bags.
- Nutrition: eating and drinking; enteral feeding.
- Dressing: putting on and taking off clothes; installing and removing corrective and compensatory equipment.
- Mobility: getting up and sitting/lying down; getting from one place to the next; entering and leaving home; going up and down stairs.
The assistance of another person may be required for one or several ADL categories.
It may also take different forms depending on the dependent person's state of health:
- performing all or some ADLs for the dependent person;
- supervising or supporting the dependent person while they perform the ADLs.
The assistance required to perform the ADLs must be qualified in terms of a specific intensity: the 'intensity' of the required assistance must be at least 3.5 hours/week (threshold).
The state of dependency must remain unchanged, or be expected in all likelihood to remain unchanged, for at least 6 months, or be irreversible: long-term care insurance is meant to cover permanent, definitive and irreversible dependency.
A person with a need for short-term assistance, or for assistance only with household chores or preparing meals, is not a dependent person under the law.
The need for assistive technology and home adaptations
Long-term care insurance coverage may also be sought when there is a need for assistive technology and/or home/car adaptations, irrespective of any need for assistance to perform ADLs.
Certain categories of individuals may be entitled to long-term care benefit insurance based on other eligibility criteria (set by Grand-Ducal regulation)
- visually impaired persons;
- persons who have trouble communicating due to a severe hearing impairment, aphasia or dysarthria, and persons who have undergone a laryngectomy;
- persons with symptomatic forms of spina bifida.
Once the hearing or visual impairment criteria have been assessed by an AEC-approved ENT specialist (ear, nose and throat specialist) or ophthalmologist, the person may be granted a lump-sum cash benefit.
Dependent young children (up to 8 years old)
All young children need their parents' help to perform ADLs. Some children, however, as a result of illness or disability, need more help with ADLs than others.
When long-term care insurance is sought for an ill or disabled child, the AEC considers the child's need for additional assistance compared to a healthy child of the same age.