Standby Assistance

More Information

Stand-by assistance is when someone needs a caregiver nearby when they complete an activity of daily living. These individuals need a caregiver nearby to prevent injuries or physically step in. 

In Long-Term Care Insurance, stand-by assistance is a part of the legal definition of a benefit trigger. The legal definition states that a policyholder can access their policy’s benefits if they need hands-on or stand-by help with two or more activities of daily living.  

In other words, they trigger their benefits. You can read our FAQ article on the components of Long-Term Care Insurance to learn more.  

Care recipients may need stand-by assistance for many reasons. Some may need it for supervision due to cognitive decline. Others may need it if they have conditions that put them at risk of injuries like: 

• Dementia or cognitive decline
• Disability
• Chronic illness
• Accident
• Frailty from aging
• Mobility issues

As the name suggests, stand-by care doesn't involve physically helping an individual. It just means a caregiver must remain at arm's length in case they're needed. However, a need for stand-by care can lead to hands-on care over time.

Example: Bathing

Imagine an 80‑year‑old woman who can shower on her own but has poor balance and a high risk of falling.

• She can wash herself.

• She can step into the shower.

• But she needs someone within arm’s reach because she could lose her balance.

• The caregiver may never need to physically assist her.

Under federal rules, this qualifies as standby assistance with bathing.

Having someone elsewhere in the home—or available by phone—does not meet the standard.

How It Affects LTC Insurance Claims

Tax-qualified Long-Term Care Insurance policies use the following benefit triggers:

• ADL trigger: The insured is unable to perform at least two of six ADLs without substantial assistance from another person, with the inability expected to last at least 90 days.

• Cognitive impairment trigger: The insured requires substantial supervision to protect against threats to health and safety due to severe cognitive impairment.

The six ADLs are bathing, dressing, eating, toileting, transferring and continence.

Importantly, standby assistance can count toward the two-ADL requirement. The insured does not have to be completely incapable of performing the activity.

Important Distinction: Standby Assistance vs. Supervision

Standby assistance and substantial supervision are different concepts.

Standby assistance addresses the need for someone to be physically available to prevent injury while an individual performs an ADL.

Substantial supervision generally involves protecting someone with severe cognitive impairment, such as Alzheimer's disease, from threats to health and safety.

For example, someone who can physically bathe and dress but needs continual supervision because of severe dementia may qualify under the cognitive impairment trigger without meeting the two-ADL trigger.