Journal of Gerontological Nursing

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Exclusionary Eligibility Criteria

Abstract

The criteria used to determine which elderly are eligible for federally-funded programs or private long-term care insurance policies may exclude up to 25% of the eligible population. Using the strictest criteria, only 41 1,000 elderly are eligible for home care. This number jumps to 4 million when the least restrictive criteria are used. The criteria are hinged on the number of activities of daily living (ADLs) or instrumental ADLs with which the elderly person needs help. The most commonly used criteria, needing help with two or more ADLs, would exclude 700,000 elderly who need help with one ADL and more than 2 million who need help with one or more instrumental ADLs. By requiring help with three ADLs, the eligible population is reduced by 25% [Research Activities: Agency for Health Care Policy and Research. 1990; 133:7].…

The criteria used to determine which elderly are eligible for federally-funded programs or private long-term care insurance policies may exclude up to 25% of the eligible population. Using the strictest criteria, only 41 1,000 elderly are eligible for home care. This number jumps to 4 million when the least restrictive criteria are used. The criteria are hinged on the number of activities of daily living (ADLs) or instrumental ADLs with which the elderly person needs help. The most commonly used criteria, needing help with two or more ADLs, would exclude 700,000 elderly who need help with one ADL and more than 2 million who need help with one or more instrumental ADLs. By requiring help with three ADLs, the eligible population is reduced by 25% [Research Activities: Agency for Health Care Policy and Research. 1990; 133:7].

10.3928/0098-9134-19910101-12

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