Loss of independent existence means a definite diagnosis of either:
- a total inability to perform, by oneself, at least 2 of the following 6 activities of daily living, or,
- cognitive impairment, as defined below,
for a continuous period of at least 90 days with no reasonable chance of recovery.
Activities of daily living are:
- Bathing: the ability to wash oneself in a bathtub, shower or by sponge bath, with or without the aid of equipment.
- Dressing: the ability to put on and remove necessary clothing including braces, artificial limbs or other surgical appliances.
- Toileting: the ability to get on and off the toilet and maintain personal hygiene.
- Bladder and bowel continence: the ability to manage bowel and bladder function with or without protective undergarments or surgical appliances so that a reasonable level of hygiene is maintained.
- Transferring: the ability to move in and out of a bed, chair or wheelchair, with or without the use of equipment.
- Feeding: the ability to consume food or drink that already have been prepared and made available, with or without the use of adaptive utensils.
Cognitive impairment means mental deterioration and loss of intellectual ability, evidenced by deterioration in memory, orientation and reasoning, which are measurable and result from demonstrable organic cause as diagnosed by a specialist. The degree of cognitive impairment must be sufficiently severe to require a minimum of 8 hours of daily supervision.
Determination of a cognitive impairment will be made on the basis of clinical data and valid standardized measures of such impairments.
The diagnosis of loss of independent existence must be made by a specialist.