You are caring for a relative and notice that you are reaching your limits?
Information correct as of November 2021
The rules governing the helplessness allowance, personal assistance allowance, and intensive care supplement are extremely complex, so it can be hard to work out what support you and your family are entitled to receive. We've chosen the two examples below to help you understand what these terms mean, and we explain where you can get further information and assistance.
Example 1: Helplessness allowance for a physically disabled adult
Tim is 34 and has been physically disabled from birth. He relies on help from others. He lives with his parents because he isn't able to take care of himself. His disability has worsened to the extent that he has difficulty even standing up and lying down, and it recently reached the point where he needs constant care and help going to the bathroom. Tim is of sound mind and completed his education. He works from home in an IT job. Tim's father still has a job, and his mother did too until recently, but she can't work anymore because she's now needed at home. They want to keep Tim with them rather than putting him in a care home. Tim's parents feel all alone in their new situation and are looking for support to help them care for their son. An assessment by their health insurer for basic home care services under the Health Insurance Act would be a step in the right direction for them. It could result in them getting a care assistant.
Determining the degree of incapacitation and monthly benefits
The above description of Tim's situation helps to determine how much help he needs. He isn't able to complete any of the six day-to-day tasks (standing up, sitting down, lying down, dressing and undressing, eating and personal hygiene, and going to the bathroom and moving around) on his own and regularly needs help from another person. This qualifies as severe incapacitation. Tim's an adult, so he's entitled to a monthly flat-rate allowance of CHF 1,912. He still needs to be assessed for a personal care allowance. Tim has an acute need for assistance, lives with his parents, and works at least 10 hours a week, so he meets the requirements for receiving one. This would help his parents pay for a care assistant to help them look after him, offering them a glimmer of hope to get some of their own lives back while still keeping Tim at home with them.
Example 2: Helplessness allowance for a child with health problems
Unlike Tim, seven-year-old Mina can eat unaided, but she needs help dressing and undressing and going to the bathroom. Mina's parents are concerned that her degree of incapacitation may have been wrongly assessed and want to know how they can get a new assessment.
Determining the degree of incapacitation and daily allowance
Mina is severely restricted in three of the six day-to-day tasks and regularly needs help from another person. Her degree of incapacitation has been assessed as slight.
Unlike disabled adults, children receive a daily allowance. This is CHF 15.95 a day for slight incapacitation. However, Mina's parents must state how many days she spends at home and how many she spends in a care home because she isn't entitled to a daily allowance for the days spent in the care home.
Intensive care supplement for children
Children qualify for an intensive care supplement if they need intensive care for at least four hours a day. Mina doesn't currently receive the supplement because she isn't at risk of harming herself or others and doesn't need an extra four hours of special care a day due to her disability, e.g. physiotherapy or respiratory therapy.
Personal care allowance for children
Since Mina attends an integrative school five days a week, her slight incapacitation also entitles her to a personal care allowance. Attending an integrative school is a prerequisite for children to qualify for the allowance. The standard rate of CHF 33.50 per hour can be used to hire a care assistant (not a close relative) for 20 hours a week to support someone with slight incapacitation. More hours could be added if Mina's degree of incapacitation were to increase.
The two examples above offer an insight into how the helplessness allowance, personal care allowance, and intensive care supplement work.
You can get more information and the necessary forms from your cantonal contact, and information leaflets and forms (available in French, German, and Italian) are also available directly from the Old Age and Survivor's Insurance/Disability Insurance office.