A Caregiver's Guide to Activities of Daily Living (ADLs)
When an older loved one needs more help with everyday tasks, families often find themselves wondering what level of support is appropriate. Evaluating an aging loved one's ability to perform activities of daily living (ADLs) can help families better determine next steps.
Key Takeaways
- Activities of daily living (ADLs) measure the ability to perform essential self-care tasks like bathing, dressing, eating, and toileting.
- Instrumental activities of daily living (IADLs) measure cognitive abilities needed for independent living, including managing medications, finances, transportation, shopping, and meal preparation.
- Healthcare providers assess ability to perform ADLs and IADLs to monitor changes in physical and cognitive function.
- ADL and IADL assessments help families develop care plans and evaluate eligibility for certain services.
- Changes in ADLs and IADLs can help families determine whether additional in-home support or a senior living community may better meet a loved one's needs.
What are Activities of Daily Living?
Activities of daily living (ADLs) refer to self-care routines people perform every day to care for themselves. Eating, bathing, dressing, using the restroom—these activities are all examples of activities of daily living.
Whether or not an older adult can complete ADLs helps caregivers better understand what level of support they need for safety and dignity.
How are ADLs Assessed?
Families who have concerns about their loved one's functional abilities may request an official evaluation from a licensed healthcare provider, such as an occupational therapist or registered nurse. Common formal assessments that licensed professionals may perform for ADLs include the Katz Index, Barthel Index and Lawton IADL Scale.
While these tests vary, they all serve the same purpose: helping families and healthcare providers determine an older adult's cognitive and physical abilities so that they can be matched to the best support services possible.
Why is It Important to Have ADLs Assessed?
Assessing ADLs gives healthcare providers a clearer picture of how someone functions day to day. Based on these assessments, providers can better support the individual in the way they need. That means more personalized care plans and more immediate support for changing physical and cognitive abilities. Official ADL assessments from a licensed professional also help determine eligibility for certain support programs, long-term care benefits, and senior living options.
What are Basic Activities of Daily Living?
Basic activities of daily living are the essential self-care tasks required to meet everyday personal needs. These activities focus primarily on physical functioning and personal independence.
Ambulating, Mobility, and Transferring
What it is:
The ability to safely move from one place to another and change positions independently.
Examples:
- Walking throughout the home
- Standing up from a chair
- Getting in and out of bed
- Moving into or out of a wheelchair
- Climbing a few stairs safely
Eating and Drinking
What it is:
The ability to eat and drink independently after food has been prepared.
Examples:
- Holding utensils
- Bringing food to the mouth
- Drinking from a cup
- Swallowing safely
- Finishing a meal independently
Dressing
What it is:
The ability to pick out appropriate outfits and put them on without significant assistance.
Examples:
- Putting on shirts and pants
- Fastening buttons or zippers
- Tying shoes
- Choosing clothing appropriate for the weather
Personal Hygiene and Bathing
What it is:
The ability to maintain personal cleanliness and grooming.
Examples:
- Showering or bathing
- Washing hands and face
- Brushing teeth
- Shaving
- Combing or brushing hair
Continence
What it is:
The ability to control function of both the bladder and bowels (or appropriately manage incontinence).
Examples:
- Recognizing the need to use the restroom
- Maintaining bladder control
- Managing continence products when needed
Toileting
What it is:
The ability to safely use the restroom and complete all associated hygiene tasks.
Examples:
- Getting on and off the toilet
- Cleaning oneself afterward
- Adjusting clothing
- Washing hands afterward
What are Instrumental Activities of Daily Living?
ADLs are basic tasks. Instrumental activities of daily living (IADLs), meanwhile, are more complex skills that support independent living. They require judgment, memory, and organizational skills.
Transportation
What it is:
The ability to travel safely to and from different locations.
Examples:
- Driving
- Using public transportation
- Scheduling rides
- Navigating familiar routes
Finance Management
What it is:
The ability to manage personal finances.
Examples:
- Paying bills
- Managing bank accounts
- Creating a budget
- Recognizing fraudulent activity
- Keeping financial records organized
Shopping
What it is:
The ability to obtain groceries, medications, clothing, and household supplies.
Examples:
- Creating shopping lists
- Comparing products
- Purchasing needed items
- Carrying groceries
Meal Preparation
What it is:
The ability to plan, prepare, and safely cook meals.
Examples:
- Following recipes
- Using kitchen appliances safely
- Preparing balanced meals
- Storing food properly
Housecleaning and Home Maintenance
What it is:
The ability to maintain a safe and functional home environment.
Examples:
- Vacuuming
- Laundry
- Washing dishes
- Changing light bulbs
- Basic household organization
Communication
What it is:
The ability to communicate effectively and manage everyday correspondence.
Examples:
- Making phone calls
- Sending emails or text messages
- Reading mail
- Scheduling appointments
- Understanding important information
Medication Management
What it is:
The ability to take medications correctly and consistently.
Examples:
- Remembering medication schedules
- Taking correct dosages
- Refilling prescriptions
- Following healthcare provider instructions
How ADLs Help Senior Living Communities Offer the Right Level of Care
Understanding a person's ADL and IADL abilities helps healthcare providers and families determine what level of support may best match their current needs.
In senior living communities, these assessments help staff create individualized care plans that encourage independence while assisting where appropriate. With regular ADL reassessments, communities can adjust care plans as needed.
ADL Assistance at Each Level of Care
"Senior living" is a broad term. It can refer to independent living communities or skilled nursing care communities, both of which offer distinct services and amenities. Knowing what type of support each type of senior living community offers means families can find a better match.
Independent Living
Independent living residents generally manage their own ADLs independently. While residents can manage their own ADLs and IADLs, these communities may offer perks like housekeeping and transportation services. However, these services are typically offered based on convenience, not need.
Assisted Living
Assisted living residents may benefit from assistance with some ADLs while remaining as independent as possible.
At Belmont Village, Personal Assistance Liaisons (PALs) provide support with daily activities while licensed nurses are on site 24/7 to coordinate care.
Memory Care
Residents living with Alzheimer's disease or other forms of dementia often need increasing support with both ADLs and IADLs.
Belmont Village communities offer memory care neighborhoods for people living with mild cognitive impairment or advanced memory loss. With on-site nurses available around the clock, each resident receives the personalized assistance they need in a welcoming, dignified environment.
Skilled Nursing Care
Skilled nursing care residents typically require ongoing nursing care and assistance with most or all ADLs throughout the day.
Continuing Care Retirement Communities (CCRCs)
Continuing care communities (CCRCs) are communities that offer a continuum of care within one place. In other words, care services adapt to the evolving needs of each resident, without requiring a move to a different community.
Respite Care
Short-term stays offer temporary assistance with ADLs while family caregivers are away.
Supporting Independence Through Personalized Care
Activities of daily living provide valuable insight into how older adults function in their everyday lives. By understanding both ADLs and IADLs, families and healthcare providers can better recognize changing needs and, therefore, identify the right supportive services.
At Belmont Village, we recognize that every resident's needs are unique. Monitoring ADLs is not about looking for reasons to take away a loved one's independence. It is about helping seniors get the care they need while still supporting their independence wherever possible.
FAQs
What is the Katz Index?
The Katz Index of Independence in Activities of Daily Living, or Katz Index, is a formal evaluation that healthcare providers use to measure basic ADLs. One of the most widely used assessments, it measures six core activities: bathing, dressing, toileting, transferring, continence, and feeding.
What is the Lawton IADL Scale?
The Lawton Instrumental Activities of Daily Living Scale, or Lawton IADL Scale, measures a person's ability to perform more complex daily tasks required for independent living. Specific areas this scale covers include using the telephone, shopping, and managing medications.
What is the difference between an ADL and an IADL?
ADLs and IADLs are both measures of a person's functional abilities, but ADLs focus on basic physical tasks, whereas IADLs focus on more complex cognitive tasks.
Disclaimers: This article is for informational purposes only.