Nearly 60% of people turning age 65 will need some form of long-term care at some point in their life, according to the U.S. Department of Health & Human Services. Often, long-term in-home or residential care is necessary to help seniors perform everyday tasks and take care of their households, finances and other responsibilities.
The medical term for such tasks is activities of daily living (ADLs). You might also hear the term instrumental activities of daily living (IADLs), which sounds similar but covers an entirely different set of capabilities necessary for seniors to continue living independently.
Understanding ADLs and IADLs can help you or a loved one decide whether to age in place in your current home or move to an assisted living or other type of senior living community that can provide some help with ADLs and IADLs.
Activities of Daily Living (ADLs)
The six activities of daily living are routine tasks most of us do every day, including:
- Personal hygiene: Grooming and bathing abilities, including dental hygiene, nail and hair care.
- Ambulating: Moving from one position to another, such as getting in and out of a bed or chair, and walking independently.
- Feeding: The ability to feed oneself.
- Dressing: Selecting appropriate clothes and dressing oneself.
- Continence: Managing bladder and bowel functions.
- Toileting: Getting to and from the toilet, using it properly and cleaning oneself after use.
Direct assessment of ADLs is typically performed by occupational, physical or speech therapists, or by a nurse at a doctor's office. An ADLs assessment often takes place after a fall or stroke, or in the mid-to-late stages of dementia. The evaluation covers cognitive, emotional and behavioral factors that could interfere with these basic tasks.
Once limitations in one or more ADLs are recognized, your doctor may order short-term in-home or outpatient physical therapy, speech therapy, or occupational therapy to help improve or manage ADL impairment. After further assessment by your health care team, you may decide to enlist in-home care services long-term or move to an assisted living community that provides assistance for routine activities.
Instrumental Activities of Daily Living (IADLs)
While ADLs focus mainly on physical activities, a second set of instrumental activities of daily living, is also used to evaluate a person's ability to live independently. IADLs require a person to engage in more complex thinking and planning to live independently and function in the community. There are a few different IADL assessment methods, but the main focus is on the following IADLs:
- The ability to make a grocery list and shop independently.
- The ability to use a telephone.
- The ability to plan, prepare and serve adequate meals.
- The ability to do laundry.
- The ability to drive, arrange travel or navigate public transportation.
- The ability to manage medications and take correct dosages at correct times.
ADLs and IADLs Determine One's Ability to Live Independently
ADL and IADL assessments may demonstrate a need to obtain help with one or more activities of daily living. In these cases, it can be helpful to enlist in-home health services or family members to pitch in as caregivers and assist with tasks like paying bills, transportation and shopping. You or your loved one could also consider moving to an assisted living community that offers this kind of assistance.
Another benefit of an assisted living community is that it typically also provides daily social contact and events, outings, or activities that can benefit mental wellness and cognitive skills. If an ADL assessment finds that a person isn't capable of living independently due to cognitive or other impairments, a memory care unit or skilled nursing facility may be recommended by the health care team.
However, you don't have to wait for an assessment to start considering what steps you could take to help yourself or a loved one continue living independently. Pay close attention to your ability (or your loved one's ability) to perform the ADLs and IADLs listed above, and if you notice difficulties, ask your doctor for an activities of daily living assessment and recommendations on how to support continued independence.