Understanding the Basics: Activities of Daily Living (ADLs)

Growing Older: Why Daily Tasks Become Harder

As we get older, everyday things can start to feel more challenging. For example, balancing becomes trickier, we may not be as flexible, and our senses like vision and hearing can become weaker. These changes are a normal part of aging, but how quickly they happen and how many we experience can affect our ability to stay independent. To keep track of how well someone can live on their own, caregivers focus on certain tasks, which they call activities of daily living or ADLs. These are basic things we do every day, and we’ll talk about them more in a moment. There are also instrumental activities of daily living (IADLs), which are slightly more complex tasks. Caregivers look at both ADLs and IADLs to see how well someone is doing and decide if they need more help to stay safe and healthy.

What Are the Basics of Daily Living (ADLs)?

When we think about all the little things that help us live our daily lives, it’s easy to forget how important they are. But if someone wants to live alone, it's important to make sure they can handle these essential tasks. ADLs are basic self-care tasks, and doctors and nurses see them as necessary for staying healthy. There are six main ADLs:

• Personal hygiene: This includes things like bathing, brushing your teeth, and grooming.
• Dressing: Putting on clothes, including handling buttons, zippers, and choosing the right outfit for the day.
• Eating: Feeding yourself, chewing, swallowing, and using utensils like a fork or spoon.
• Transferring: Being able to move from one place to another, like getting in and out of bed or a chair without help.
• Continence: Controlling your bladder and bowels or making a plan if this is difficult.
• Toileting: Being able to use the bathroom by yourself, including sitting down, wiping, and washing up.

Someone might still live pretty independently if they have trouble with one or two of these activities, but when multiple ADLs become hard, they may need more help.

What Are More Complex Daily Tasks (IADLs)?

IADLs are a bit more complex than ADLs. They involve tasks that help people live independently, but they often require more thinking, planning, and organization. Here are some examples:

• Housekeeping: Keeping your living space clean, doing laundry, and other household chores.
• Meal preparation: Planning meals, shopping for groceries, cooking, and cleaning up afterward.
• Managing finances: Paying bills, keeping a budget, and handling money.
• Transportation: Driving or using public transport to get around.
• Medication management: Keeping track of your medications and taking them on time.
• Communication: Being able to make phone calls, read, write, and stay in touch with people.

Why Is It Important to Track ADLs and IADLs?

Healthcare workers and caregivers pay close attention to ADLs and IADLs because they show how well someone can take care of themselves. For example, if someone has trouble using the bathroom or keeping clean, they might face health risks. Also, if a person becomes less able to do these things, they might avoid going out, leading to feelings of loneliness, which can lead to problems like depression or memory loss.

When a senior needs help with ADLs or IADLs, monitoring these tasks helps caregivers create a plan that provides the right amount of support. This plan can change over time as the senior’s needs change, making sure they get the best care possible.

How Are ADLs Checked in Assisted Living and Nursing Homes?

In places like assisted living facilities or nursing homes, ADLs are regularly checked to see how much help a person needs. There are some differences between these two places:

• Assisted living is for people who can mostly take care of themselves but might need help with a couple of ADLs.
• Nursing homes are for people who need more help with several ADLs or have serious health problems.

In assisted living, caregivers help residents with one or two tasks, but in nursing homes, there’s a bigger focus on providing more hands-on care.

How Do Nursing Homes Use ADL Assessments?

When someone moves into a nursing home, the facility will usually evaluate their ADLs to make sure it’s the right place for them. This process might involve:

• Medical checkup: The doctor reviews the person’s medical history and performs a physical exam.
• Functional checkup: This looks at how well the person can perform ADLs.
• Decision-making: Based on these assessments, the doctor will help the family decide if a nursing home is the best choice.

The nursing home will also evaluate ADLs to ensure they can provide the right care and support for the person.

What Happens Next?

If you're helping someone move into a nursing home, it can feel overwhelming. But knowing that ADL assessments help caregivers create a care plan can make the process a little easier. Nursing homes are designed to provide the help and support seniors need to live safely and comfortably.