The Activities of Daily Living (ADLS): An Overview

For many seniors, retirement can be an exciting time filled with opportunities to try new hobbies and socialize with friends. If you're having difficulty with your activities of daily living, though, you may find it hard to do all the things you'd like in your golden years. Thankfully, many care providers offer help with your ADLs in assisted living facilities or your own home.

In this guide, you'll learn about the different types of ADLs, common methods for assessing ADLs and how you can get ADL help from a long-term care provider near you.

ADLs are basic daily tasks that you must be able to do by yourself to maintain full independence. The five most commonly evaluated ADLs are:

• Mobility/transferring: This refers to the ability to move around inside and outside your home. It includes your ability to walk, get into and out of bed, stand from a seated position and go up and down stairs.
• Personal hygiene: Hygiene includes your ability to perform grooming activities, such as brushing teeth, cutting nails, shaving and safely getting into and out of the bathtub or shower by yourself.
• Eating: As an ADL, eating encompasses your ability to use utensils to feed yourself in addition to the physical act of eating.
• Dressing: This is the ability to choose appropriate clothing, put on garments, zip and unzip zippers and fasten buttons.
• Toileting/continence: This refers to the ability to control bladder/bowel functions, get on and off the toilet and clean yourself after toilet use.

What Are the Instrumental Activities of Daily Living? 

Instrumental activities of daily living are tasks that don't need to be done every day but are considered necessary for independent living. IADLs include:

• Housework: This is the ability to maintain your home, including doing laundry, taking out trash, cleaning and other household chores.
• Meal preparation: This refers to your ability to plan meals, gather ingredients and cook.
• Shopping: As an ADL, shopping includes buying groceries, clothes, medications and other necessities.
• Communication: Communication refers to your ability to look up phone numbers and communicate using the telephone or computer.
• Money management: This includes managing your bank account, paying bills, filing taxes and other financial tasks.
• Transportation: As an ADL, transportation involves the ability to drive, take public transportation or arrange rides with another driver.

Long-term care Medicaid facilities use ADL and IADL assessments to determine whether an applicant meets the functional need requirement. Family caregivers can also use them to determine how much assistance a senior needs. There are six common ADL assessments, and each measures a senior's ADL capability in slightly different ways.

The Katz ADL assessment is a simple checklist that measures a senior's ability in feeding, toileting, bathing, transferring and dressing. It's typically used for seniors who live at home. Activities that require no assistance are given 1 point. Activities that require direction, supervision, personal assistance or total care receive a score of 0. Scores can range from 0 points (highly dependent) to 6 points (highly independent).

The K-B Scale is a generic assessment for people with or without disabilities. The 170-item list measures ability in dressing, toileting, eating, bathing/hygiene, mobility and emergency communication. Seniors receive one point if they can do the activity independently and zero points if they can't perform it by themselves.

The Lawton-Brody assessment is for people living at home or in a community setting. It measures IADL ability in eight categories: financial management, medication management, transportation, housekeeping, laundry, meal preparation, shopping and phone use. Seniors can receive up to 8 points, with a score of 8 meaning high-functioning ability and a score of 0 indicating low-functioning ability.

BADLS is a 20-item questionnaire that measures a combination of ADLs and IADLs. It's intended for seniors with dementia. Items are rated on a 4-point scale. Seniors can receive a score from 0 (total dependence) to 60 (total independence). Some of the activities measured include dressing, toileting, mobility, handling finances, preparing meals, eating and orienting in time and space.

The Cleveland Scale is a 47-item checklist that’s suited for people with Alzheimer’s disease and dementia. Ability is rated from 0 points (never dependent) to 3 points (always dependent).

The Barthel Index measures ability in people who have had a stroke. It rates individuals on their ability to perform 10 ADLs: climbing stairs, mobility on level surfaces, feeding, grooming, bathing, dressing, toileting and bowel/bladder control. Each activity is rated from 5 to 15 points. A score of 10 to 15 means the individual can do the activity independently, while a score of 0 indicates they can't perform the activity.

If you need help with your ADLs, in-home care or assisted living can be a good choice. Assisted living is ideal for seniors who prefer care in a social community setting. In-home care provides assistance in a comfortable and familiar environment, letting you stay in the place you love for as long as possible.

With so many long-term care providers available, finding one to support your ADLs can feel overwhelming. Call 1(800) 748-4024 to learn more about your care options and get help choosing the provider that's right for you.