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What Are Activities for Daily Living (ADLs)?

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Do you have a senior loved one living in Idaho?

You’re probably trying to help them age in place as long as possible, but can they perform the activities for daily living (ADLs)? Adults who can’t meet their basic needs alone require help, such as the care provided in an assisted living community.

The United States National Health Interview Survey found that 20% of seniors aged 85 or older needed help with ADLs. If you want to know if your loved one is safe to be alone in their home, you need to assess their level of independence.

We’ll explain what the ADLs and IADLs are and why they’re important. Read on!

Activities of Daily Living

What are ADLs? The activities of daily living were initially developed in the 1950s by Sidney Katz. The goal was to devise an evaluation tool that could measure someone’s functional status on a scale.

Later, additional assessment tools were introduced, such as the Barthel ADL index, but the principle was the same. An ADL checklist assesses whether a person can perform the essential activities required for them to survive in their daily life.

The Katz Index of Independence in Activities of Daily Living focusses on these key areas:

  • Can the person properly bathe themselves?
  • Can they get their clothes and put them on?
  • Can they go to the toilet without help?
  • Can they move in and out of bed unassisted?
  • Do they have complete control of bodily functions?
  • Can they eat food without help?

Sometimes, the core ADLs are referred to as basic ADLs (BADL) or physical ADLs. This differentiates them from the more complex instrumental activities of daily living (IADLs), which we’ll cover next.

Instrumental Activities of Daily Living

The Roper-Logan-Tierney model of nursing ADLs was introduced to extend the scale beyond basic needs. Instrumental activities of daily living (IADLs) were introduced, which also cover activities that aren’t essential for basic functioning.

That said, the IADLs are needed for a person to maintain independence in their local environment. The first part of the assessment model conceptualizes 12 ADLs to measure and monitor care:

  • Breathing
  • Maintaining a safe environment
  • Communication
  • Elimination
  • Eating and drinking
  • Washing and dressing
  • Mobilization
  • Controlling temperature
  • Expressing sexuality
  • Working and playing
  • Sleeping
  • Death and dying

The rating scale extends from full independence to some independence or full dependence. An additional five determining factors are used as an element of this model:

  • Biological factors such as health history
  • Psychological factors such as core beliefs
  • Sociocultural factors such as cultural beliefs
  • Environmental factors that impact wellness
  • Finances factors such as access to funds

When used with the ADLs above, they help determine and restore independence.

Importance of ADLs and IADLs

ADLs and IADLs cover slightly different but related needs. Often, the use of the term “activities of daily living” can refer to both.

The “activities for daily living checklist” and other determining factors underpin most successful care plans. Family members can use an informal ADL checklist themselves. Formal assessments are usually scheduled when ADLs are used for a patient to meet eligibility criteria for geriatric care services.

If an individual requires eldercare, a case manager (often a social worker or registered nurse) uses ADLs to help formulate a care plan.

Long term care insurance plans will typically require a nurse to conduct an ADL test to trigger benefit eligibility. Social Security Disability Insurance (SSDI) also factor ADLs when determining eligibility for some services.

Many state-funded community care programs use ADL and IADL as part of their assessments. Medicaid often uses them to determine nursing home qualification. Some Medicare programs also consider ADLs for in-home assistance programs and may pay for the assessment.

A primary care physician might use a slightly different set of criteria when they are assessing independent living capabilities. Occupational therapists also carry out formal geriatric assessments.

It’s important to understand that a simple ADL checklist is one tool used to augment an assessment and shouldn’t be used exclusively. Some important factors may not fit neatly inside the ADL criteria. A verbal interview is also required so that medical professionals can get a complete picture of an individual’s current state.

Assistance with ADLs and IADLs

If an individual struggles with any ADL categories, they will need some kind of assistance to avoid unsafe conditions or poor quality of life.

In many cases, there is technology available that can assist a person in successfully performing essential tasks. These adaptive devices can decrease the time needed to undertake ADLs and prevent the need for a caregiver.

Examples of assistive equipment include:

  • Toilet seat riser and grab bars
  • Shower chair and handheld showerhead
  • Bed rails and hallway railings
  • Large utensil handles and double-handed cups
  • Walker and wheelchair
  • Velcro footwear instead of laces

When a task cannot be aided with an assistive device, the individual will need a caregiver to help with the activity. If it is not practical for a caregiver to help within the home, an assisted living senior community is a perfect alternative.

When seniors stop being able to go out into the community, they can feel increasingly isolated and are prone to depression. An assisted living retirement community or memory care facility can help with activities of daily living in a social environment of peers.

The mental support coming from companionship is an important psychological factor tied to ADLs. An independent senior living center that can transition to increasing levels of need is the perfect environment for a safe retirement. Staying positive is an important factor for overall health.

Activities for Daily Living: Final Thoughts

We’ve explained the activities for daily living and why they are vital to maintaining independence. Don’t let a senior loved one neglect their own basic needs.

If you’re considering assisted senior living for your loved one, we can help. We are a retirement community in Meridian, ID, offering independent or assisted living, as well as memory care.

Contact us or schedule a pre-leasing appointment.

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