Activities of Daily Living
75% of people 85 years or older report some degree of permanent limitation in performing activities of daily living or "ADLs"
The “Slower Go” Years…
There is a point in our lives, called the "slower go” years when life truly slows down. Our physical capacities are lower and, at times, cognitive function can be diminished. This time can be incredibly stressful for us as individuals, and family members, as everyone tries to accept new limitations as well as plan for what is ahead. At times, this "slow down" can happen more rapidly, which can create added stress in trying to find the best possible living arrangements for loved ones.
The great news is that there is a wide variety of living options that are adaptable to maximize privacy and independence coupled with the safety and security of a care team available at any time.
Below, we discuss "Activities of Daily Living" - what they are, what they mean, and how to assess whether you or someone you love may be in need of a more supportive, nurturing and cared for living environment.
Helping Your Decision Making: Understanding Activities of Daily Living or ADLs
Activities of Daily Living (ADLs) is a term used to describe some fundamental activities that are required for a person to be able to independently care for themselves. They are essential and routine tasks that most healthy individuals can perform without assistance. However, as individuals age, these tasks can become more difficult, and have become a standard to determining the right type and level of care that an elderly person may require.
ADLs are broken down into two sub-categories - Physical ADLs and Instrumental ADLs:
Physical ADLs
These activities refer to basic physical activities that must be completed daily in order to maintain day-to-day life, such as eating, using the bathroom, getting dressed and getting from one place to another.
Bathing - The ability to take a bath or shower as well as maintain personal hygiene, including brushing hair, brushing teeth, and nail care
Dressing - The ability to select weather-adequate clothes and dress oneself
Toileting - The ability to get to and from the toilet, use it and clean oneself without assistance
Eating - The ability to eat, including using cutlery, chewing and swallowing
Transferring - The ability to move from one place to another, either in our out of bed and or a chair
Maintaining Continence - The ability to control one's bladder and bowels
Instrumental ADLs
These are more complex activities (both cognitive and physical) that impact the ability to live a fully independent life. These activities include:
Transportation and Shopping - The ability to go to the store and make purchases, either groceries or other goods, as well as to manage transportation (either transporting oneself or arranging for transportation)
Managing Finances - Paying bills and managing financial assets
Shopping and Meal Preparation - Planning and preparing meals
House Cleaning and Home Maintenance - The ability to keep up with cleaning and maintenance, including cleaning up after meals, cleaning and tidying the house and maintaining the home.
Managing Medications: The ability to procure and take medication as prescribed
Laundry: The ability to regularly clean clothing, bedding and towels
Communication: The ability to use communication devices such as phones and computers without issue
Individuals may be able to continue with independent living by hiring service providers to help with things like home maintenance, meal preparation, cleaning and laundry services. However, defining the extent of ADL impairment - both physical and instrumental ADLs - is critical to ensure an appropriate level of care.
In many instances, changes in ADL capabilities change gradually over time, so as a family member or caregiver, regular monitoring and testing ADL function is important to recognizing possible health issues that may be arising or deterioration and/or improvement of physical and cognitive function.
There are multiple tests that have been created to help monitor ADL capacity. The main tests are the Katz Index of Independence in Activities of Daily Living, the Lawton Instrumental Activities of Daily Living, The Barthel ADL Index and the Functional Independence Measure.
Discussing ADLs with health care professionals can also help family members make informed decisions about the type and level of care needed for their parents or loved ones.