What Are ADLs, and Can Your Aging Parent Manage Them?

Posted: 7/16/2018 2:23 PM by Interim HealthCare

A person who can’t perform these activities may need help at home.

Contributed by Maura Rhodes, a health journalist based in Montclair, New Jersey, who has written about caregiving throughout all ages and stages of life. 
 
Most of the simple things we do each day — getting out of bed,  getting into the shower, lining up the buttons of a shirt, scooping a spoonful of cereal and delivering it to the mouth — we never think twice about. For some older adults, however, they become a real challenge.
 
Doctors, caregivers and insurance companies use the term Activities of Daily Living, or ADLs, to describe the everyday tasks people need to do to take care of themselves. A person’s degree of difficulty with ADLs, based on an ADL assessment, may dictate whether they are able to live independently, and also what services they may qualify for.
 
A decline in the ability to manage ADLs can not only cause frustration and a sense of helplessness but also put a person’s health and safety at risk.
 
If you’re familiar with the acronym ADL, you may have come across a similar one, IADL. It stands for Instrumental Activities of Daily Living. These are more advanced and often cognitive-based activities, such as managing finances, doing housework, taking medication and cooking. Most people begin to falter in these areas before reaching the point where they’re unable to handle ADLs. Often they can continue to live on their own as long as they have regular help with paying bills, keeping the fridge stocked with food, and so forth.
 
The loss of ADL abilities, however, usually requires a deeper level of intervention.  
 
This can be a hard truth to face: After all, your loved one most likely is a parent or grandparent or other beloved family member who up until now has been a source of strength for you. But with the appropriate level of care services, many people can continue to live at home comfortably and safely.
 
How do you know if an older person has reached that level of need? There are many different indexes and models for assessing whether someone is no longer able to manage ADLs. Most of them group ADLs into six categories:
 
  • Bathing. The person needs help cleaning more than one part of the body (not just hard to reach areas, isn’t able to get in or out of the tub or shower, and/or needs help with the entire bathing process.
 
  • Dressing. The person isn’t able to remove clothing from closets or drawers or manage buttons, zippers, or other fasteners, and/or needs partial or total help getting dressed.
 
  • Toileting. The person can’t move onto or off of the toilet without help, isn’t able to clean themselves and may need to rely on a bedpan.
 
  • Transferring. The person needs help moving from a bed to a chair or wheelchair or getting up from a chair.
 
  • Continence. The person has partial or total loss of control of their bladder and/or bowels.
 
  • Feeding. The person can’t get food from plate to mouth and must be spoon-fed.
 
If your loved one is having difficulty with ADLs, talk with their doctor. You can also take the Independent Living Assessment Interim HealthCare developed to help you determine whether your loved one is safe at home by themselves. For information on home care, contact your local Interim HealthCare office.