ADLs (Activities of Daily Living) and IADLs (Instrumental Activities of Daily Living) are two types of skills required to live independently. They play a critical role in understanding a senior’s health status, level of independence, and need for support.
What are ADLs?
Activities of Daily Living (ADLs) refer to the basic self-care tasks that a person must perform every day for personal care. The concept was developed in the 1950s by Sidney Katz and his team at the Benjamin Rose Hospital in Cleveland, OH, USA.
ADLs typically comprise six key activities:
- Ambulation: The ability to move around, including the ability to get in and out of bed.
- Feeding: The capacity to eat independently.
- Dressing: The ability to select and put on appropriate clothing.
- Personal Hygiene: The capacity to groom oneself, including brushing teeth and combing hair.
- Toileting: The ability to get to and from the toilet, use it appropriately, and clean oneself.
- Bathing: The ability to wash one’s own body.
What are IADLs?
Instrumental Activities of Daily Living (IADLs) refer to more complex activities that are usually necessary for independent living in the community. These activities are not necessarily needed for fundamental functioning but enable a person to live independently.
The IADLs commonly include:
- Shopping: The ability to make appropriate decisions when shopping for groceries or other necessities.
- Food preparation: The ability to prepare balanced meals.
- Housekeeping: The ability to perform tasks like cleaning, laundry, and other home maintenance activities.
- Managing Finances: The capacity to manage one’s financial affairs, like paying bills on time.
- Medication management: The ability to take medications as prescribed.
- Communication: The ability to use a telephone or other communication devices.
- Transportation: The ability to travel independently, either by driving oneself or by organizing other means of transport.
Assessing ADLs and IADLs
The assessment of ADLs and IADLs typically involves observation, self-reports, and input from caregivers or health professionals. Standardized assessment tools such as the Katz ADL scale and the Lawton IADL scale are frequently used by healthcare professionals to assess an individual’s capability to perform these tasks.
The Katz ADL scale assesses six basic activities: bathing, dressing, toileting, transferring, continence, and feeding. The Lawton IADL scale evaluates eight activities: ability to use a telephone, shopping, food preparation, housekeeping, laundry, mode of transportation, responsibility for own medications, and ability to handle finances.
Self-Assessing ADLs and IADLs
In order to self-assess a loved one’s ability to handle their ADLs and IADLs, it’s essential to spend time observing them and noting any difficulties they may have with the aforementioned tasks. For example, you might notice if they have difficulty getting dressed, appear unkempt, or if their fridge is empty because they are unable to go shopping. It may be helpful to utilize a checklist of ADLs and IADLs to guide your observations.
Remember, it’s important to approach these observations with empathy and respect, as losing independence can be a challenging experience for seniors. You may consider having open discussions about any challenges they may be experiencing and possible solutions.
Understanding ADLs and IADLs is essential in determining a senior’s ability to live independently. It can aid in the identification of the level of assistance required and inform the development of care plans. If you notice a decline in the ability to perform these tasks, it’s essential to seek professional help and advice as soon as possible. This could involve getting an occupational therapist involved, discussing the issue with your loved one’s primary care physician, or possibly considering support options like in-home care or assisted living.