Professionals who work in aging often want to know whether an older person needs any help with “ADLs or IADLs.”
These terms stand for Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs). They represent key life tasks that people need to manage, in order to live at home and be fully independent.
If you’re a family caregiver, it can be good to familiarize yourself with these terms and the related skills.
Difficulties with ADLs and IADLs often correspond to how much help, supervision, and hands-on care an older person needs. This can determine the cost of care at a facility, whether someone is considered “safe” to live at home, or even whether a person is eligible for certain long-term care services.
Activities of Daily Living (ADLs)
These are the basic self-care tasks that we initially learn as very young children. They are sometimes referred to as “Basic Activities of Daily Living” (BADLs). They include:
- Walking, or otherwise getting around the home or outside. The technical term for this is “ambulating.”
- Feeding, as in being able to get food from a plate into one’s mouth.
- Dressing and grooming, as in selecting clothes, putting them on, and adequately managing one’s personal appearance.
- Toileting, which means getting to and from the toilet, using it appropriately, and cleaning oneself.
- Bathing, which means washing one’s face and body in the bath or shower.
- Transferring, which means being able to move from one body position to another. This includes being able to move from a bed to a chair, or into a wheelchair. This can also include the ability to stand up from a bed or chair in order to grasp a walker or other assistive device.
If a person is not fully independent with ADLs, then we usually include some information about the amount of assistance they require.
For each ADL, people can vary from needing just a little help (such as a reminder or “stand-by assist”) to full dependency, which requires others to do the task for them.
Instrumental Activities of Daily Living (IADLs)
These are the self-care tasks we usually learn as teenagers. They require more complex thinking skills, including organizational skills. They include:
- Managing finances, such as paying bills and managing financial assets.
- Managing transportation, either via driving or by organizing other means of transport.
- Shopping and meal preparation. This covers everything required to get a meal on the table. It also covers shopping for clothing and other items required for daily life.
- Housecleaning and home maintenance. This means cleaning kitchens after eating, keeping one’s living space reasonably clean and tidy, and keeping up with home maintenance.
- Managing communication, such as the telephone and mail.
- Managing medications, which covers obtaining medications and taking them as directed.
Why ADLs and IADLs matter
Generally, older adults need to be able to manage ADLs and IADLs in order to live independently without the assistance of another person.
Geriatricians assess ADLs and IADLs as part of assessing an older person’s “function.” Problems with ADLs and IADLs usually reflect problems with physical health and/or cognitive health. Identifying functional difficulties can help us diagnose and manage important health problems.
But most importantly, we try to identify functional difficulties because we want to make sure older adults are getting the help and support they need to compensate for, or overcome, these difficulties. We also want to help any family caregivers who might be struggling to assist a relative who needs help.