What Are Activities of Daily Living (ADLs)?
As you age, basic personal care tasks — or activities of daily living (ADLs) — can become more difficult. Age, illness and injuries can also affect your ability to perform these activities independently. But what are ADLs specifically, and how do they affect your loved one's ability to stay safe and independent at home?
Without the right support, seniors struggling to perform basic ADLs may be at risk for falls and other physical injuries, as well as hygiene-related health complications.
If you know or care for someone who's struggling to perform ADLs on their own, it could be time for some extra support.
What Are ADLs, and Why Are They Important?
Activities of daily living (ADLs) commonly refer to six basic tasks everyone must do every day to care for themselves independently. They include: bathing, dressing, eating, toileting, transferring (mobility) and continence.
The Roper-Logan-Tierney Model of Nursing suggests there are 12 ADLs, with the main difference being the scope and complexity of activities assessed. The six ADLs listed above focus on basic self-care, while the 12 ADLs include more complex activities such as maintaining a safe environment, communicating, working and playing, sleeping and others.
Research shows about one in five older adult Americans have difficulty with ADLs. A lack of support for these basic tasks can lead to increased dependence on others, social isolation and mental health struggles, according to Hawthorne.
What Are the 6 ADLs?
According to the Katz Index, there are six basic ADLs:
- Bathing. To successfully bathe on your own requires the ability to give yourself a sponge bath, or get in and out of the tub or shower to wash and dry off.
- Dressing. Getting dressed requires you to choose and put on weather- or occasion-appropriate clothing. You must be able to get clothes out of a drawer or closet, pull them on and manage fasteners like buttons, laces and zippers.
- Eating. Feeding yourself means being able to set up, prepare and bring food and drinks to your mouth, as well as move food around in your mouth, chew and swallow.
- Toileting. Being able to get on and off the toilet, manage clothing and clean yourself are all components of toileting. You can also manage continence products such as a catheter or colostomy bag, if needed. However, toileting is not the same as continence.
- Continence. Continence is the ability to control your bowel and bladder function. Some adults who have continence control lack toileting ability, while the opposite is true for others. This is why these are two distinct ADLs.
- Transferring. This refers to your overall mobility — your ability to move your body from one position or location to another one on your own, such as from a bed to a wheelchair, or from one room to another.
How Do Health Care Professionals Assess ADLs?
ADL skills directly affect a senior's ability to live independently. According to Hawthorne, ADL screenings should be done on a regular basis — during annual wellness visits, upon hospital admission and if there has been a significant change in health status, such as a fall or illness.
Health care professionals who commonly assess ADLs include nurses, health care providers (HCP), occupational or physical therapists and case managers. These professionals use different assessments to look at ADLs, such as:
- Katz Index of Independence in ADLs. The Katz Index is used by clinicians to assess function and problems performing the six ADLs so they can plan care accordingly. They assign a point for each ADL a senior can do on their own. The total score shows how independent or dependent they are with each task.
- Barthel ADL Index. The Barthel Index looks at the same ADL categories as the Katz Index, but it also includes grooming and climbing stairs. A lower score can reveal a senior's dependence on others to complete ADLs, while a higher score points to greater task independence.
- Functional Independence Measure (FIM). More comprehensive, the FIM combines ADLs with other activities requiring social and cognitive skills. The lower the score, the more assistance one may need to perform certain tasks.
Caregivers can ask seniors in their care to tell them about their experience with ADLs, or they can observe and assess on their own. For example, you may notice a senior you care for having difficulty eating or getting dressed. Or, they may tell you that it's hard for them to get into bed at night. Once you see or hear which ADLs are causing them difficulty, you can start providing more assistance in these areas.
ADLs vs. IADLs
While ADLs are the activities important for meeting our basic physical needs, they don't include more complex tasks many of us do regularly. These more complex tasks are known as instrumental activities of daily life (IADLs). They include:
- Managing medications and health conditions
- Grocery shopping and meal preparation
- Driving a car or the ability to organize transportation
- Housekeeping
- Financial tasks, such as paying bills, investing or managing assets
- Daily communication, such as using a telephone, texting or writing an email
ADL and IADL assessments are often used as a measure to gauge one’s eligibility for long-term care Medicaid, including Nursing Home Medicaid eligibility. Home care agencies also use both ADL and IADL assessments to understand how to best provide in-home support. They can help with long-term care planning such as assisted living or nursing home placements.
Don't Wait to Get Support
ADLs are the basic tasks necessary for daily living. Being unable to perform these tasks can pose risks to older adults' safety and their ability to remain independent. Caregivers and health care professionals can help screen seniors for problems with ADL function. If you or someone you know is struggling to complete basic daily tasks, reach out for extra support. In-home caregiver services can assist seniors with a wide range of ADLs and IADLs.
FAQs
What are the 12 Activities of Daily Living (ADLs)?
Unlike the Katz Index, which identifies six basic tasks, the Roper-Logan-Tierney nursing model looks at 12 essential ADLs. These include: maintaining a safe environment, communicating, breathing, eating and drinking, toileting, personal cleansing and dressing, controlling body temperature, mobility, working and playing, expressing sexuality, sleeping and dying.
Who identified the 12 activities of daily living?
In 1980, nurses Nancy Roper, Winifred Logan and Alison Tierney developed the Roper, Logan and Tierney model of nursing based on the 12 ADLs. This model is used to assess a person's needs to maintain a good quality of life.
Which activity of daily living is the most common?
The most common ADLs vary from person to person, and their difficulty depends on many factors from age to genetics to overall health. Physical tasks, such as eating, dressing, bathing, moving and toileting, tend to be done more frequently. Others, such as shopping, cleaning, driving and managing finances, are more complex tasks and may be done less often, especially if one depends on others to complete them.
BrightStar Care® Can Help Support Your Loved Ones
BrightStar Care caregivers can help seniors struggling with ADLs, personal care and more. Whether you're looking for in-home care services or assisted living for your loved one or a reliable medical staffing partner for your organization, our experienced local care team members are ready to help. Find a location near you, contact us online or call (866) 618-7827 to learn more about how BrightStar Care offers A Higher Standard®.