As we or our loved ones age, terms like ADLs and IADLs start appearing in medical evaluations, care plans, and conversations with healthcare providers. These acronyms play a big role in determining the level of assistance someone may need to live safely and independently. But what do they actually mean?
In this blog post, we’ll break down Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs)—what they are, why they’re important, and how they’re used in healthcare and caregiving.
What Are ADLs?
ADLs, or Activities of Daily Living, refer to the basic self-care tasks that a person typically performs on a daily basis. These are fundamental skills necessary for independent living.
The six basic ADLs are:
- Bathing and showering – The ability to wash oneself and maintain personal hygiene.
- Dressing – Choosing appropriate clothing and dressing oneself.
- Eating – Feeding oneself (though not necessarily preparing food).
- Toileting – Getting to and from the toilet and managing related personal hygiene.
- Transferring – Moving in and out of beds, chairs, or wheelchairs.
- Continence – Controlling bladder and bowel function.
When someone has difficulty with one or more ADLs, it may indicate the need for support services such as in-home care, occupational therapy, or even assisted living.
What Are IADLs?
IADLs, or Instrumental Activities of Daily Living, involve more complex skills that are necessary for living independently in a community. These tasks go beyond basic self-care and are often the first areas where people begin to struggle as they age or experience cognitive decline.
Common IADLs include:
- Managing finances – Paying bills, budgeting, and handling money responsibly.
- Handling transportation – Driving, using public transit, or arranging rides.
- Shopping – Buying groceries and other necessary items.
- Preparing meals – Planning and cooking nutritious meals.
- Housekeeping – Cleaning, laundry, and maintaining a safe home environment.
- Managing medications – Taking prescribed medicines correctly and on schedule.
- Using communication devices – Using a phone, email, or other tools to communicate.
Unlike ADLs, which are more about physical function, IADLs often require higher-level thinking and planning abilities. Declines in IADLs can signal early cognitive challenges such as dementia or the need for more comprehensive care.
Why ADLs and IADLs Matter
Understanding and assessing a person's ability to perform ADLs and IADLs is key in many areas:
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Healthcare planning – Doctors, nurses, and occupational therapists use these assessments to determine care needs and recommend interventions.
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Caregiver decisions – Family members can better understand the kind of support their loved one might need—whether it's occasional help or full-time care.
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Insurance and benefits – Long-term care insurance and government programs like Medicaid often use ADL/IADL assessments to determine eligibility for services.