Understanding Activities of Daily Living (ADLs): Key Skills for Independence

Activities of Daily Living, commonly abbreviated as ADLs, are basic tasks that people must perform to keep their bodies functioning well and to survive. These are very common, everyday tasks like eating, going to the washroom, and moving from one place to another.

With aging, ADLs can be adversely impacted. So whenever care and assistance are needed, healthcare providers often use ADLs as a measure to understand the level of support that is required.

What Are Activities of Daily Living (ADLs)?

Activities of daily living was first coined by Sidney Katz in the 1950s. They refer to the basic skills people need in life, usually movement, grooming, dressing, eating, and toileting. However, with age, these ADLs can be adversely impacted. In fact, of late, there has been an upward trend of ADL disability in people aged between 60 – 79, while among those aged 80 and older, there has been a significant decrease from 1982 onward.

Healthcare providers use ADLs as a measure to cater to the different levels of care and assistance that might be required as people age.

Along with ADLs, Instrumental Activities of Daily Living (IADLs) are also used to measure overall functioning. These are more complex activities like taking care of own health and managing finances. The basic difference between ADLs and IADLs is that the latter is generally used as a measure to get a person’s life back on track. The ability to perform IADLs indicates the same.

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Basic Activities of Daily Living (ADLs)

The basic activities of daily living are tasks that are crucial for survival and overall well-being. These include:

• Eating – Eating involves the ability to feed oneself, like the ability to bring food to the mouth, chew, and swallow food so that it reaches the stomach.
• Movement – It involves maintaining basic movement. This basically refers to the ability to transfer oneself from one place to another, like from the bed to the washroom to the drawing room to the dining room, and so on.
• Toileting – It involves the ability to go to the toilet, position oneself in a proper position, and use the devices to keep clean. It also refers to the ability to maintain continence. Moreover, if any other devices like catheters are present, it involves the ability to manage them as well.
• Bathing – It refers to the ability to use water, soap, towels, and other bathing supplies to keep the skin clean. It also involves the ability to move the body in a manner so that every part of the body can be rinsed and cleansed.
• Grooming – The basic abilities to maintain good personal hygiene, like cleaning teeth, washing hair, and using tweezers or nail clippers, among others.
• Dressing – It is the ability to get the clothes out of the drawer or cupboard and put them onto the body. It also involves the ability to use hooks, buttons, zip, and any other material that may be needed.

Instrumental Activities of Daily Living (IADLs)

Instrumental activities of daily living or IADLs differ from activities of daily living in that they are more complex. They can be used as a measure while getting a person’s life on track. The common IADLs are as follows:

• Caring for Health – The ability to care for one’s own health, like visiting doctors and taking medicines as prescribed.
• Managing Finances – It is the ability to manage one’s own finances, like using banking services, paying bills, and planning on how to manage expenses.
• Running Errands – Running the basic errands like doing grocery shopping, purchasing toiletries or clothes, or other basic necessities.
• Cooking – It is the ability to cook one’s own meals, and to do so properly and safely.
• Household Chores – The ability to perform household chores includes cleaning, gardening, and so on.
• Managing Communication Devices – This refers to the ability to use post, telephone, e-mail, and other devices that are used for communication.
• Managing Transport – It is the ability to manage own transport, like driving vehicles, using public transport, availing cabs, and so on.
• Caring for Others – This involves the ability to care for dependents, like children, pets, and others.
• Maintaining Other Activities – It refers to maintaining religious practices, and hobbies, and engaging in other interests as well as maintaining a social life.
• Understanding Safety – It involves knowing safety procedures, what the emergency contacts are, and how to contact them during emergencies.

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Why Are ADLs Important for Independent Living?

Activities of daily living indicate a person’s functional status. They are the basic indicators of independent living, and the inability to perform ADLs means that it can lead to an unsafe and poor quality of life. It also indicates that the person may require care and assistance from other people or devices.

Therefore, healthcare providers take ADLs as a measure to cater to different levels of care and assistance needs, especially among older persons and those suffering from chronic illnesses. They also become a measurement for needing hospitalization, admission into care homes, requiring paid home care services, or other living arrangements.

As per the US National Health Interview Survey in 2011, it was found that approximately 20.7% of persons aged 85 or older, 7% of persons aged between 75 – 84, and 3.4% of persons aged between 65 – 74 needed care and assistance when it came to managing their ADLs.

Challenges in Performing ADLs

There can be many challenges in performing activities of daily living as one ages, or for persons suffering from disabilities and chronic illnesses.

Physical Impairments – Usually happen with decreasing strength, imbalance, pain, and other conditions. It can impede people from performing ADLs properly and promptly.

Mobility Issues – With physical impairments come mobility issues, and this makes it difficult for a person to move from one place to another. For instance, basic movements like getting up from the bed and going to the washroom begin to feel difficult.

Cognitive Impairments – They develop with cognitive decline and are most evident in people suffering from Alzheimer’s disease. People can have difficulty eating and cleaning themselves, and this can lead to unhygienic, unhealthy, and highly unsafe conditions.

Toileting – Mobility and incontinence are the main challenges that can lead to problems with toileting. In fact, incontinence can be embarrassing and stigmatizing for many.

All of the challenges in performing ADLs can lead to unhygienic and life-threatening conditions. Therefore, care and assistance must be provided to persons finding it difficult and challenging to perform ADLs on a consistent basis.

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What Is The Difference Between ADLs And IADLs?

ADL full form in medical terminology is Activities of Daily Living. Meanwhile, IADL full form in medical terminology is Instrumental Activities of Daily Living.

While ADLs refer to basic activities that are required for daily functioning and survival, IADLs are more complex activities. Some examples of ADLs will be eating and toileting, and some examples of IADLs will be running errands and managing finances.

The ability to perform ADLs indicates the ability to live independently, and any challenges or inability will indicate the care and assistance required for the person to lead a safe and healthy life. Meanwhile, IADLs are more important in terms of getting a person’s life back on track, whether after an illness or a disorder.