Aging In Place

12/12/2022 | By Kari Smith

All industries have their acronyms, which can be confusing to people not immersed in the space. The senior living industry is no exception, sometimes puzzling senior adults and their families when they begin exploring options for this stage in life. Two senior living acronyms, ADLs and IADLs, help providers and families communicate about the activities that people need to do to live independently – and help steer them to the best living arrangements for their situation.

Many older adults experience lessened ability to accomplish routine self-care tasks. This may happen suddenly, as after a fall or stroke or other incident, or gradually. Since these tasks are important for independent living, being able to assess a person’s ability to perform them can help seniors and their families know when it may be time to find additional aid.

ADLs and IADLs measure task success

ADLs and IADLs, used with hospitalized patients of all ages and often in the senior care industry, refer to tasks that individuals need to accomplish daily. ADLs are often thought of as the tasks that we learn as children, whereas IADLs are tasks that we learn as a teenager or young adult.

Activities of daily living (ADLs)

ADLs refer to basic tasks that are essential to independent living.

A healthy individual should be able to perform all of these activities with no assistance. If a patient is unable to perform them, it will likely affect their quality of life and even may cause hazardous living conditions.

ADLs include tasks such as:

  • Feeding: Being able to feed oneself (not including food preparation).
  • Dressing and grooming: Choosing clothes and dressing or undressing oneself
  • Personal hygiene: Keeping oneself clean, from bathing to dental hygiene and hair and nail care.
  • Ambulating: Walking, moving from one position to another (including sitting up from a lying position in bed, getting out of bed and standing up), or moving from a seated position into a wheelchair.
  • Continence: Controlling bladder and bowel function.
  • Toileting: Mobility in getting to the restroom, using the restroom, managing continence issues, and properly cleaning oneself afterwards.

Instrumental activities of daily living (IADLs)

Senior woman being helped as she walks. ADLs and IADLs help providers and families communicate about the activities that people need to do to live independently – and help steer them to the best living arrangements for their situation.

These are the more complex organizational skills that may not be considered essential to daily life, but are still very important, especially for independent living. These include:

Cooking and meal prep: All functions of getting a meal on the table, including shopping for and preparing food.

Shopping for essential items: Purchasing essential items such as clothing, household supplies, etc.

Cleaning and home maintenance: Keeping rooms clean, washing, drying, and folding laundry, and basic home maintenance such as changing light bulbs or tackling – or arranging for – more complex maintenance tasks.

Transportation: Even if a patient is unable to drive, they should still be able to manage alternative forms of transportation. This may mean public transportation such as buses or trains, or even hiring a driving service such as Uber or Lyft.

Communication: Through mail, phone, text, or video chat.

Medication management: Staying on top of one’s medication routine involves having them prescribed or refilled on time, getting them from a pharmacy, and remembering to take them on time. It may also require transportation for injections, infusions, and other regimens that cannot be completed at home.

Financial management: Paying bills, managing assets, going to the bank, making deposits, and balancing checkbooks.

Related: Useful tech for aging in place

So why are ADLs and IADLs important?

When a people’s ability to care for themselves diminishes, their ability to thrive independently diminishes, too. Assessing what they are still physically and mentally able to do helps determine solutions. It can also help elderly or disabled individuals determine their eligibility to receive state and federal assistance.

When families begin to research support options, they will probably be asked about the individual’s ability to perform ADLs or IADLs.

In addition to family and self-assessments, ADL judgments can be provided by professionals in the field, including nurses, occupational therapists, social workers, or elder care experts. Assessments help determine the patient’s abilities to perform all functions and help provide direction to the level of care needed.

Sometimes, simple solutions can renew their independence: computer aids for grocery delivery, technology for medication reminders, a meal service to provide healthy prepared meals, etc.

Other solutions range from in-home care services and adult day care to an assisted living community.

When a senior is experiencing difficulty doing routine things they used to be able to do, this loss of independence and the possible physical and psychological impacts can be significant, especially if the changes go unnoticed and support is not given.

Seniors generally want to hold on to their independence for as long as possible. Assessing ADL and IADL functions is not only a great way to ensure a loved one is getting the care they need, but also to discover adaptations and alternative methods that can actually increase their independence.

Kari Smith

Kari Smith is a frequent contributor to Seniors Guide, helping to keep those in the senior industry informed and up-to-date. She's a Virginia native whose love of writing began as a songwriter recording her own music. In addition to teaching music and performing in the Richmond area, Kari also enjoys riding horses and farming.

Kari Smith