What are the Activities of Daily Living?

Imagine suddenly being unable to bathe yourself, prepare a meal, or manage your medications. For many individuals facing health challenges or aging, losing the ability to perform Activities of Daily Living is like falling down a steep slope – each lost capability represents another step away from independence.

Understanding ADLs isn’t just academic; it’s essential for maintaining dignity and quality of life for vulnerable populations. This guide explains these critical functions and how healthcare professionals assess and support them.

What does this term “Activities of Daily Living” mean?

The term “Activities of Daily Living” or ADLs for short is a term used to describe the fundamental skills required to taking care for oneself independently, such as eating, bathing, and mobility. The term “Activities of Daily Living” was first coined by Sidney Katz in 1950.

According to the book “Activities of Daily Living” by Peter^[1], ADLs are essential and routine tasks that most young, healthy individuals can perform without assistance. The inability to accomplish essential activities of daily living may lead to unsafe conditions and poor quality of life.

The healthcare team should be aware of the importance of assessing ADL in patients to help ensure that patients who require assistance and are identified. This activity details the activities of daily living and highlights the role of the interprofessional team in assessing ADLs to enhance patient care and management.

The book further suggests that the ADLs are essential and routine tasks that most young, healthy individuals can perform without assistance. The inability to accomplish essential activities of daily living may lead to unsafe conditions and poor quality of life.

The healthcare team should be aware of the importance of assessing ADL in patients to help ensure that patients who require assistance and are identified. This activity entails the activities of daily living and highlights the role of the interprofessional team in assessing ADLs to enhance patient care and management.

Assessment of Activities of Daily Living (ADLs)

The screening of ADLs is performed at two levels, namely Basic ADLs and Instrumental ADLs. The former is commonly referred to as just ADLs.

A. Basic Activities of Daily Living (or simply ADLs)

The ADLs 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 are fundamental for self-care. The activities include:

1. Dressing: Changing clothes
2. Eating: Feeding own self
3. Ambulation: Walking without assistance. If a patient needs a walker or holds walls or any other help, then they need help with this ADL.
4. Transferring: Moving from one body position to another. This includes being able to move from a bed to a chair, or into a wheelchair; the ability to stand up from a bed or chair in order to grasp a walker or other assistive device.
5. Toileting: Using toilet and wiping self without help.
6. Hygiene: Bathing and cleaning self.

B. 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:

1. Shopping: Shopping for clothing and other items required for daily living.
2. Housekeeping: Cleaning and home maintenance. This means cleaning kitchens after eating, keeping one’s living space reasonably clean and tidy, and keeping up with home maintenance.
3. Accounting: Managing finances, such as paying bills and financial assets.
4. Food preparation: Getting or preparing a meal on the table. It also covers managing medications, which covers obtaining medications and taking them as directed.
5. Telephone: Managing communication, such as the telephone and mail.
6. Transportation: Either driving or arranging other means of transportation.

Why ADLs Matter: Applications Across Healthcare Settings

ADL assessments serve as crucial clinical indicators across various healthcare environments:

• Hospital Care: ADL evaluations help determine discharge readiness and identify needed support services.
• Rehabilitation: Tracking ADL progress provides objective measures of functional recovery after injury or illness.
• Long-term Care: ADL assessments determine appropriate level of care and staffing requirements.
• Home Health: Evaluating ADLs helps establish eligibility for services and create personalized care plans.
• Insurance and Benefits: Many insurance providers and government programs require ADL assessments to determine eligibility for benefits and services.

Regular ADL monitoring allows healthcare teams to detect subtle functional declines early, potentially preventing more serious health events or unnecessary institutionalization.

How can we remember the ADLs?

You can use the mnemonic words^[4] to help you remember.

1. How to remember ADL? Use the mnemonic word “DEATH“: Dressing, Eating, Ambulation, Transferring & Toileting, Hygiene.
2. How to remember IADL? Use the mnemonic word “SHAFT“: Shopping, Housekeeping, Accounting, Food preparation, Telephone & Transportation.

Assessment Tools for ADLs

There are a number of tools to help care professionals assess the ADLs. The common tools as follows:

1. ADLs – Katz Assessment Tool^[5]
2. IADLs – Lawton Assessment Tool^[6]

Feel free to ask for more practical solutions should you need assistance with your loved-one. Our rehabilitation programs will support the Activities of Daily Living.

Written by Tommy Tan
Managing Director
Hovi Club Ulu Pandan

* References:

^[1] https://www.ncbi.nlm.nih.gov/books/NBK470404/

^[2] https://hign.org/consultgeri/try-this-series/katz-index-independence-activities-daily-living-adl

^[3] https://betterhealthwhileaging.net/what-are-adls-and-iadls/

^[4] https://www.timeofcare.com/adl-mnemonic

^[5] https://www.alz.org/careplanning/downloads/katz-adl.pdf

^[6] https://nursing.ceconnection.com/ovidfiles/00000446-200804000-00023.pdf