Understanding the many different terms associated with elder care can be overwhelming when you first become exposed to it. It’s like another language. Medicare vs Medicaid, assisted living vs independent living, IADLS vs ADLs, etc.
I know this firsthand because I had to learn the terms when I first began working in senior services, and I was reminded of it again (and again) when I met with seniors, caregivers, and family members who were applying for services or entering the nursing facility.
As you get older, you may start hearing all kinds of new unfamiliar acronyms. These can be overwhelming and confusing, especially as you’re trying to make important decisions regarding the care of you or your loved ones. The medical field – and long-term care facilities especially – use acronyms to describe different conditions, organizations, and types of care, but it’s often difficult to find answers on what each of these terms describe.
IADLs and ADLs are two acronyms that you’re likely to start hearing more and more as you reach senior status. And although they seem similar, understanding the differences between the two is critical as you begin to make long-term care decisions for yourself or for your loved ones. Being able to categorize daily living activities and assessing which are more difficult than others can help you determine what kind of care will be the most beneficial over time.
ADLs = Activities of Daily Living
ADLs, or activities of daily living, are the most basic tasks a person does in their day-to-day life. In order to live independently, a person should be able to achieve these tasks safely either on their own or with the help of assistive devices such as walkers. ADLs are the types of activities that you don’t give a second thought to when you’re able to do them, but being unable to complete these tasks can make living quite difficult.
When deciding what kind of care you or your loved ones need as they age, first consider if these tasks are easily achievable. Although they may be a bit slower with age, if the answer is no for any of the below – or any other task essential to basic daily living – a skilled nursing facility or extensive home healthcare support may be required.
7 Examples of ADLs
Walking is an essential activity of everyday living. This can include walking around the house, down the street, or in public places such as the grocery store. Consider using an upright walker if the act becomes difficult. If severe joint pain or other circumstances keep an individual from walking comfortably or prevent them from doing so altogether, extensive home care is likely needed.
In addition to walking, a person should be able to move around comfortably. This includes standing up from a sitting or lying position, getting in and out of the shower, and being able to reposition your body as needed. If any of these activities become difficult or dangerous for you – even with tools such as power lift chairs and shower transfer benches – consider looking into additional care options.
Being able to eat food is critical to a person’s survival, so always make sure you or your loved ones can feed themselves as they need to. Although they don’t necessarily have to cook or prepare the food, being able to hold utensils, chew, and swallow are very important activities of daily living. If at any point eating becomes difficult, more involved care options should be considered.
Being able to select clothing, put clothes on, and take them off requires much more mobility than we think about before old age, but it’s an important piece of daily living. If getting dressed becomes difficult, consider different clothing for seniors options that may make the act of getting dressed a bit easier. If the act is still difficult or dangerous, additional care may be needed.
Toileting includes being able to get to and from the toilet, using it appropriately, and then taking the proper measures to clean oneself afterward. If getting on or off becomes difficult, adjusting toilet height may be helpful. However, if the entire activity becomes difficult or leads to frequent accidents, consider hiring in-home care or looking into assisted living.
In addition to the mobility it takes to get in and out of the shower or bathtub, being able to bathe oneself is also essential to high-quality living. If you’re worried about showering becoming dangerous for you or a loved one, consider installing shower handles or using a shower stool. If the activity is still difficult, additional care is likely required.
Activities such as brushing and flossing teeth, brushing hair, and being able to maintain one’s personal appearance are also important for daily living. If a senior is unable to manage basic grooming tasks, it may be a sign that critical functions are deteriorating. Consider your options for ongoing care if these tasks become difficult.
IADLs = Instrumental Activities of Daily Living
Once it’s determined that a person is able to comfortably complete ADLs, the next step is measuring how well they’re managing IADLs. IADLs, or instrumental activities of daily living, are more complex tasks that are generally a part of day-to-day life. These aren’t as critical as walking or eating, but they still play a significant role in a person’s quality of life.
Although these tasks are important in everyday life, getting assistance with these activities is typically easier than hiring the type of care one would need if an ADL couldn’t be accomplished. However, it’s still important to take into account what you or your aging loved one can and cannot manage on their own. This will help you determine what kind of care they need now and what they may require in the future.
7 Examples of IADLs
Being able to manage one’s own finances is a huge piece of being independent. This can include paying bills on time and maintaining a budget; however, managing finances plays a role in many aspects of day-to-day life. If you or your loved one has overdue bills due to forgetfulness or overspending, consider assisting them yourself or hiring someone to take on this responsibility.
Many people lose the ability to drive as they age. This could be due to an injury or disability, weakened reflexes, or cognitive decline. If driving is out of the question, consider what kinds of public transportation options may be available in the area. If there is concern about navigating public transit, look into senior transportation service options. Many services offer subscriptions for seniors who need rides frequently, and some medical plans may even cover part of the cost whenever it’s medically necessary.
If driving or transportation is already taken care of, it’s also important to ensure seniors are able to complete errands outside of the house including grocery shopping. Tasks such as shopping require mobility, memory, and many other functions that make living easier. If you or a loved one is having trouble shopping or doing other out-of-the-home tasks, consider services such as grocery delivery to minimize the level of effort needed to maintain the household (and check out our list of discounts for seniors to make the most of the service).
While eating is considered an ADL, preparing meals is considered to be a bit more complex. This can include gathering ingredients, chopping vegetables, safely handling meat, and cooking and/or baking the food itself. If preparing meals becomes difficult or dangerous, consider different food options that don’t require preparation or hiring a service that will deliver already-prepared meals directly to your door.
Making Phone Calls
Being able to successfully use technology to communicate is critical as we reach old age. And although phone calls are the most commonly used, this could also include email or other technologies used to keep in touch with others. This is not only important for mental health reasons, but it’s also essential in case there were ever an emergency that required help from friends, family, or emergency services. If you or a loved one is struggling with phone calls, consider investing in a medical alert system that’s simple and effective for seniors to operate.
Maintaining a home is already a difficult job on its own, but factoring in slower speeds and lessened mobility can make it overwhelming for seniors. This can include cleaning, gardening, or home repairs/upgrades. If you or a loved one is having trouble with routine housekeeping or home maintenance tasks, consider hiring a regular housekeeper or other professionals to take care of any tasks needing attention around the house.
As we age, medications often become essential to our comfort and survival. However, the daily – or several times daily – task of managing medications can be difficult. This includes keeping medications organized, refilling prescriptions, and knowing what to take and when to take them. If you or a loved one is struggling with managing all of the various medications, consider tools like pill organizers. If needed, there are also in-home care services that can help keep seniors up-to-date on all of their medications.
How ADLs and IADLs are Used in Personal Care
When looking into personal care options for you or a loved one, considering how well the senior can accomplish ADLs and IADLs can help determine what kind of care will best suit their needs. For example, if you or your loved one is, for the most part, struggling with activities considered IADLs, the kind of care required may not be as extensive as it would be for those struggling with ADLs. However, a senior struggling with basic tasks such as eating and walking may need to consider frequent in-home care or an assisted living facility.
What are ADL and IADL Checklists?
ADL and IADL questionnaires and checklists can help ask the right questions to determine the type of care that would be best for you or your loved one’s independence and well-being.
The Katz Index of Independence ADL checklist is a questionnaire that has seniors or their caregivers rate how well they’re able to complete activities of daily living such as bathing, toileting, and feeding. If the senior is able to complete these tasks independently, they gain a point. If they’re dependent on a caregiver, they receive no points. The total score will then determine how much a senior is in need of personal care.
Similarly, the Lawton-Brody IADL checklist measures how well seniors can manage instrumental activities of daily living. They are given points for being able to partially or fully complete tasks such as dialing the phone, doing laundry, and managing finances. The total score can help determine what kind of assistance that senior may need with more complex tasks.
Changes to or complete loss of a person’s abilities to do these everyday tasks could, unfortunately, hinder the quality of life of an individual as they age. These deteriorations, however, are often gradual, so it’s important to continuously monitor your own or your loved ones’ abilities to take care of themselves and their households. If you notice any sudden changes in comfort while completing these tasks, speak to your doctor about how to best manage the situation.
Although losing these abilities can seem scary or frustrating, there are many options for products or services that can help make these everyday items a little bit easier. By keeping an eye out for sudden or gradual changes, you can quickly find convenient ways to manage any conditions and maintain a healthy quality of life for years to come.