What Are Activities of Daily Living?
Date Updated: July 26, 2024
Written by:
Rachel Lustbader is a writer and editor with a background in healthcare and technology. Her work has been published on websites including HealthCare.com, BiteSizeBio.com, BetterHelp.com, Caring.com, and PayingforSeniorCare.com. She studied health science and public health at Boston University.
Both of Rachel’s grandmothers had very positive experiences in senior living communities, and Rachel saw firsthand the impact that kind, committed caregivers and community managers can have on seniors’ and their family members’ lives. With her work at Caring, Rachel hopes to help other families find communities, caregivers, and at-home products that benefit elderly loved ones and make life less stressful for family caregivers
As the number of people aged 65 and older increases, so also does the demand for specialized housing to meet their changing needs. Whether you need help for yourself or a loved one, it’s challenging to know exactly what type of care you might need and where to find that care. Assisted Living Facilities provide help with “Activities of Daily Living” (ADLs) – but what exactly does that mean? Do you need that type of care?
This guide explains what ADLs are, signs that you need help with them and other types of care often provided in assisted living communities.
What Are the Main Types of Activities of Daily Living?
We may not often realize how many tasks of daily living we take for granted until disability, illness or natural aging makes them more difficult, if not impossible, to execute. The main activities of daily living can fall into three categories. When determining which long-term care plan is the right fit, it’s important to first assess your capabilities within each category and where you need the most support.
Personal Care Assistance
Activities that you cannot skip without posing risks to your health or safety are considered activities of daily living. Many of these tasks fall under self-care or personal care and shouldn’t be neglected. If you notice that a loved one is regularly skipping several of these activities, whether because they’re unable or unwilling, then it’s likely they need caretaker assistance of some form.
ADLs include:
- Going to the bathroom, including proper toilet hygiene
- Bathing, showering and washing your face and hands as needed
- Getting into or out of bed or getting up and down from sitting in a chair
- Personal hygiene, such as brushing and flossing teeth, taking care of your fingernails and toenails, shaving and, if desired, putting on makeup and moisturizer
- Getting dressed and undressed; also, ensuring that you’re dressed appropriately for the weather and destination
- Eating or preparing simple meals and snacks
- Walking or climbing stairs
- General ability to respond to a safety alert or emergency response, such as a fire alarm, tornado warning or other alarm
Depression sometimes occurs as people age and they realize that they’re unable to live their life independently or they’re facing a reduced capability to be independent. Sometimes, an individual may be physically able to complete ADLs but may be unwilling to do so. Regardless of the reason why your loved one isn’t practicing self-care, finding the right support to help them complete these tasks can have a significant impact on their quality of life.
Instrumental Activities of Daily Living
Instrumental activities of daily living (iADLs) are typically the type of activity that individuals or elderly couples seek support for first, such as hiring a housekeeper or a meal preparation service. Most activities that involve living independently and running one’s own household, including taking care of a spouse or other dependent, fall under the category of iADLs. While they aren’t related to fundamental functioning, they are a necessary part of living independently.
iADLs include:
- Shopping for groceries and running errands
- Preparing meals and cooking, plus washing up afterward
- Driving or taking public transportation
- Medication management, including diabetic insulin checks and dosage
- Communicating through technology and using the phone or internet
- Making appointments for medical professionals, household maintenance or other services
- Cleaning and doing chores around the house, such as dishes, laundry and vacuuming
- Managing finances and paying bills on time
Many of these tasks can be handled by a homemaker service that specializes in helping the elderly and infirm retain their independence at home. However, for tasks that involve finances, it may be wiser to have a financial planner or someone designated as power of attorney to take care of these responsibilities and to ensure that your elderly loved one is protected from fraud.
Domestic Activities of Daily Living
One of the first things that many people stop doing as they age is domestic activities of daily living (dADLs). These include hobbies, favorite pastimes or activities that require dexterity and fine motor skills, such as needlepoint, some forms of woodworking or crafting models. These activities may not be necessary for life, but engaging in hobbies and pastimes, including those with a social aspect, can improve the quality of anyone’s life.
dADLs include:
- Light or more intensive exercise
- Mental exercises, such as crosswords, sudoku or other puzzles
- Any type of activity that requires fine motor skills
- Socialization or other companionship
- Taking care of a pet
- Caring for others
- Participating in community activities
How Do I Know if Myself or a Loved One Needs Help With Activities of Daily Living?
Individuals who need help with personal care and ADLs are generally easy to spot. You can tell if someone isn’t able to bathe or groom themselves if they’re wearing the same clothing for days. Another sign is if they’re unable to eat or prepare food. However, many seniors may hide the fact that they can no longer do things that they once did.
You may be able to tell if your loved one needs a higher level of care if:
- Their eating habits have changed or they’ve gained or lost weight.
- They have noticeably poor hygiene and grooming.
- Their home is messy, dirty, unsanitary or unsafe.
- They exhibit inappropriate behavior, such as being unusually loud in the wrong situations, being agitated or suspicious or making strange phone calls.
- Friends and neighbors have expressed concerns about their behavior or appearance.
- They’ve had injuries from accidents, carelessness or forgetfulness, such as burns, bruising or cuts.
- They misuse prescribed medication or alcohol.
- They no longer participate in activities or engage in hobbies they used to enjoy.
- They show signs of forgetfulness, such as unopened mail and unpaid bills, clutter, missed appointments, double-paying bills or losing money.
- They exhibit other unusual behavior.
Anything worrisome about a loved one, including a change in their character, may warrant a trip to a doctor to assess their health, both physically and mentally. Some of the signs above can also indicate the early warning signs of dementia and cognitive decline.
What Types of Care Are Provided in Assisted Living?
Not only do assisted living communities provide the personal care, grooming and mobility assistance that frail and ill seniors require, they also offer specialized services to help with iADLs, such as all-in-one fees that include a private apartment and utilities, light housekeeping and maintenance, healthy meals and snacks, and transportation to errands, appointments and group outings.
These facilities also have caseworkers who can help seniors renew their benefits and medical care, apply for different services as they become eligible and ensure they have the right legal documents prepared by referring them to a lawyer for a will or living will.
In addition to taking care of many of the daily household chores and tasks for seniors, assisted living communities also strive to create a sense of community. Regular activities are scheduled, including games and dances, plus seniors can form hobby groups for special interests. Often, these homes have a small fitness center, and many offer classes geared to seniors, such as chair yoga, tai chi or SilverSneakers.