Activities of daily living

Activities of daily living (ADLs) is a term used in healthcare to refer to daily self care activities within an individual's place of residence, in outdoor environments, or both. Health professionals routinely refer to the ability or inability to perform ADLs as a measurement of the functional status of a person, particularly in regard to people with disabilities and the elderly.^[1] Younger children often require help from adults to perform ADLs, as they have not yet developed the skills necessary to perform them independently.

ADLs are defined as "the things we normally do...such as feeding ourselves, bathing, dressing, grooming, work, homemaking, and leisure."^[2] A number of national surveys collect data on the ADL status of the U.S. population.^[3] While basic categories of ADLs have been suggested, what specifically constitutes a particular ADL in a particular environment for a particular person may vary. Adaptive equipment or device may be used to enhance and increase independence in performing ADLs.

Basic ADLs

Basic ADLs (BADLs) consist of self-care tasks, including:^[4]

• Bathing and showering (washing the body)
• Dressing
• Self-feeding (not including chewing or swallowing)
• Functional mobility (moving from one place to another while performing activities)
• Personal hygiene and grooming (including brushing/combing/styling hair)
• Toilet hygiene (completing the act of urinating/defecating)

Although not in wide general use, one mnemonic that some consider useful is DEATH: dressing/bathing, eating, ambulating (walking), toileting, hygiene.^[5]

Instrumental ADLs

Instrumental activities of daily living (IADLs) are not necessary for fundamental functioning, but they let an individual live independently in a community:^[6]

• Housework
• Taking medications as prescribed
• Managing money
• Shopping for groceries or clothing
• Use of telephone or other form of communication
• Using technology (as applicable)
• Transportation within the community

A useful mnemonic is SHAFT: shopping, housekeeping, accounting, food preparation/meds, telephone/transportation.

Occupational therapists often evaluate IADLs when completing patient assessments. The American Occupational Therapy Association identifies 12 types of IADLs that may be performed as a co-occupation with others:^[4]

• Care of others (including selecting and supervising caregivers)
• Care of pets
• Child rearing
• Communication management
• Community mobility
• Financial management
• Health management and maintenance
• Home establishment and maintenance
• Meal preparation and cleanup
• Religious observances
• Safety procedures and emergency responses
• Shopping

Evaluation of ADLs

There are several evaluation tools, such as the Katz ADL scale,^[7] the Lawton IADL scale and the Bristol Activities of Daily Living Scale.

Most models of health care service use ADL evaluations in their practice, including the medical (or institutional) models, such as the Roper-Logan-Tierney model of nursing, and the resident-centered models, such as the Program of All-Inclusive Care for the Elderly (PACE).

See also

References

External links

• The Thin Edge of Dignity Moving presentation about one man's experience in an assisted living facility.