Activities of Daily Living

(Estimated reading time: 3 minutes)

Take a moment to picture all the routine activities that are part of daily life, starting with getting out of bed to start the day. Things like: using the bathroom, maybe taking care of pets, getting breakfast, making the bed, brushing teeth, getting dressed, and so on…

And as the day goes on, there are other everyday, but necessary tasks that need to be done if you are an independent adult. You can probably think of more, but here are a few things that come to mind. Things like: driving, shopping, cooking, cleaning, laundry, arranging for repairs, managing medications, plus all the activities that are part of managing a household.

All of these mundane, but necessary tasks are what healthcare professionals call the activities of daily living or ADLs.

Healthcare professionals often use the activities of daily living to measure the ability to function or to live alone safely. A decline in personal hygiene or mobility may be signs of a health issue that needs to be addressed.

Recognizing someone’s limitations is the first step in developing a plan to safely age in place at home. Holidays and other family gatherings offer a good opportunity for family and friends to compare notes on how a loved one is doing and to discuss if it’s time to plan for extra help around the house or possible time to think about assisted living.

Assessing someone’s functional status can be tricky. Sometimes people deny or even try to hide or downplay that they need any help. More than once, I’ve heard a someone tell me that yes, they can walk without any help, and then later admit that by walking, they meant that they were able to manage a few steps from their wheelchair to their bed and vice versa. Taking a step or two isn’t the same as being able to walk or use stairs with no fear of falling.

Activities of Daily Living

Most of the activities of daily living have to do with routine personal care. Here’s a list:

• Personal hygiene (bathing, grooming, brushing teeth, trimming nails, hair care)
• Dressing (the ability to get dressed without assistance, to select and wear appropriate clothes for the weather or for an occasion)
• Walking and managing stairs
• Transferring (generally moving from one place to another without assistance, getting in and out of bed, chairs, cars; stepping over a bathtub to get into a shower)
• Eating without assistance (does not include cooking, chewing, or swallowing)
• Toileting (continence management, getting to the toilet, cleaning oneself, getting back up off the toilet); mental and physical ability to properly use the bathroom)

A pattern

There’s a pattern you can look for when it comes to the activities of daily living starting with hygiene, mobility, and then with eating.

As someone ages and their health starts to decline, one of the first things to look for are changes in their personal hygiene. Are they forgetting or refusing to shower or wash their hair? Are they wearing pajamas all day or wearing the same clothes for several days at a time? Are fingernails and toenails clean and trimmed?

Often after a decline in hygiene comes problems with mobility: walking, using stairs, getting into and out of a chair or bed, and eventually using the shower without someone on standby, help getting to the toilet.

Late in the aging process comes difficulty using knives, forks, and spoons when eating, or chewing or swallowing certain foods.

Instrumental Activities of Daily Living

The experts lump activities that aren’t related to self-care in a category called the instrumental activities of daily living (or IADLs). These are the mundane, but necessary tasks for being a responsible adult and for living independently. You can think of the IADLs as adulting skills. They include:

• Driving, using public transportation, or arranging for transportation
• Preparing meals (shopping, storing groceries, cooking)
• Managing a household (cleaning, tidying up, removing trash and clutter, doing laundry, folding clothes, handling home repairs, making a home hospitable, decorating for holidays)
• Managing medications (getting prescriptions filled, keeping medications up to date, taking medications on time and in the right dosages)
• Managing money (managing bank balances and checkbooks, paying bills on time)
• Managing time (maintaining a schedule, tracking appointments on a calendar)
• Caring for others (children, pets)
• Having companionship and mental support (family, friends, clubs, groups, religion)
• Communicating with others (conversations without struggling for words; mail, phone calls, text, email)
• Responding appropriately to emergencies, safety concerns

Checklists for the activities of daily living

A checklist may help you prepare for a discussion with family, caregivers, or medical professionals. There are many checklists available online. They are usually in the form of a table that lists self-care activities plus column headings for independent, needs someone to stand by, and needs help. I have one that I’ve created myself that I will post in the future.