Caring for an elderly person? Here’s your guide to Activities of Daily Living

What does ADL mean?

According to the National Cancer Institute, ADL refers to ‘Activities of Daily Living’ or basic self-care tasks, and is a concept of how independent an elderly person is.

These are routine activities that people have learned from a young age and usually do on a daily basis without any assistance such as eating, dressing, grooming, and using the toilet.

This term is commonly used amongst professionals who work in elderly care services as it helps them identify which seniors need more support in certain areas.

If you work in a nursing facility, or perhaps an elderly home care service agency, it is essential to familiarise yourself with these terms as you go along.

Many of these activities of daily living may seem like simple and mundane tasks for most people. However, given the increasing ageing population in different societies, there may be elderly people who are unable to function like they used to and need assistive care with basic ADLs.

What are the six activities of daily living?

The six most basic activities of daily living are washing, toileting, dressing, feeding, mobility, and transferring.

Washing

This refers to one’s ability to wash their face or body in the bath or shower independently, as well as physically getting in and out of the shower.

While this is a basic and simple task, it can be quite tiresome and even dangerous for the elderly.

Generally, seniors get cold more easily and can experience a loss in balance or range of motion as they age. Seeking assistance with washing can prevent falls and other related injuries.

Toileting

Toileting is the ability to get to and from the toilet, using it properly, and being able to clean oneself afterwards.

This can also mean putting on protective undergarments such as diapers or surgically appliances unaccompanied if required. As you grow older, you may also begin to lose control of your bladder and bowel functions and need to use adult diapers.

Since functional disability is associated with falling and seniors are generally more susceptible to falls, unaccompanied toileting may result in minor or major injuries for the elderly.

Dressing

This refers to the ability to choose which clothes to wear, putting them on, and managing one’s self appearance.

Dressing also includes securing and unfastening any artificial limbs, braces, and other medical and surgical appliances, if needed.

Along the way, some elderly adults may lose the ability to dress themselves due to a number of health conditions like arthritis, a stroke, broken bones, or even cognitive impairments like dementia, and may need an extra hand when getting dressed.

Feeding

Feeding refers to being able to feed oneself after the food has been prepared. Over time, elderly adults with cognitive or physical decline may lose their ability to feed themselves completely. This could be due to a decline in motor or swallowing functions.

Furthermore, they can also experience dietary and nutritional challenges such as simply forgetting to eat meals and loss in appetite.

Mobility

Functional mobility touches on the ability to sit, stand, walk and move from one place to another on level surfaces all by yourself.

Other mobility-related activities include getting onto and off of the toilet, sitting and rising from the couch or other furniture, as well as going up and down the stairs.

Transferring

While it is similar to functional mobility and sometimes used interchangeably, transferring focuses on all aspects of being able to move from a bed to an upright chair or wheelchair and vice versa.

READ MORE: What to do when your loved one has a fall

Technology and equipment that can help with ADL

Since most activities of daily living revolve around being physically able, there are various assistive equipment that can help you complete these tasks with far more ease.

Not only does this make the process of completing ADLs easier, but also reduces the amount of time needed to complete them as well.

For activities that require your elderly loved one to get up from a seated position, whether that’s on a toilet seat or chair, grab bars and bed rails can prep them up by giving them the added support that they need.

For those with mobility-related problems, walkers and wheelchairs can allow seniors to get from one place to another more quickly and conveniently.

Other examples of assistive equipment for the elderly include:

• Ramps
• Hearing aids
• Buttoning aid hook
• Medical alert devices
• Chair lifts
• Toilet seat risers
• Shower chairs
• Handheld shower heads
• Washcloth mitts
• Kitchen utensils with larger handles for more grip
• Shoes with velcro straps

Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL): How are they different?

Activities of daily living can be classified into two different categories. There are activities of daily living (ADLs), which we are already familiar with, and instrumental activities of daily living (IADLs). So, how do these two classifications differ from one another?

ADLs are basic self-care tasks that are necessary for basic functional living. On the other hand, instrumental activities of daily (IADLs) involve slightly more complex tasks that require more thinking and organisational skills than regular activities of daily living (ADLs).

The list is rather long, but some of these activities include cooking, cleaning, doing your own shopping, managing your own transportation, and even handling your finances.

What is an ADL assessment?

If a person is not fully independent with the various ADLs or IADLs, they will require assistance depending on their different needs. However, how do we then determine if one needs help with these activities?

An ADL assessment is a tool used to evaluate one’s level of cognitive and physical functioning with regards to their personal care and social activities.

This process is typically conducted by an occupational therapist, and can be done either in the elderly person’s home environment or at an elderly care facility.

The common areas covered in an ADL assessment include:

• Personal care (hygiene and grooming)
• Physical functions (feeding, dressing, toileting)
• Functional mobility (access and transferring)
• Community integration
• Communication and social interaction
• Home establishment and maintenance

What is the purpose of an ADL assessment?

Not only is an ADL assessment useful in determining the cognitive and physical functions and limitations of an elderly, but it also helps to define and ensure appropriate care support.

By evaluating one’s independent living skills, it allows occupational therapists and elderly care service agencies to decide which areas your elderly loved one needs more assistance with.

Moreover, these assessments can also determine whether or not an elderly person may need further rehabilitation or assistance in their own homes or at a long-term care facility. It may also be used as a tool to detect early signs of illness or physical injury amongst patients.

The inability to ambulate such risks may lead to potential falls and injuries that could have been prevented.

Where can I receive the necessary help?

If an elderly person in your family requires further assistance after taking an ADL assessment, the next step is to figure out where and how they can receive the necessary care support.

Nursing homes and assisted living facilities can provide practical care to seniors who are unable to perform certain ADLs or IADLs.

From personal and emergency care to food preparation and recreational activities, skilled caregivers and nurses will assist seniors with ADLs and IADLs to the best of their abilities.

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On the other hand, in-home care providers for the elderly are suitable for seniors who have mobility-related issues and are designed to aid independent living all at the same time.

Receiving care and assistance right from your home also eliminates the need to travel to an elder care facility and allows for more convenience and comfort as well.

Trained care professionals will visit your home and assist you according to your needs, allowing you to perform basic ADLs with greater ease. Licensed caregivers are also trained to spot potential health hazards in your home and will advise you on the different measures you can take to prevent any accidents.

Once they become unable to perform ADLs on their own, many seniors tend to feel held back by certain disabilities and begin to lose their sense of independence in the process.

Finding the right care option is incredibly crucial not just in helping your elderly family members complete basic ADLs, but also making them feel empowered and independent in their daily lives.

Assisted care isn’t meant to remove the aspect of independence from an elderly person’s life but rather, to give them a sense of dignity and normalcy despite physical limitations.

This article was first published in Homage.