Written by Anne Bogardus, Founder (and former caregiver)
This information is provided for educational and information purposes only. It is not medical advice. Please consult a medical professional for specific questions.
If you are new to the caregiving journey or are trying to figure out if a family member is in need of care, one measurement that can help you is that of ADLs (Activities of Daily Living) and IADLs (Instrumental Activities of Daily Living). An evaluation of ADLs and IADLs is used by medical professionals, assisted living facilities, nursing homes, and government assistance programs to determine the level of impairment an individual has in different areas. While there are several generally recognized categories, quite often the way they are interpreted in a particular situation or by different states can vary. For concerned family members, an ADL/IADL assessment provides an objective way to identify warning signs that an aging parent is in need of assistance.
So what are the general ADL and IADL categories, and what is the difference between the two designations?
Difference between ADLs and IADLs
First, the difference: ADLs are the basic activities we perform each day to get ourselves ready to face the world, while IADLs involve activities that allow us to be independent.
General ADL Categories
It would be nice if there was a consistent list, but depending on who is asking, the list can vary. Generally, according to the Department of Health and Human Services, a list of ADLs usually includes the following activities:
- eating
- toileting
- transferring (moving from a bed to a chair, getting out of bed, or similar functions)
- dressing, and
- bathing.
In some cases, the ability to walk or get around inside and/or outside and whether or not an individual is continent of urine or bowels are also part of an ADL evaluation
General IADL Categories
IADLs get into areas that are often difficult for family members to discuss with an elderly parent because they involve activities that most of us consider essential to our independence:
- driving
- using the telephone
- shopping
- managing finances
- cleaning house
- preparing meals, and
- doing the laundry.
ADLs/IADLs as Objective Measures for Aging Parents
It can be difficult to for elderly parents and their adult children to agree on whether or not assistance is needed in any of these areas, so an objective measure such as the ADL/IADL categories can assist in having these sometimes contentious conversations about an aging parent’s need for some level of support.
In many cases, the IADLs seem to be the most problematic—“Of course I can still drive! What do you mean you are taking my car keys away! How dare you!” ADLs, in most cases involve more personal activities and are usually much more difficult for an impaired person to deny—either they can walk or they can’t; they are incontinent or they are not.
This simple concept provides an objective framework to help adult children determine whether or not an aging parent is self-sufficient and able to continue living on their own, or that the parent needs some type of assistance, whether that is a part-time caregiver once or twice a week, living full –time with a family member, or moving to an assisted living or other type of care facility.