What’s the Difference
Between ADLs and IADLs
Activities of daily living (ADLs) are a series of basic activities performed by individuals on a daily basis necessary for independent living at home or in the community. The 6 basic activities of daily living are as follows:
- Eating — Feeding oneself by getting food into your body from a receptacle (such as a plate, cup or table) or by a feeding tube or intravenously.
- Bathing — Washing oneself by sponge bath; or in either a tub or shower, including the task of getting in or out of the tub or shower.
- Dressing — Putting on or taking off all items of clothing and any necessary braces, fasteners or artificial limbs.
- Transferring — Moving into or out of a bed, chair, or wheelchair.
- Toileting — Getting to and from the toilet, getting on and off the toilet, and performing associated personal hygiene.
- Mobility — Walking and getting around unaided.
Instrumental activities of daily living (IADLs) are actions that are important to being able to live independently, but are not necessarily required activities on a daily basis. These activities are not as noticeable as the ADLs when it comes to loss of functioning, but functional ability for IADLs is generally lost prior to ADLs and can help determine, with greater detail, the level of assistance required by an elderly or disabled person. Some instrumental activities of daily living are as follows:
- Basic communication skills — Telephone use, email use, or internet use.
- Transportation — Driving oneself, arranging rides or the ability to use public transportation.
- Shopping — The ability to make appropriate food and clothing purchase decisions.
- Housework — Doing laundry, washing dishes, dusting, vacuuming, and maintaining a hygienic place of residence.
- Managing medications — Taking accurate dosages at the appropriate times, managing refills, and avoiding conflicts.
- Managing personal finances — Operating within a budget, writing checks, paying bills and avoiding scams.
Assistance with IADLs, in the absence of ADL assistance, most likely will not be covered by a long term care or home health care policy; however, assistance may be available through local government agencies for the aged/disabled.
Testing and assessments:
- Katz Index of Independence in ADLs — measures on a scale of dependency to independency.
- Lawton IADL Scale — measures on a scale of low functioning to high functioning.
There are also multiple online geriatric assessment tools available to families who wish to have an assessment of their loved one’s ability to complete activities of daily living; or families can turn to their family doctor to discuss concerns.
Understanding the difference between ADLs and IADLs is imperative. Losing independence is a struggle for us, as human beings. After living independently for a long time, the elderly may feel less dignified, and anxious as they lose this ability. By assisting one step at a time, and getting the appropriate assistance when needed, the transition can be made a lot easier.