When caring for elderly parents or planning for long-term care, understanding ADLs (Activities of Daily Living) is essential. ADLs form the foundation for assessing a senior’s ability to live independently and help determine the level of care and support they may need. This guide provides a complete overview of ADLs and IADLs, how they’re assessed, and what evaluations they are relevant for.
Key Takeaways about ADLs and IADLs
ADLs (Activities of Daily Living) are basic self-care tasks essential for independent living.
IADLs (Instrumental Activities of Daily Living) involve more complex activities like managing money or medication.
ADL assessments help determine levels of care, insurance eligibility, and long-term care planning.
Tools like the Katz Index and Barthel Index are commonly used by healthcare professionals.
Understanding ADLs empowers caregivers and families to plan proactively and access the right services.
What Are ADLs?
Activities of Daily Living (ADLs) are the basic, routine tasks a person must be able to perform to live independently and safely. These activities serve as a key indicator of functional health and are often used by medical professionals and insurance providers to assess whether a person needs assistance or specialized care.
The 6 Core ADLs
ADL
Description
Includes
Eating
Ability to feed oneself (excludes meal preparation)
Bringing food to the mouth using utensils, chewing, and swallowing safely. May include cutting food or using adaptive devices if needed.
Bathing
Personal hygiene and cleanliness
Using soap and water to cleanse the entire body, including getting in and out of the tub/shower and drying off. May include grooming tasks.
Dressing
Selecting appropriate clothing and dressing independently
Retrieving clothes, putting them on in the correct order, fastening buttons/zippers, and using assistive devices such as prosthetics.
Toileting
Safely using the toilet and performing hygiene afterward
Getting to and from the toilet, positioning oneself, managing clothing, cleaning with toilet paper or hygiene products, and handling devices.
Continence
Control of bladder and bowel function
The ability to maintain control or manage incontinence through the use of devices such as briefs, catheters, or ostomy bags.
Transferring
Moving between surfaces safely and independently
Transitioning from bed to chair, standing up from seated positions, or moving between other essential locations within the living space.
The 6 Core ADLs
These are referred to as basic activities, forming the benchmark in ADL assessments used by home healthcare providersnursing homes, and long-term care insurance evaluations. Individuals who struggle with one or more of these tasks may require in-home assistance,rehabilitation, or nursing home care.
What is the difference between ADLs and IADLs?
Feature
ADLs
IADLs
Type of activity
Basic self-care
Complex daily tasks
Dependency indicator
Used for insurance and care eligibility
Used to assess independence
Examples
Eating a sandwich, bathing, dressing
Cooking dinner, managing finances
Instrumental Activities of Daily Living
In addition to basic ADLs, there are Instrumental Activities of Daily Living (IADLs). These involve more complex tasks needed for independent living. The American Occupational Therapy Association (AOTA) lists 12 essential Instrumental Activities of Daily Living (IADLs):
IADL
Description
Care of Others
Providing physical and emotional support to others, such as children or elderly family.
Care of Pets
Feeding, grooming, and maintaining the health and safety of pets.
Child Rearing
Responsibilities related to raising and supervising children.
Communication Management
Using phones, computers, or other devices to send and receive messages.
Community Mobility
Using transportation options (driving, public transit, walking) to move safely in the community.
Financial Management
Managing money, budgeting, paying bills, and handling financial transactions.
Health Management and Maintenance
Scheduling medical appointments, taking medications, and managing personal health needs.
Home Establishment and Management
Maintaining a household, including cleaning, organizing, and repairing.
Meal Preparation and Cleanup
Planning, preparing, and cleaning up after meals.
Religious Observance
Participating in spiritual or religious activities important to the individual.
Safety and Emergency Maintenance
Recognizing/responding to hazards and maintaining a safe environment.
Shopping
Planning and purchasing groceries, clothing, and other essential items.
Not all of these IADLs are used in clinical assessments or insurance evaluations, but they can help create a full picture of daily functioning and support needs.
Common ADL and IADL Assessment Tools
Professionals use various standardized tools to evaluate ADL performance. These assessments often involve both self-reporting and observational scoring.
Common Tools:
Katz Index of Independence in six basic ADLs
Measures six basic self-care tasks: bathing, dressing, toileting, transferring, continence, and feeding.
Purpose: Evaluates how independently a person can manage essential daily activities. Often used in primary care and long-term care planning.
Barthel Index
Assesses ten areas of daily function, including mobility, grooming, eating, and bladder/bowel control.
Purpose: Determines the level of assistance a person needs. Widely used in hospitals and rehabilitation settings.
Lawton IADL Scale
Focuses on eight Instrumental Activities of Daily Living (IADLs), such as using the telephone, shopping, cooking, housekeeping, managing medications and finances.
Purpose: Helps determine if someone can live independently in the community. Common in outpatient and home health settings.
Functional Independence Measure (FIM)
Evaluates 18 items across both physical and cognitive domains, including ADLs, communication, and social interaction.
Purpose: Tracks a patient’s functional progress in rehabilitation and informs care planning. Often used in inpatient rehab.
Roper-Logan-Tierney Model of Nursing
A holistic nursing model that examines 12 activities of living (e.g., breathing, eating, sleeping, communicating, working).
Purpose: Guides comprehensive, patient-centered care by addressing physical, emotional, and social needs. Common in nursing homes and hospital care.
These tools influence eligibility for Medicare, Medicaid, VA benefits, and long-term care insurance. ADL assessments help determine the level of support a person needs and play a crucial role in care planning, eligibility for long-term care insurance, and recommendations for services like home care or assisted living.
How Do Professionals Assess ADLs?
To assess your ability to perform ADLs, your doctor will typically:
Ask structured questions about how difficult certain everyday tasks have become
Inquire about recent changes in how you perform tasks due to illness, pain, or mobility limitations
Observe your physical movements to evaluate coordination, balance, and strength
They may observe or ask about your ability to:
Walk across the room and maintain balance
Move from a bed to a chair or sit to stand
Button and unbutton a shirt or dress independently
Put on and remove shoes
Perform grooming and personal hygiene tasks like brushing your hair or teeth
Assessments can be done:
During a routine health checkup (especially for seniors)
As part of an annual wellness visit under Medicare
Before hospital discharge
When evaluating a need for rehabilitation or long-term care
In the context of a functional decline or after an injury
Tip: Bring Someone with You. It can be helpful to bring a caregiver, family member, or friend to the appointment. They may provide insights you forget or feel hesitant to share, and they can help advocate for the support you need.
Why ADLs matter in Elder Care Planning
Understanding and tracking your elderly parent’s ability to perform ADLs is essential to:
Identify the right care services (e.g. part-time help, nursing home, or in-home health care)
Consulting with a home health care provider can help identify specific areas where additional support is beneficial. Recognizing these challenges is a critical first step toward selecting appropriate care options that facilitate daily living while promoting independence.
Many families choose to care for loved ones at home, either independently or with professional support. In numerous U.S. states, family members who provide care may be eligible for compensation through Medicaid programs or other state-funded programs. These programs recognize the invaluable role of family caregivers by offering financial support, training, and respite services, helping to ease the burden and improve quality of care.
FAQ
Advanced ADLs refer to even more complex tasks that support social and community engagement:
Working a job
Volunteering
Participating in hobbies
Driving long distances
Though not part of standard insurance metrics, these are important for quality of life and independence.
Examples of ADLs:
Getting dressed
Walking to the bathroom
Eating a sandwich
Examples of IADLs:
Preparing dinner
Managing a bank account
Taking a bus to the doctor
Scheduling medical appointments
In the United States, there are 6 core ADLs (Activities of Daily Living) commonly used in medical assessments, care planning, and long-term care insurance.
Some care models include “Mobility” or “Walking” as a separate seventh ADL. This can vary based on the clinical setting or rehabilitation approach. In most U.S. policies, however, mobility is considered part of transferring.
Long term care insurancepolicies in the U.S. rely on the6 core ADLs. Toqualifyforbenefits, a persontypicallymustbeunableto perform at least twoofthesewithoutassistance.
In medical documentation, ADLs are used to assess functional status, design care plans and determine eligibility for services like Medicaid, Veterans Affairs benefits, or long term care insurance.
In the U.S., long-term care insurance policies often trigger benefits when a person cannot perform 2 or more ADLs without help. An ADL is a benchmark for determining functional impairment. Most policies define qualifications based on inability to perform specific ADLs such as toileting or dressing. Knowing these definitions helps policyholders understand coverage eligibility.
Lisa is an experienced copywriter specializing in topics related to caregiving, health, and social security. With a deep understanding of the needs of family caregivers and individuals requiring care, Lisa creates informative and compassionate content that provides practical support and makes complex subjects easy to understand. As part of the Entyre Care team, Lisa helps make knowledge and resources accessible for a secure and financially stable life in later years.
