ADLS and IADLS are common terms in the senior care industry. It is important that you know what these terms mean. ADLS stands for activities of daily living, and IADLS stands for instrumental activities of daily living. These are the basic tasks that a person must be able to accomplish to get through the day and care for themselves successfully. An inability to perform these tasks means that the person will likely need ongoing care. Here’s what you need to know.
Activities of Daily Living (ADLS)
ADLS are the basic life skills that most people learn from an early age. This category encompasses the things that people typically perform first thing in the morning, like grooming, bathing, eating, moving around the house and using the bathroom. Although most people pick up these skills in early childhood, they can often become difficult for the elderly to do without help.
Getting Around the House
No matter who you are or where you live, your day starts with getting out of bed. However, even this seemingly simple task can present challenges for some seniors. Those who use wheelchairs, for example, may need assistance moving from the bed to the chair and back again at the end of the day. Those who are still able to walk may still have difficulty with balance, making it risky for them to try to get things off high shelves or walk up and down stairs.
Mobility can impact just about all areas of a person’s life as people have to move around frequently to engage in other ADLS and IADLS. This can be especially problematic for Alzheimer’s and dementia patients as they may forget how to get from one room to another. If a person only has trouble getting around but can perform other activities with minimal assistance, in-home care can be of great assistance.
Using the Bathroom
This is a bit of a touchy subject for many people as it encompasses activities that are normally done in private. This universal task is something that everyone will have to do several times throughout the day. Because bathrooms are often wet areas, this task can be particularly perilous. There is an increased risk of slipping or falling. Many elderly individuals also have difficulty getting on and off the toilet, making this task even more challenging.
Because using the restroom is normally a private affair, it is important that the caregiver you choose is able to assist with it tactfully and respectfully. Maintaining dignity is a major concern for many seniors. Installing handles near the toilet can make it easier for your loved one to be able to get up and down so they can continue to care for themselves safely.
As with using the toilet, showering or taking a bath can pose problems for seniors. Shower and bathtub floors can be quite slippery, as can the floor of the bathroom itself. This is another area where handles can be particularly useful. You should also install non-slip flooring or use non-slip mats to minimize the risk of slipping and falling. A small stool or chair in the shower can be helpful as well.
Towels should be placed close to the shower or bath so the person doesn’t have to reach very far to grab them. This way, they can dry off before stepping out, reducing the risk of slipping while getting out and after the fact. Caregivers can provide support whenever the person is entering and exiting the shower or bath as well.
Getting dressed in the morning is an important part of the day. Choosing appropriate clothes for the daily events and activities can give a person an extra dose of self-esteem. When people look good, they feel better about themselves. Clothes play a big role in this.
However, getting dressed can be difficult for those with limited mobility or balance issues. Standing on one leg to put on pants can be a recipe for disaster for someone who has trouble balancing even on two legs. Most caregivers will provide assistance in this area, giving the person an extra set of hands when they need them most.
Aside from getting dressed, there are a number of other tasks that can boost a person’s self-esteem. These tasks fall under the general category of grooming and include things like brushing teeth, styling hair and using cosmetics and other beauty products. Of course, brushing teeth or caring for dentures is just as important for good health as it is for personal hygiene, so this important daily activity should not be overlooked.
Styling hair and wearing makeup won’t necessarily have any health implications, but they can still go a long way towards making the person feel good about themselves. However, these tasks often require precision and manual dexterity, making them difficult for many seniors to accomplish unaided. Most caregivers can help with these activities as needed. This is another area, like using the toilet, that can impact a person’s dignity, so the caregiver must approach these tasks with compassion and respect.
Eating a healthy diet is absolutely essential for daily living. A person must be able to accomplish this task in order to live safely on their own. Issues with finger strength and dexterity can make using utensils difficult, and many dementia and Alzheimer’s patients often forget that they even need to eat. Other physical and cognitive impairments can make dining challenging as well.
If a person is unable to feed themselves, they will require assistance with meals. Depending on how well they are able to perform other ADLS and IADLS, they may need around-the-clock care, or they may only need assistance at meal times. The caregiver you choose should be able to assist with meals as needed.
Instrumental Activities of Daily Living (IADLS)
IADLS are a sub-category of ADLS. These are the skills that a person needs to have in order to live independently and are typically a bit more complex than ADLS. In general, these are the skills that a person acquires as a teenager, like cooking, communicating, performing housework, managing money and using transportation, among others. Although these skills aren’t necessarily essential for self-care, they are, nonetheless, important for independent living.
This is a separate category from eating, discussed in the previous section, as modern conveniences make it easier than ever to prepare meals without cooking. However, this is still an important skill to have as it enables a person to eat food that is not only delicious but nutritious as well. Many pre-prepared meals are nowhere near as nutritious as the same meal prepared from scratch. Of course, dining out is also a possibility, but that presents other challenges and can be quite expensive.
In-home caregivers can assist a person with preparing their own meals, as well as with eating them, if needed. This makes it easier to stick to any doctor-recommended nutrition guidelines, control portion sizes and eat preferred foods.
Modern technology makes it easy to communicate, either on the phone, over email or even using video chat. However, seniors did not grow up using this type of technology and may not fully understand how to use it. Not only that, but some cognitive problems can make it difficult for the person to speak clearly.
A caregiver can help the person get the appropriate technology set up and show them how to use it. For those who have difficulty speaking, email may be a better option. If a person has difficulty communicating in any form, though, they may need more comprehensive care, as they won’t be able to let anyone know how they are feeling or what they need. A professional caregiver will know the signs to look for to ensure the person’s daily needs are being met.
Keeping a clean home is almost as important as maintaining good personal hygiene, but house cleaning tasks can be a bit more challenging due to the amount of physical activity required. Even light cleaning can become hazardous for someone who has trouble with balance and mobility. Cleaning products should be kept in places where they are easy to reach to minimize the risk of falling.
Whether housekeeping is included in your loved one’s care depends on the extent and scope of services offered by the particular caregiver you choose. If a caregiver doesn’t provide this service, you can always hire an outside housekeeper to keep your loved one’s home clean.
Even in the senior years, managing finances is still an important task. Your loved one will have bills to pay for utilities, and they’ll have to cover housing expenses if they do not own their property outright. They’ll also have monthly expenses for food, clothing, leisure activities and more. Many seniors live on a fixed income, which makes adequately managing their finances even more important to ensure they have the funds to cover their expenses throughout their retirement.
This is a task that should not be left to the person’s caregiver. This can create a conflict of interest so it is better for someone else to handle this task if your loved one is no longer able to. They may wish to instate a power of attorney to manage their affairs in the event that they become mentally or physically incapacitated.
Seniors don’t spend all of their time at home, which means they need to have a means of transportation to get from place to place. While many seniors are still perfectly capable of driving, many are not, which means they must rely on public transportation to get around town. However, this can be especially problematic for dementia and Alzheimer’s patients as they may forget where they need to go or how to get back home.
Many caregivers provide transportation services, either driving the person around themselves or taking public transportation with them. Even if a person has not yet shown signs of memory problems, it is always a good idea to monitor their condition on a regular basis to minimize the risk of them getting lost while out and about.
Measuring ADLS and IADLS
As your loved one gets older, you’ll need to make a decision as to whether they can continue to care for themselves or need a part-time or full-time caregiver. When it comes to making this decision, doctors and senior care specialists typically grade each skill on a sliding scale. Skills are rated in terms of whether the person can perform each task independently, with minimal help, with greater assistance or not at all.
The more tasks a person can do independently, the more likely it is that they can continue to live in their own home, possibly only requiring the assistance of a caregiver a few times each week. If a person has severe difficulty with many of the tasks, on the other hand, they will likely need full-time care, either in-home or in a senior care facility.
Those in the early stages of being a senior can often accomplish most or all of the ADLS and IADLS, but as they get older, they will likely need more assistance. People with dementia or Alzheimer’s typically need the most care as their memory issues and other cognitive complications make these basic tasks far more difficult.
You and your loved one can complete an assessment on your own to help guide you in making your decision about ongoing care. If you are unsure how to rate a particular task, your doctor or a professional caregiver can offer advice and guidance.
You have numerous options available to you when it comes to elder care. Most senior care providers, both in-home and residential, can assist with ADLS and IADLS. The amount of assistance provided will depend on the particular care provider you choose.
Here at San Diego Compassionate Care, we provide in-home care services, allowing your loved one to age gracefully in the same place that they have called home for many years. This is an attractive option for many people as it doesn’t require them to move to an unfamiliar setting. Get in touch with us today to learn more about our in-home care services for seniors.