Activities of daily living

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Activities of daily living (ADLs) are "the things we normally do in daily living including any daily activity we perform for self-care (such as feeding ourselves, bathing, dressing, grooming), work, homemaking, and leisure." ^[1] A number of national surveys collect data on the ADL status of the U.S. population. ^[2]

Health professionals routinely refer to the ability or inability to perform ADLs as a measurement of the functional status of a person.^[3] This measurement is useful for assessing the elderly, the mentally ill, those with chronic diseases, and others, in order to evaluate what type of health care services an individual may need. There are several evaluation tools, such as the Katz ADL scale and the Lawton IADL scale.

Most models of health care service use ADL evaluations in their practice, including the medical (or institutional) models, such as the Roper-Logan-Tierney model of nursing, and resident-centered models, such as the Program of All-Inclusive Care for the Elderly (PACE).

In the US, most medical insurance policies will not cover assistance with performing ADLs, whereas such assistance is often covered by policies specific to long-term care.

Daily living skills[]

Daily living skills are the skills required to complete the activities of daily living. being able to master these tasks is an important goal for people with severe mental health difficulties and intellectual disabilities as it brings independence , helps maintain dignity and self respect

Basic ADL[]

Occupational therapists typically look at 11 categories of ADLs. These are the activities that are fundamental for self care. ^[4]

Bathing/Showering
Bowel and bladder management
Dressing
Eating
Feeding
Functional mobility
Personal device care - Includes items like hearing aids, glasses, prosthetics, adaptive equipment, etc.
Personal hygiene and grooming
Sexual activity
Sleep/Rest
Toilet hygiene

Many of the above are consider to be a given. Physicians, nurses and occupational therapists are typically interested in the ability to: dress, eat, ambulate (walk), do toileting and take care of their own hygiene. These five tasks can be remembered with the mnemonic DEATH: dressing, eating, ambulating, toileting, hygiene.^[5]

Mobility[]

Refers to a person's ability to move around, including: walking (independently or with the assistance of another person or a piece of equipment, such as a cane, walker), wheeling a wheelchair, being able to get in and out of their bed, bathtub, vehicle, etc

Instrumental ADL[]

This includes activities not necessary for fundamental functioning, but still very useful in a community. Cooking, shopping, housework and transport are in this category, as is the use of community resources such as entertainment and leisure facilities, financial services and health and social services.

Occupational therapists also look at IADLs when completing assessments. They include 11 areas of IADLs that are generally optional in nature, and can be delegated to others. These areas are:^[4]

Care of others (including selecting and supervising caregivers)
Care of pets
Child rearing
Communication device use
Community mobility
Personal financial management
Personal health management and maintenance
Household management
Meal preparation and cleanup
Safety procedures and emergency responses
Shopping

There are systems (such as the Katz ADL scale) that seek to quantify these functions and obtain a numerical value. These systems are useful for the prioritising of care and resources.

Generally though, these should be seen as rough guidelines for the assessment of a patient's ability to care for themselves.

A simple assessment of the IADLs is frequently done by asking about the ability to do shopping, housekeeping, personal finances, food preparation, and get around (e.g. driving). These tasks can be remembered with the mnemonic SHAFT: shopping, housekeeping, accounting, food preparation, transportation.^[5]

Assessment instruments[]

Hygiene
Independent Living Skills Survey

References[]

↑ MedicineNet.com Medical Dictionary
↑ National Center for Health Statistics
↑ "Activities of Daily Living Evaluation." Encyclopedia of Nursing & Allied Health. Ed. Kristine Krapp. Gale Group, Inc., 2002. eNotes.com. 2006.Enotes Nursing EncyclopediaAccessed on: 11 Oct, 2007
↑ ^4.0 ^4.1 [No authors listed] Occupational Therapy Practice Framework: domain and process. Am J Occup Ther. 2002 Nov-Dec;56(6):609-39. PMID 12458855. Erratum in: Am J Occup Ther. 2003 Jan-Feb;57(1):115. Cite error: Invalid <ref> tag; name "AOTA" defined multiple times with different content
↑ ^5.0 ^5.1 Onn ILY, Jin PCW. Assessment of the Elderly Patient. The Singapore Family Physician. 25(2). 1999. Available at: http://www.cfps.org.sg/sfp/25/252/articles/e252008.html. Accessed on: April 22, 2006.

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[MN-1] MedicineNet.com Medical Dictionary

[NCHS-2] National Center for Health Statistics

[EN-3] "Activities of Daily Living Evaluation." Encyclopedia of Nursing & Allied Health. Ed. Kristine Krapp. Gale Group, Inc., 2002. eNotes.com. 2006.Enotes Nursing EncyclopediaAccessed on: 11 Oct, 2007

[AOTA-4] 4.0 ^4.1 [No authors listed] Occupational Therapy Practice Framework: domain and process. Am J Occup Ther. 2002 Nov-Dec;56(6):609-39. PMID 12458855. Erratum in: Am J Occup Ther. 2003 Jan-Feb;57(1):115. Cite error: Invalid <ref> tag; name "AOTA" defined multiple times with different content

[onn-5] 5.0 ^5.1 Onn ILY, Jin PCW. Assessment of the Elderly Patient. The Singapore Family Physician. 25(2). 1999. Available at: http://www.cfps.org.sg/sfp/25/252/articles/e252008.html. Accessed on: April 22, 2006.

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