Last Updated on March 29, 2022 by Ian Evans
Eventually, we all reach a point in our lives when our bodies undergo significant changes, and we find ourselves unable to do the things that we used to, even the little everyday things. When we begin to observe that we cannot do daily activities on our own, we should not ignore these signs and consider getting further assistance, like home care. There are several ways that we can measure our capacity to perform self-care activities, and one of the most effective and commonly used methods is the activities of daily living scale. There are two subcategories for this scale: the basic activities of daily living (ADLs) and instrumental activities of daily living (IADL).
ADL is a concept that was coined by Sidney Katz in the 1950s and has since then been a key instrument in measuring capacity levels in daily living activities among people with injuries, disabilities, and older adults. It is essentially a list of basic self-care activities. Over the years, several developments have been made, but there are two main distinctions: the ADL and IADL. Before we go into the specifics of each type, it is essential to know first the difference between them.
Difference between ADL and IADL
The main difference between ADL and IADL is that ADL consists of basic self-care activities essential for daily living, such as eating and bathing. IADL are more complex tasks that are mainly measured to determine the capacity of the senior to perform daily activities in a community, like going grocery shopping and paying bills.
Activities of Daily Living Scale
The Katz ADL lists items containing specific activities that assess a person’s capacity to perform basic ADLs. It is more on the general daily activities and does not go into detailed and more complex ones, but it is of great use in getting the bigger picture and establishing a shared understanding of what ADLs are and what they are for. This information is beneficial to healthcare professionals for them to provide better care for patients.
The following are the items in the basic ADL:
- Continence – Being able to control bladder and bowel movement
- Bathing – Being able to wash on their own in the shower or bath
- Feeding – Being able to eat independently
- Dressing – Being able to dress on their own and maintain good grooming
- Transfering – Being able to move around, like getting up from the bed and move to a chair
- Toileting – Being able to use the toilet and clean up after
Instrumental Activities of Daily Living Scale
The IADL scale is mainly used in assessing the ability of people to live independently. It contains more items that go beyond a person’s basic needs. It also measures other activities that are essential for everyday living.
Areas measured in this scale are:
- Shopping for essentials like clothes and food
- Preparing their meals
- Handling their finances and paying bills
- Driving or commuting on their own
- Handling communication like writing mail or using the telephone
- Acquiring and taking medication according to schedule
- Maintaining the house, do proper cleanups, and organizing
Purpose of ADL and IADL Scales
Aside from measuring a senior’s performance level on daily living tasks, the ADL and IADL scales are also for people who are recovering from injury and are undergoing rehabilitation. In rehabilitation, both are essential in making sure that one can live an active life, but ADL takes precedence over IADL. Once the ADL part is covered, it is ideal to move on to the IADL activities. For example, once established that the person can handle properly eating, the next step would be meal preparation.
ADL and IADL are widely used by physiotherapists when identifying seniors’ functional abilities and any problems they may have. Since having difficulties with everyday tasks may also point to other health problems, it is essential to have this basic assessment. Treatment for ADL difficulties is done through physical therapy to increase strength and decrease pain from joints. Physiotherapists also encourage exercise and create programs aimed at improving the performance of ADLs.
Studies have shown that physical therapy has helped seniors in several ways, such as increased physical strength, better mobility, and reduced risk of falls. Regular exercise is an excellent way to help prevent ADL disabilities. It is vital to keep an active lifestyle early on and get proper exercise to maintain physical health. After all, prevention is better than cure.
Causes of Difficulty in Performing ADLs
Difficulty in performing ADLs stems from several causes. One of the primary and most natural causes is aging. The slow decline of several physical and mental functions due to old age leads to decreased ADL abilities. Another one could also be side effects from medication.
Older people who have been hospitalized have also experienced difficulties with ADLs. Many seniors admitted for acute illnesses had a significant decline in ADL skills upon discharge.
The home environment can also be a cause, like being socially isolated, which negatively impacts a person’s general well-being. It is crucial to consider the environment that a senior is in and make sure that they are still living comfortably in their homes. There are different solutions available when someone cannot have the best care within their own homes, and one of them is getting professional care.
Activities of Daily Living: Nursing Care
In the case of the senior found out to require assisted care, there are several options for this to be arranged. One option is to have a Certified Nursing Assistant (CNA). A CNA’s job is mainly to provide care to patients, including bathing, dressing, monitoring medication, and checking temperature. When we are unable to provide primary care for ourselves, a CNA will assist with all of our needs, making sure that we are as comfortable as possible.
Aside from nursing care, all healthcare professionals involved in caring for a person, like a physical therapist or occupational therapist, should work together to determine the best course of action for their patient. There should be regular assessments in ADL functionality to monitor any changes that may occur. After the whole team communicates and collaborates on different ideas and the situation is looked at from different angles, they can create an ideal plan to provide the best possible care.
Top 3 Points
1. ADLs consist of basic self-care activities essential for daily living. This can include eating and bathing. IADLs are more complex tasks like grocery shopping and managing finances.
2. ADLs and IADLs are widely used by physiotherapists when identifying seniors’ functional abilities and any problems they may have.
3. Difficulty in performing ADLs may be due to aging, health problems and side effects of medication.
It might not be the smoothest transition to ADL assistance. But the earlier we accept that we need help, the easier it will be to handle the changes. There is no shame in admitting that we need help on certain things. Being able to acknowledge this only shows that we are not afraid of whatever challenge life may throw at us. And we are also ready to do whatever we can to make sure that we are ready in the best way possible. It is all about setting ourselves up for the long-term care we need. And having our basic needs taken care of will allow us to have more time to do other activities we love. Channeling our energy into the things that bring us joy will lead us to have more productive and happier lives.
It gives family members peace of mind when they know that their loved ones are adequately cared for. There is nothing more important than protecting and providing for our family. We can’t always do this by ourselves. Thus, the best thing we can do is make sure that we have the best care arrangement.