Activities of Daily Living: What You Need To Know

Brushing our teeth. Taking a shower. Getting dressed. Using the restroom.

Each one a facet of everyday life and each one an activity performed out of pure instinct and autonomy.

It’s human nature to take for granted those activities that come so naturally because we do them with such great frequency. But what do we do once the ability to fulfill that autonomy is suddenly not as easy as it used to be?

This is a question countless Americans ask themselves, but perhaps the more important question is how do you know when it’s time to seek a little assistance when doing what has come naturally for so many years no longer seems so natural.

Before we get to all that, let’s first cover the basics of what are clinically known as activities of daily living (ADLs).

The Numbers Behind Activities of Daily Living 

According to a 2017 study performed by the Center for Disease Control (CDC), more than 7% of adults aged 65 or older in the United States need assistance with activities of daily living. 

Not surprisingly, this has resulted in an incremental rise in the number of Americans who say they provide informal (unpaid) care for a fellow adult. As of 2020, nearly one in five people in our country — more than 53 million — assisted another adult with health or functional needs, an increase of three percent from five years ago.

And that number, as our nation’s population gets older with every passing year, will only increase, making the discussion about assistance with activities of daily living all the more imperative.

What Qualifies As An Activity of Daily Living?

The American Association of Retired Persons (AARP) defines activities of daily living as “actions a person must do by themselves to engage independently in everyday life, including bathing, dressing, eating, being mobile, moving from bed to a chair, and using a toilet.”

In other words, ADLs are those activities that are necessary for an individual to maintain an personal care and an independent lifestyle and, in the process, sustain a high quality of life.

The exact number of ADLs can vary depending upon based on who you ask, but most experts agree that these basic activities fall into six categories.

According to the National Center for Biotechnology Information, the six basic ADLs, more specifically, are classified as follows:

  • Ambulating: Walking independently from one spot to another
  • Dressing: Selecting appropriate clothing and putting them on
  • Feeding: The ability to feed oneself
  • Bathing: Maintaining personal hygiene (e.g. showering)
  • Toileting: Going to and from the toilet and cleaning oneself after use
  • Continence: Control of bladder and bowel function

Activities of Daily Living Checklist

Specific care needs can vary greatly from person to person.

So, then, what is the most efficient way to accurately gauge the exact level of care that is needed?

If you’re considering whether you or an aging loved one can no longer live alone or may require the help of healthcare professionals to execute one or more activities of daily living, doing so can be as elementary as running down a checklist.

Caring for Your Parents (a Kirk Documentary Group, Ltd., Production for WGBH Boston) provides this checklist in the form of a printable PDF.

Using this free and easy tool will give you a clear idea of what exact type of care will be needed for you or your loved one.

Other ADL Assessments

The PBS checklist is but one resource among many to measure how much help you or a family member or loved one needs with activities of daily living. Other tools to accurately and quickly measure ADL needs include the following:

Aside from these tools, it is also a good idea to consult your primary care physician or other local health practitioner to determine what level of care assistance you or a loved one may need.

Why Should We Care About ADLs?

We should care about ADLs for two reasons:

  • Determining the proper care plan
  • Identifying the amount of financial support needed

Conducting an open and honest evaluation about your health or that of your aging loved one is paramount, and not just because it determines the level of care that is needed.

It’s also incredibly crucial in determining how much financial support you or your loved one is eligible for under programs like Medicare or Medicaid.

Services commonly provided by nursing homes and other types of assisted living facilities are classified by insurance companies as custodial or long-term care. This is important to note because Medicare typically does not cover long-term care services

That being said, you or your loved one may still qualify for certain Medicare benefits if you cannot perform a specific number of ADLs

Still, it is recommended that anyone that may require assistance with activities of daily living purchase a long-term care insurance policy to help compensate for any expenses not covered by Medicare or Medicaid.

Do You Or A Loved One Need Help With ADLs?

As humans, we instinctively crave the freedom and autonomy of independent living.

However, the stark reality is that, as we age, the chances that we or a loved one may require some level of assistance on a daily basis to help maintain a healthy quality of life.

And there’s certainly no shame in admitting you or someone else could use a helping hand with ADLs or what are known as instrumental activities of daily living (IADLs), such as housekeeping duties, management of finances, or meal preparation.

In  fact, the benefits cannot be understated. 

If you or a loved one has been diagnosed with an impairment that inhibits the performance of everyday self-care activities, consider consulting a resource such as Eldercare Locator, a public service from the U.S Administration on Aging that connects older adults and caregivers to available resources within local communities.