What Are “Activities of Daily Living?”
Activities of Daily Living (ADLs) are one of the tools that doctors, insurance companies, hospitals, and long term care facilities can use to measure independence in someone with Alzheimer’s. Think of them as a short list of what a person needs to know to live independently. There are two categories: basic and instrumental.
Basic Activities of Daily Living (ADLs)
- Personal Hygiene & Grooming
- Bathing & Showering
- Dressing
- Using The Toilet
- Transferring (Mobility)
- Self-Feeding
Basic Activities of Daily Living (ADLs) are personal habits and routines we use to take care of ourselves. They are basic skills we learned when we were young, that as adults, seem automatic. After so many years, we perform these activities without thinking. In reality, they are embedded in our long term memory.
Instrumental Activities of Daily Living (IADLs)
- Managing Money
- Transporting (Moving Within Community)
- Meal Preparation
- Grocery & Necessities
- Shopping
- Taking Prescription Medications
- Using Phones & Communication Devices
Instrumental Activities of Daily Living (IADLs) are personal habits and routines people learn as adults that allow them live independently in a community. Instrumental Activities of Daily Living (IADLs) require complex planning and thinking skills.
Monitoring both Basic and Instrumental Activities of Daily Living helps caregivers adapt to the changing needs of Alzheimer's caregiving at home, and is an important planning tool for future needs.
ADL Tracking Keeps Caregivers One Step Ahead Of Alzheimer’s
Monitoring and tracking ADLs at home give family caregivers valuable insights into their loved one’s abilities, behavior, and emotional triggers — before they become a problem. Recognizing your loved one’s declining abilities helps you manage expectations with more responsibilities that take longer to finish. Adaptive caregiving strategies are the cornerstone to harmony at home.
Diminished ADL Abilities
Diminished ADL abilities start slowly. At the beginning of Alzheimer’s, it’s easy to get lulled into a false sense of security because symptoms are intermittent, harmless, mild. Many families misinterpret this as a sign that Alzheimer’s will get better.
Maintaining this false belief comes at the expense of their loved one’s health, financial security, and most importantly, the mental and physical health of unprepared caregivers. Make no mistake: nothing in life prepares you for Alzheimer’s caregiving. Not raising kids, nursing the sick back to health, or taking care of aging parents (without Alzheimer’s). All pale in comparison to expectations of Alzheimer’s caregivers.
How Can ADL Changes Look?
Here are three real stories from Alzheimer’s caregivers representing the changes they experienced at different disease stages: mild, moderate, and severe. Every person is unique, and your loved one could behave differently. But, only by tracking the changes in their independence, will you be able to know what’s happening.
Mild Changes in ADL Abilities: Personal Grooming
WHY ARE YOU STARING AT ME?!
I used to be able to count on her to brush her own teeth, but not anymore. Yesterday morning she came into the bedroom, and I could tell by her breath that she didn’t brush her teeth.
“Did you brush your teeth?” I asked.
“Yes,” she answered. (defiant stare included)
“With toothpaste?” I asked.
(laughing now) “No,” she answered.
We went back into the bathroom.
I put the toothpaste on the toothbrush and handed it to her.
“Why are you staring at me?!” she yelled.
I sat on the toilet, grabbed a magazine, and watched her while pretending to read.
She brushed her teeth, with toothpaste.
That’s our new routine now.
Moderate Changes in ADL Abilities: Managing Bills
I NEED TO LOOK AT THIS
I needed to pay bills, so I went upstairs where I could concentrate. Within a few minutes, he came upstairs to find me. These days I am never alone—he follows me everywhere. I had all my bills organized in piles on the table. He sat down and took some of them for a closer look.
“I need to look at this,” he said with authority.
Fortunately, I had anticipated this and brought something to keep him busy.
“Can you look at this for me instead?” I asked as I handed him his Busy Board.
He was forced to put down the papers to hold the board. I know he wants to be close and feel like a part of things. We sat together while I did bills, and he worked the Busy Board.
Severe Changes in ADL Abilities: Toileting
HIS LEGS WERE LOCKED
Yesterday, he went into the bathroom and used the toilet all by himself! It was like a dream!
Today was the polar opposite.
At first, he wouldn’t bend his legs and sit down. Finally, he sat down and went. But, when it was time to get up, he just sat there.
We tried everything we could to get him to stand up from the toilet. He just looked at me with that blank stare. His legs were locked in a seated position. He couldn’t get up, and we couldn’t move him. Both of us used all our strength, but he didn’t move an inch. It took three giant paramedics to get him out of the bathroom. He was still in a seated position when they took him outside and put him in the ambulance.
When Alzheimer’s advances, activities of daily living become more challenging as your loved one loses more of their independence. Don’t wait for your doctor to interpret at what’s happening at home. Monitor and track it yourself—you’re there in person.
