Is it hard to do daily activities alone? Let's talk (Activities of Daily Living - ADLs)

Have you ever seen your beloved mother, father, or grandmother take a moment to put on their own button? Or seem a little forgetful while making a cup of tea? We see these little things every day. Sometimes we forget about them, thinking, "That's just how it is when we get older." But these simple things actually say a lot about our health, especially our ability to live independently. That's what we call "Activities of Daily Living (ADLs)" in medicine.

Simply put, what are these activities of daily living (ADLs)?

This is very simple. ADLs are the essential tasks we do every day to take care of our bodies and stay healthy. Think about it, the things we do from the time we wake up in the morning to the time we go to bed at night. We can't live without things like eating, bathing, and going to the toilet. Those are the basic things that come into play.

Also, this adds a little more complexity. For example, things like managing money, bringing groceries home, cooking, and doing laundry. Without these, it's hard for us to live alone and independently, right?

Sometimes a person only needs help with these tasks for a short time. Imagine that you have a broken leg and have had surgery. For a while, you will have difficulty bathing or walking on your own. At that time, someone will need help. But once the wound heals, you will be able to do these things on your own again.

But some people need help with these tasks for a long time, perhaps for the rest of their lives. This is because they have a chronic condition. For example, someone with severe arthritis may have difficulty buttoning clothes or eating because they cannot bend or straighten their limbs properly. Similarly, someone with a progressive memory loss condition (such as Alzheimer's disease) may begin to forget things like cooking and using money.

Doctors divide these ADLs into two parts. Let's look at them separately.

1. Basic Daily Activities (Basic ADLs)

2. Activities of daily living involving the use of instruments (Instrumental ADLs or IADLs)

Basic Daily Activities (ADLs) - The essentials for survival

This includes the things that we absolutely need to do to survive, things that are directly related to our bodies. These are like the basic needs of our body. If we cannot do any of these, it will directly affect our health.

Think about it this way. If you can walk, but you lose your balance and fall while walking, that's a problem. It means you can do it, but you can't do it safely . If you trip over a small piece of rug at home and fall, or if you slip and fall in the bathroom, you should definitely tell your doctor about those things.

Don't put these things off thinking, "This is just how it is when you get older." Even a small change can be the beginning of a big problem.

Assisted Living Activities (IADLs) - Things that help you live independently

Now let's look at the second part. We call these `Instrumental Activities of Daily Living (IADLs).` These may not be as essential to living as those basic tasks. However, if a person is to live alone, safely, and independently in society, they must be able to do these tasks. This requires a little complexity, planning, and organization.

Often, the first thing that comes to mind when someone needs help is when they can't do these IADLs. Sometimes they realize, "Oh, I can't take the bus by myself anymore," or "I forget to take my medicine sometimes." Sometimes the person doesn't realize it, but their family and doctors can see the difference.

Most of the time, even someone who has difficulty performing IADLs can still perform the basic ADLs we talked about earlier (like bathing and eating) without any problems. However, when there are things like memory-related illnesses, over time, even basic ADLs start to become difficult to perform.

At what times do doctors look for these ADLs?

This is not a test that is done on everyone all the time, but it is specifically looked at in certain situations. Such situations include:

• While in the hospital: If you are being treated in the hospital for an illness, the nurses and doctors will check to see if you are able to function independently before sending you home.
• After surgery, an accident, or a stroke: Since the body's function is reduced after something like this, these abilities are often explored during recovery.
• When there are diseases that reduce memory and brain function: Since the condition of people with diseases such as `Alzheimer's disease` and `Parkinson's disease` changes over time, they are regularly checked to see if they can work independently.
• When there are mental health problems: Some mental health conditions can reduce a person's interest and ability to do their work. This is also a time to pay attention.

How are these abilities measured?

Doctors use various methods for this.

• Direct observation: You directly observe someone doing the task and assess how well you can do it.
• Asking a Caregiver: If you have a caregiver, ask them about your abilities and get information.
• Self-report: Sometimes you ask yourself , "Can you do this alone? What are the difficulties?"

Using one or more of these methods, you will determine the level of help you need. Based on this, your doctor may suggest:

• Using assistive devices: Things like a walker for walking, special cutlery for eating, and handles for the bathroom.
• Making changes to the home environment: Things like using chairs with armrests, removing slippery rugs, etc.
• Hiring someone to help: Hiring someone to help with household chores or the services of a `home health aide`.
• Other accommodation options: Depending on the situation, referral to a place like an assisted living or nursing home.

Let's also learn about the Katz ADL Scale questionnaire.

This is a method that is widely used by doctors around the world. It is called the `Katz Index of Independence in Activities of Daily Living` or `Katz ADL scale`. It measures how well you can perform the 6 basic ADLs that we discussed earlier on your own.

This is very simple. You give 1 point for each task that you can do alone, without help. You give 0 points for each task that requires help. The maximum score is 6.

Let's see what those 6 basic ADLs are and what you need to do to get a mark.

The doctor will use the Katz ADL scale, along with other questionnaires such as the Lawton Instrumental Activities of Daily Living Scale, which measures IADLs, to get a complete picture of your condition. If you find such questionnaires on the internet, do not fill them out and draw conclusions on your own. You may misinterpret the information. The best and safest thing to do is to talk to a doctor and do these things under his guidance if you or a loved one is experiencing this type of discomfort.