There are some things we all do every day that we don't even think about. Things like getting up in the morning, washing our face, brushing our teeth, getting dressed, eating, taking a shower, and going to the bathroom. These are what doctors call 'Activities of Daily Living' (ADLs) . These are the essential things to keep our bodies healthy and functioning well. Sometimes, even doing these seemingly simple tasks on our own can be a challenge for some people. Let's talk a little more about these ADLs today, shall we?
What are ADLs? Simply put...
Simply put, (ADLs) are the basic things we do to keep our bodies healthy and live our daily lives. These can be divided into two categories. One is the essential things for the body – like eating, bathing, and going to the toilet. Without these, it would be difficult for us to live.
The other part is the more complex tasks , which are tasks that help you live independently and independently. For example, managing money, bringing groceries home, gardening, and doing laundry. Doing these things requires a bit of thought and planning.
Sometimes, imagine you have to have a minor surgery. You may need help with these ADLs for a few days. That's normal. However, some people may need help with these tasks for a long time, perhaps even for the rest of their lives. This may be because they have a chronic condition that affects their ability to move their body, their memory, and their problem-solving skills.
Why is it important to talk about these ADLs?
When you visit a doctor or take care of a family member, the medical team will likely talk about these ADLs. To be honest, this is not an easy topic to talk about. You may think, "Oh, will I have to rely on others?" or, "Will my mom/dad be able to stay home alone?" These fears and anxieties are very common.
The most important thing is to talk about this openly and honestly with your doctor or your loved one's healthcare team.
They will listen to you and understand what you want. By talking about it this way and understanding what your options are, you and your family can make the best decision. To prepare for this conversation, it helps to know exactly what doctors mean when they say ADLs.
There are two main types of ADLs...
We mentioned earlier that ADLs are mainly divided into two parts.
1. Basic daily activities (Basic ADLs)
These are the things we do every day, essential to our physical survival. These are sometimes called physical daily activities , because they are directly related to our body's needs.
Some examples of basic ADLs:
- Feeding: Taking food from a plate, putting it in your mouth, and eating it properly.
- Bathing/Personal Hygiene: Going to the bathroom alone, washing your body, and cleaning yourself. This includes brushing your teeth and washing your face.
- Dressing: Choosing and putting on clothes on your own. Things like buttoning and zipping.
- Toileting: Going to the toilet alone, doing what is necessary, and coming out clean.
- Transferring: Things like moving from a bed to a chair, getting up from a chair, and walking around the room.
- Continence: The ability to control the ability to defecate and urinate when and where you want.
Here's an important thing to remember. There's a difference between doing this basic ADL and doing it safely . Imagine, you can move around the house, but you feel off-balance, or you've had a few falls and barely escaped. If so, it's very important to tell a doctor about it.
It's easy to put things off, thinking, "Oh, that's just how it is when you're getting older." But if you find that doing these basic tasks is harder than it used to be, don't let that discourage you. When you tell a doctor, they may recommend making some simple changes. For example, removing slippery rugs from your home or installing grab bars in the bathroom.
2. Instrumental ADLs (IADLs)
These tasks, called Instrumental Activities of Daily Living (IADLs), are a bit more complex than basic ADLs. They require more mental skills to perform. IADLs support not only our basic physical needs, but also our overall well-being. To perform these tasks, you need to be able to think complexly, keep things organized, and be able to move around inside and outside the home.
Some examples of IADLs:
- Managing a household: cleaning the house, making beds, taking out the trash.
- Preparing meals: Planning a meal, preparing the necessary ingredients, and cooking it safely.
- Managing medications: Taking medications at the right time and in the right dosage.
- Managing finances: paying bills, doing banking, and using money wisely.
- Shopping: Making a list of items you need for your home, going to the store, and picking them up.
- Using the telephone: Being able to make a call to someone and answer incoming calls.
- Transportation: Traveling alone by bus, train, or driving your own vehicle or booking a taxi.
- Laundry: Sorting, washing, drying, and folding clothes.
Often, when people realize they can't do these IADLs on their own, they first ask for help with these tasks. Sometimes, a person doesn't even realize they need help with IADLs until a family member or doctor points it out. Many people who need help with IADLs can do basic ADLs without any problems.
A person's needs may change over time. For example, someone with mild cognitive impairment or early-stage Alzheimer's disease may have difficulty performing some IADLs but may not need any help with basic ADLs. However, as the condition progresses, they may begin to have difficulty performing even basic ADLs.
This is why assessing ADLs is not usually a one-time thing. Instead, healthcare providers, such as doctors, nurses, and occupational therapists, can regularly check your ability to perform basic and IADLs. They look for any changes that might indicate the need for further help.
When do doctors check for ADLs?
When and how often doctors assess your ability to perform ADLs will vary depending on your medical history and current condition. Typically, nurses and occupational therapists can check how well you are doing these ADLs when:
- When you are hospitalized.
- After coming home from the hospital.
- While recovering from surgery, a physical accident, a traumatic brain injury, or a stroke.
- If you have a neurodegenerative disorder, such as Alzheimer's disease or Parkinson's disease, which gradually weakens the nervous system.
- If you have an intellectual disability.
- If you have a mental health problem.
How are ADLs assessed?
Doctors use a variety of methods to assess a person's ability to perform daily activities. For example, they may directly observe you or your loved one doing these activities. Sometimes, they ask caregivers about what they see. Other times, the person who is having difficulty with ADLs will self-report .
Doctors may use one or more of these methods together to get the best understanding of how well a person is able to care for themselves and what kind of help they need. Depending on how much help is needed, doctors may recommend things like:
- Using specially designed eating utensils and equipment such as transfer belts to help lift someone.
- Making adjustments at home, such as using chairs with armrests to make it easier to sit and get up from chairs.
- Employing a family member (informal caregiver) or a home health aide for care.
- Considering other accommodation options, such as assisted living or nursing homes.
Doctors always try to recommend options that will keep you or your loved one as safe as possible.
What is the Katz Index? (Katz ADL Scale)
This is also called the ``Katz ADL scale.`` This is a checklist that doctors often use to determine how well you can perform daily activities. The ``Katz ADL scale`` mainly looks at basic ADLs , and it does not look at IADLs (more complex tasks).
The ``Katz ADL scale'' measures how well you can perform six (6) basic ADLs. You get a score of one (1) for each task you can do independently , and a score of zero (0) for each task you need help with . So, you can get a maximum score of six (6). The higher the score, the more you can do the task independently. The lower the score, the more help you may need in your daily life.
Here are the six basic ADLs on the ``Katz ADL scale'' and what you need to do to get a score for each of them:
1. Bathing: If you can clean your entire body without any help, or with help for only one part of the body (e.g., back).
2. Dressing: If you can choose and put on all your clothes, and do things like buttons and hooks and eyes on your own (you may need help tying your shoelaces).
3. Toileting: If you can go to the toilet without any help, sit on it, use it, and come back clean.
4. Transferring: Get out of bed or a chair without help from someone else, if possible.
5. Continence: If you have complete control over when and where you urinate and defecate.
6. Feeding: If he can take food from the plate and put it in his mouth on his own.
Doctors use the Katz ADL scale and other checklists or assessments to get a complete picture of what you can do and what kind of help you need. For example, they may use the Lawton Instrumental Activities of Daily Living Scale to see how well you can do more complex tasks, such as preparing meals or doing household chores.
If you find an ADL checklist online, it's best to talk to a doctor before using it on your own. No matter how well-intentioned, it's easy to misunderstand a checklist like this or what it says. If you have any concerns about yourself or someone in your family, the best and safest thing to do is to talk to a doctor and get their guidance on what to do next.
The most important thing for you to remember (Take-Home Message)
These activities of daily living (ADLs) are things we do regularly and are deeply embedded in our lives. So, we often don't think about them until you or a loved one can't do them. That's when questions like, "What kind of help will we need? How long will we need it? What will happen to the future of all this?" start to arise.
Questions come to mind easily, but finding answers isn't always easy. That's why it's important to share your concerns with a doctor. They'll be ready to work with you and find solutions.
If you're feeling sad, overwhelmed, or just plain tired because of this type of anxiety, consider talking to a mental health counselor . They can understand how you're feeling and help you find positive ways to manage these life changes a little more easily. Remember, you're not alone!
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