ADL
Meaning of ADL: A diagnosis says what a person has; an ADL assessment says what they can still do, which is what determines the support they need.
Definition of ADL
ADL stands for activities of daily living, the basic self care tasks a person carries out to get through an ordinary day: eating, dressing, bathing, using the toilet, controlling the bladder and bowel, and moving between bed and chair. How many of these a person manages without help is a standard measure of functional independence.
What counts as a basic ADL?
| Task | What it covers |
|---|---|
| Bathing | Washing the whole body, and getting into and out of a bath or shower |
| Dressing | Choosing clothes and putting them on, fastenings included |
| Toileting | Reaching and using the toilet, and cleaning afterward |
| Transferring | Moving between bed, chair and standing |
| Continence | Control of the bladder and bowel |
| Feeding | Getting food from plate to mouth, once it has been prepared |
These are listed roughly in the order they tend to be lost and regained, bathing usually first and feeding usually last, a pattern noted in the original scale and still used as a rough guide.
How do IADLs differ?
Instrumental activities of daily living are the tasks that make independent living possible rather than the tasks of caring for the body. They cover preparing meals, shopping, housework and laundry, managing money, taking medicines correctly, using a telephone and arranging transport. They call for more planning, memory and judgment than the basic tasks do, which is why they usually falter first. Someone who still dresses and bathes without help may already be losing track of bills or of which tablet was taken when. That order makes the instrumental tasks a more sensitive early signal of cognitive change, while loss of the basic ones marks more advanced decline.
Where are they assessed, and what for?
They appear wherever function rather than diagnosis is the question. In rehabilitation after a stroke, a fracture or a long admission, these scores set the goals and track progress. In care of older adults they inform decisions about support at home and about the level of care a setting has to provide. In physical therapy and occupational therapy they define what treatment is aiming at, since the point of regaining shoulder movement is usually to reach a shelf or comb hair. They also decide eligibility for benefits, insurance and long term care funding in many systems, which is why the wording of an assessment carries weight well beyond the clinical record. Assessment uses standard scales rather than impression, and because what a person manages in a clinic room is not always what happens at home, accounts from family and observation in the person's own surroundings are gathered alongside the score.
Also known as
Used in a sentence
The therapy team assessed the patient's ADLs prior to planning the discharge.
Good to know
Basic ADLs cover fundamental self care such as bathing and dressing while instrumental ADLs cover more complex tasks such as managing money or medicines, and because the complex tasks usually falter first, they often signal decline earlier.