What Are ADLs (Activities of Daily Living)?
ADLs refer to the basic tasks necessary for daily life. Examples include:
- Bathing and Showering: Ability to bathe oneself.
- Dressing: Selecting appropriate clothes and dressing oneself.
- Eating: Feeding oneself.
- Transferring: Moving from one position to another, like from bed to chair.
- Toileting: Using the toilet independently.
- Mobility: Walking or moving around.
What Are IADLs (Instrumental Activities of Daily Living)?
IADLs are more complex skills needed for independent living. Examples include:
- Managing Finances: Budgeting, paying bills, and handling financial matters.
- Managing Medications: Taking correct dosages at the right times.
- Meal Preparation: Planning and preparing meals.
- Housekeeping and Cleaning: Maintaining a clean living environment.
- Shopping for Groceries and Necessities: Buying and transporting groceries.
- Using Communication Devices: Using phones, computers, or other technology.
- Transportation: Driving or using public transit.
ADLs vs. IADLs: Quick Comparison Chart
| Dimension | ADLs (Activities of Daily Living) | IADLs (Instrumental Activities of Daily Living) |
|---|---|---|
| Core Purpose | Higher-order tasks are needed to live independently in the community | Nurses, OTs/PTs, physicians, and care managers using standardized ADL scales |
| Typical Examples | Bathing, dressing, eating, toileting, transferring, mobility | Managing money/meds, meal prep, housekeeping, shopping, communication, transportation |
| Cognitive Demand | Lower to moderate | Moderate to higher (planning, sequencing, problem-solving) |
| Who Usually Assesses | Unpaid bills, missed meds, spoiled food, cluttered home, missed appointments. | OTs, social workers, care managers using IADL scales/interviews |
| Common Assessment Tools | Katz Index of Independence in ADLs; Barthel Index | Lawton–Brody IADL Scale |
| Early Warning Signs | Falls, weight loss from difficulty eating, poor hygiene, incontinence issues | Inability often indicates a need for hands-on personal care |
| Impact on Independence | Inability often indicates a need for support services or supervision | Often supports care planning and services, but less commonly a direct trigger on its own |
| Insurance/Benefit Relevance | Frequently used as eligibility triggers for long-term care benefits (e.g., needing help with 2+ of 6 ADLs) | Care coordination, medication organizers, meal services, housekeeping, and transportation help |
| Typical Support Needed | Personal care aides, home health aides, adaptive equipment (grab bars, shower chairs) | Often supports care planning and services, but is less commonly a direct trigger on its own |
| Progression Pattern | Loss of ADLs often follows IADL decline | IADL difficulties often appear earlier than ADL difficulties |
How ADLs and IADLs Are Assessed
- Standardized scales:
- ADLs: Katz Index, Barthel Index.
- IADLs: Lawton–Brody IADL Scale.
- Reassessment: Abilities can change after hospitalization, medication adjustments, or illness—periodic reevaluation is recommended.
- Observation + interview: Clinicians and care managers combine direct observation with questions to the individual and family.
- Scoring: Each task is rated as independent, needs some help, or dependent; scores guide care plans.
Bottom Line
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Questions From Our Readers
Why are IADLs essential to assess in long-term care settings?
IADLs are essential in long-term care to determine an individual’s ability to live independently.
How does the ability to perform IADLs impact an individual’s overall quality of life?
The ability to perform IADLs affects an individual’s independence and overall quality of life.
What is an instrumental activity of daily living?
The instrumental activity of daily living (IADL) refers to a slightly more complex task necessary for independent living, such as managing finances, doing housework, shopping, meal preparation, communication, and medication management.
Why is it important to measure both ADLs and IADLs?
Measuring Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs) is essential to comprehensively assess a person’s functional abilities, enabling a better understanding of their overall independence and the level of care they may require.