IADLs vs. ADLs: Learn the Difference To Empower Independence  

As you or your loved ones age, you may face many decisions about medical and personal care. For many, this involves learning about the differences between in-home, assisted living, and skilled nursing care.

You’ll also learn about important factors that you must consider when choosing the right care for you or your loved one. The distinctions between activities of daily living (ADLs) versus instrumental activities of daily living (IADLs) should be a priority when choosing care, but many are unfamiliar with these terms.

So, what are the activities of daily living (ADLs)? How do ADLs compare to instrumental activities of daily living (IADLs)? What role do ADLs and IADLs play in medical and personal care?

Let’s explain these terms and why you should consider ADLs and IADLs when determining if you or a loved one needs care.

What Are Activities Of Daily Living (ADLs)?

ADLs are basic self-care tasks that must be performed regularly. When someone doesn’t perform ADLs regularly, they’ll suffer from health complications.

ADLs include things such as:

• Bathing
• Brushing teeth
• Eating
• Getting dressed
• Moving
• Using deodorant
• Using the toilet
• Washing and brushing hair

Individuals should be able to perform these tasks correctly and safely. If they’re unable to perform them safely, they need assistance.

Adults 65 and older have an increased risk of developing chronic health issues, with almost 80% of those in this age group having at least two chronic conditions. In some cases, there’s a direct relationship between chronic health conditions and a person’s inability to perform ADLs safely.

Older adults must be able to move to the kitchen to get food and to the bathroom to bathe, brush their teeth, and use the toilet. The inability to move safely could prevent them from completing these ADLs or put them at risk of injury.

For example, diabetes and arthritis are among the most common health conditions affecting older adults. Diabetes can cause foot pain and swelling, and loss of vision. Arthritis causes stiff joints and can limit mobility. Individuals with these conditions may have difficulty moving around their homes and be at increased risk of falling.

The risk of falling and suffering health issues from fall-related injuries increases with age. Every year, approximately three million older adults need emergency medical care due to falls.

What Are Instrumental Activities Of Daily Living (IADLs)?

IADLs are essential tasks that are more complex than ADLs. They involve using cognitive skills to complete essential tasks to ensure a person’s physical and overall well-being.

While ADLs involve the ability to perform routine personal care tasks independently, IADLs involve activities such as maintaining a home.

What Are Examples Of IADLs?

IADLs include tasks such as:

• Budgeting and paying bills.
• Cooking meals and cleaning up after meal prep.
• Communicating via phones, emails, or video calls.
• Household management tasks, such as:
  • Cleaning
  • Doing dishes
  • Doing laundry
• Managing transportation by either walking, driving, taking public transit, or hiring a transportation service to attend appointments, go shopping, etc.
• Shopping for groceries and household essentials.

What Is The Difference Between ADLs and IADLs?

ADLs are basic self-care tasks, often performed daily or multiple times per day. IADLs are more sophisticated tasks. Some, such as meal prep, may be performed daily; others, such as budgeting and paying bills, may be performed less frequently.

It may be possible for an older adult to perform ADLs regularly but be unable to perform IADLs due to their complex nature.

Why Are ADLs And IADLs Important In Senior Care Assessments? 

Older adults must live in a safe environment where they can thrive. When older adults fear falling and sustaining injuries, they often become less physically active, which can contribute to other health issues and impair their quality of life. Not bathing regularly or brushing teeth can also cause other health issues.

An ADL assessment may occur when a person is hospitalized to ensure they can return home safely. Doctors may also note concerns during appointments and recommend assistance with ADLs.

Family members should note their loved one’s personal hygiene and whether there are signs of inadequate personal care. For example, an older loved one who’s having mobility issues may eat less, so they don’t have to go to the kitchen or bathroom as often. In this case, they may start losing weight.

Assessing a person’s ability to perform IADLs is also crucial. In some cases, a person’s inability to perform IADLs could indicate a serious health issue. Difficulties managing finances, forgetting directions, and communication challenges are among the earliest symptoms of Alzheimer’s and dementia.

Signs Of Issues Performing IADLs

Contact your loved one by phone and email to ensure they’re responding and able to use communication devices. Take your loved one shopping to ensure they create suitable grocery lists and can afford their food. You can also plan an outing with your loved one to a place they like or ask for directions or a favorite family recipe.

If your loved one struggles with any of these tasks, it could indicate they need help performing IADLs.

Medical doctors may also note concerns, particularly if a patient’s prescriptions are lasting longer than they should or running out too fast. Either could be a sign they need help managing their medications.

Skilled Nursing Care at Monument Health

Older adults may need skilled nursing after a diagnosis or hospitalization. Skilled nursing teams provide expert assistance with basic self-care tasks and can monitor residents for signs of difficulty performing IADLs.

With doctors, nurses, and licensed therapists working together, skilled nursing teams can help residents regain the ability to live independently when possible and transition to long-term care when needed.