Activities of daily living
Activities of daily living (ADLs) is a term used in healthcare to refer to people's daily self care activities. The concept of ADLs was originally proposed in the 1950s by Dr. Sidney Katz and his team at the Benjamin Rose Hospital in Cleveland, OH and has been added to and refined by a variety of researchers since that time. Health professionals often use a person's ability or inability to perform ADLs as a measurement of their functional status, particularly in regard to people with disabilities and the elderly. Younger children often require help from adults to perform ADLs, as they have not yet developed the skills necessary to perform them independently.
ADLs are defined as "the things we normally do...such as feeding ourselves, bathing, dressing, grooming, work, homemaking, and leisure." A number of national surveys collect data on the ADL status of the U.S. population. While basic definitions of ADLs have been suggested, what specifically constitutes a particular ADL for each individual may vary. Adaptive equipment and devices may be used to enhance and increase independence in performing ADLs.
Basic ADLs consist of self-care tasks, including:
- Functional mobility (moving from one place to another while performing activities)
- For most people, functional mobility is measured as the ability to walk, get in and out of bed, and get into and out of a chair; the broader definition above is useful for people with different physical abilities who are still able to get around independently.
- Bathing and showering (washing the body)
- Dressing
- Self-feeding (not including cooking or chewing and swallowing)
- Personal hygiene and grooming (including brushing/combing/styling hair)
- Toilet hygiene (getting to the toilet, cleaning oneself, and getting back up)
One way to think about basic ADLs is that they are the things many people do when they get up in the morning and get ready to go out of the house: get out of bed, go to the toilet, bathe, dress, groom and eat.
Although not in wide general use, a mnemonic that some find useful is DEATH: dressing/bathing, eating, ambulating (walking), toileting, hygiene.
Instrumental activities of daily living (IADLs) are not necessary for fundamental functioning, but they let an individual live independently in a community:
- Housework
- Preparing meals
- Taking medications as prescribed
- Managing money
- Shopping for groceries or clothing
- Use of telephone or other form of communication
- Transportation within the community
A useful mnemonic is SHAFT: shopping, housekeeping, accounting, food preparation/meds, telephone/transportation.
Occupational therapists often evaluate IADLs when completing patient assessments. The American Occupational Therapy Associationidentifies 12 types of IADLs that may be performed as a co-occupation with others:
- Care of others (including selecting and supervising caregivers)
- Care of pets
- Child rearing
- Communication management
- Community mobility
- Financial management
- Health management and maintenance
- Home establishment and maintenance
- Meal preparation and cleanup
- Religious observances
- Safety procedures and emergency responses
- Shopping