You perform dozens of tasks every day to maintain long-term health and hygiene, from brushing your teeth and dressing to cooking and eating meals.

But what happens when injury or illness makes these routine tasks difficult or impossible to accomplish alone?

The following article discusses Activities of Daily Living (ADLs), how they are defined, how they are measured in health care settings, and what you can do if you or a loved one struggle to complete these critical tasks. 

Defining ADLs        

Activities of Daily Living were first identified and organized by healthcare professionals in the 1950’s as self-care activities that must be performed to maintain long-term health.

Since their inception, the ability for an individual to perform these tasks unassisted has become a basic measure of independence, especially among older adults or those experiencing an injury or illness.

In a modern healthcare setting, the ability or inability to perform ADLs can have a major impact on access to supportive care, housing, and insurance coverage for assistance with these tasks.

While there are different ways to classify ADLs, most systems break them into six major categories:

• Bathing – The ability to clean oneself and perform personal grooming, like shaving and brushing teeth.
• Dressing – The ability to dress oneself appropriately and successfully use buttons, zippers, and other closures.
• Eating – The ability to use utensils and safely chew and swallow food.
• Transferring – Also known as ambulation, the ability to safely get into and out of bed or assistive devices like a wheelchair, and the ability to safely move without the support of others.
• Toileting – The ability to use a toilet alone, including getting on and off of the toilet.
• Continence – The ability to control bladder and bowel functions.

You are not alone

For some, acknowledging difficulty with these previously mundane tasks can be a difficult process. We all value our independence, and telling a healthcare provider or loved one that you need support can be an emotionally taxing conversation.

While everyone’s journey will be different as they age and overcome new challenges, no one needs to feel like they are going it alone – a recent AARP caregiver study found that more than 53 million Americans – nearly one in five – reported helping another adult with at least one of these ADL tasks in 2020.

Seeking help and assessing needs

Difficulty with ADLs can have a significant impact on your long-term health outlook, as regular performance of these tasks are critical to preventing illness and injury. As a result, choosing to forgo assistance can be a costly choice. Fortunately, there are many ways you can seek assistance.

In some cases, a friend or family member can provide assistance as a family caregiver, either informally or through a paid family caregiver program. While this solution can make a huge difference in the short-term, many older adults will seek professional assistance for the long-term.

When seeking long-term assistance with ADL’s, most older adults will choose one of two options – moving into a supportive living facility with staff available to provide help, or bringing a caregiver into their home, often with the support of their long-term care (LTC) insurance.

Using an LTC insurance plan to provide in-home care allows older adults to live in their long-time home and maintain their independence and way of life while still receiving the support they need to accomplish ADLs they can no longer perform alone.

When an older adult chooses to activate their LTC insurance plan, the care provider will usually send a registered nurse to perform an evaluation of the individual’s ability to complete ADLs on their own. The results of this assessment are then sent to the insurance provider for approval of services based on their needs. Typically, an older adult needs assistance with at least two of these tasks to trigger their insurance coverage.

Choosing to seek assistance with ADLs can feel like a big change, but changing abilities is a natural part of the aging process. By knowing when it is appropriate to ask for assistance, you are taking a critical step to preserve your long-term wellbeing and peace of mind for both you and your loved ones.

SelectCare Home Health Care  is a private home health care agency in New York City that provides certified home caregivers supported by nurse supervisors to assist older adults with activities of daily living, promoting independence, health, and happiness in a client’s long-time home.

If you or a loved one are facing new challenges with these activities, consider calling SelectCare or requesting a free in-home care guide to learn how we have helped New York families for 37 years.