As we get older, we lose the ability to do many of the activities that we enjoyed in our youth. Today, approximately 75% of elderly individuals over the age of 75 have their activities limited due to a functional impairment. Unfortunately, we can also lose some of the skills that are essential to healthy and independent living. That’s why it’s important to keep a close eye on how well an older adult is managing to retain those skills.
Healthcare professionals achieve this by monitoring what are known as the activities of daily living (ADL’s). Prepared with this assessment, it can be possible to promptly spot deficiencies or decay in the skills that are necessary for independent living, and to fix or prevent potential hazards to health and well-being before they have the opportunity to become a serious problem.
Activities of Daily Living (ADL’s) vs. Instrumental Activities of Daily Living (IADL’s)
There are two essential skillsets monitored by healthcare professionals in assessing the independence of older adults: ADL’ and IADL’s. The ADL’s are composed of the skills essential to living a day to day life — skills we often learn as children. These skills includes things like dressing, grooming, bathing, eating, using the bathroom, and basic mobility. By contrast, IADL’s are composed of more complicated skills that are closely linked to independence. This includes things like the ability to manage your finances, prepare food, shop, drive or use public transit, manage doctor prescribed medications, and common home maintenance tasks.
Whether or not an individual can rise to these challenges can be determined by a functional assessment. This assessment is an evaluation of how well a person can handle these basic tasks. One of the most common measures of IADL preparedness is the Lawton Instrumental Activities of Daily Living Scale, which attempts to assess the following 8 domains of function from the instrumental activities of daily living checklist:
- The ability to responsibly handle doctor prescribed medications.
- The capacity to manage finances.
- The availability to access regular transportation.
- Laundry self-sufficiency.
- The ability to prepare food.
- The ability to perform basic housekeeping.
- The ability to handle necessary shopping.
- The capacity to use telephones.
What Questions Could You Ask an Older Adult Regarding Their ADL’s?
Here are some essential questions for you to consider when speaking to an older adult:
- Can your loved one prepare and serve adequate meals independently, or do they need assistance obtaining ingredients and maintaining a healthy diet?
- Are they capable of moderate domestic work, like regularly washing the dishes?
- Can your loved one manage their finances independently (including budgeting, writing checks, paying bills, visiting the bank), or do they need assistance handling money?
- When it comes to transportation, are they capable of getting around independently, or are they restricted to traveling with the assistance of others?
- Are they prepared to operate and dial a phone to communicate with the world, or are they unable to dial, or only dial a handful of numbers?
- How do their activities of daily living change if living alone and unsupervised?
In making you own assessment, consider what answers would lead to potential safety or health concerns. Having answered these questions, you can begin to make determinations about the support necessary to ensure that your loved one can continue to live a healthy, safe, and independent life.
If there are any other important questions you can think of please share them with us in the comments below.