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, hygieneInstrumental 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 Association identifies 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

ShoppingThere are several evaluation tools, such as the Katz ADL scale, the Lawton IADL scale and the Bristol Activities of Daily Living Scale.

Most models of health care service use ADL evaluations in their practice, including the medical (or institutional) models, such as the Roper-Logan-Tierney model of nursing, and the resident-centered models, such as the Program of All-Inclusive Care for the Elderly (PACE).