Activities Of Daily Living Checklist Examples
Jordi Drake
Activities of daily living are the daily tasks that we do to take care of ourselves. These are things like bathing or eating that most people take for granted, but these tasks become more difficult as we grow older.
According to the CDC, 11.6% of adults 75 years old and above have limitations with their activities of daily living (ADLs), and 19.4% need help with their instrumental activities of daily living (IDALs).
The basic activities of daily living (ADLs) can be defined as the fundamental skills required to care for yourself and remain independent. Like the name implies, these tasks are done every day. These are sometimes referred to as functional activities of daily living.
Assistive technology may not be enough to allow your loved one to perform their activities of daily living on their own. If your loved one wants to remain independent in their own home but requires assistance with activities of daily living, home care can be a great option.
They can also help with their instrumental activities of daily living by driving your loved one around, helping with shopping, ensuring medication compliance, and doing meal preparation, housekeeping, and laundry.
Activities of daily living (ADLs) are essential and routine tasks that most young, healthy individuals can perform without assistance. The inability to accomplish essential activities of daily living may lead to unsafe conditions and poor quality of life. The healthcare team should be aware of the importance of assessing ADL in patients to help identify patients who require assistance. This activity details the activities of daily living and highlights the role of the interprofessional team in assessing ADLs to enhance patient care and management.
Objectives:
- Describe the six essential activities of daily living and know the instrumental activities of daily living and their impact on patient functioning.Summarize causes of limitation in activities of daily living and decline in activities of daily living.Review the commonly used instruments for measuring the basic and instrumental activities of daily living.Explain the role of the interprofessional team in managing and assessing patients with limited activities of daily living.
The activities of daily living (ADLs) is a term used to collectively describe fundamental skills required to independently care for oneself, such as eating, bathing, and mobility. The term activities of daily living was first coined by Sidney Katz in 1950.[1][2]
ADL is used as an indicator of a person's functional status. The inability to perform ADLs results in the dependence of other individuals and/or mechanical devices. The inability to accomplish essential activities of daily living may lead to unsafe conditions and poor quality of life. Measurement of an individual's ADL is important as these are predictors of admission to nursing homes, need for alternative living arrangements, hospitalization, and use of paid home care. The outcome of a treatment program can also be assessed by reviewing a patient's ADLs.[3][4][5][6]
Decline or impairment in physical function arises from many conditions. Aging is a natural process that may present a decline in the functional status of patients and is a common cause of subsequent loss of ADLs.[10] Musculoskeletal, neurological, circulatory, or sensory conditions can lead to decreased physical function, leading to impairment in ADLs. A cognitive or mental decline can also lead to impaired ADLs.[11] Severe cognitive fluctuations in dementia patients have a significant association with impaired engagement in activities of daily living that negatively affect the quality of life. Social isolation can lead to impairment in instrumental activities of daily living. Other factors, such as side effects of medications, social isolation, or the patient's home environment, can influence the ability to perform ADLs.[12][13]
The most frequently used checklists are the Katz Index of Independence in Activities of Daily Living and the Lawton Instrumental Activities of Daily Living (IADL) Scale. The Katz scale assesses the basic activities of daily living but does not assess more advanced activities of daily living. The Katz ADL scale is sensitive to changes in declining health status, but its limitations include the limited its ability to measure small elements of change seen in the rehabilitation of older adults. However, it is very useful in creating a common language about patient function for healthcare providers involved in the overall care and discharge planning.[16][1]
Nurses need to communicate patients' ability to perform ADLs and IADLs with providers so that the health care team and their families can discuss if a patient meets the pre-defined criteria to either continue to live in their homes, or be placed in assisted living, skilled care, or nursing home facilities. (United States National Library of Medicine, 2017) Occupational therapists assess the patients. Depending on the severity of the patient's impairment, most home health nurses complete assessments to make plans for improvements, help with medication administration, and bring resources to assist with independence. Occupational therapists are invaluable in working with these patients. Unlicensed assistive personnel help with bathing, light housekeeping, shopping, and activities to support the patient's desire for continued independent living.[25][5]
All interprofessional healthcare team members, including clinicians, nurses, physical therapists, and occupational therapists, should collaborate to assess the functionality of patients before discharge. Patients unable to perform activities of daily living may require further rehabilitation or assistance at home. The inability to dress or toilet can lead to a poor quality of life. Difficulty ambulating or transferring can lead to falls and further decline. Eating independently can lead to poor nutrition, dehydration, and further weakness. Appropriate referrals to OT, PT, and dieticians should be considered. Assessment of functionality should become routine practice for all patients as it can affect people of all ages. An interprofessional team communicating and collaborating will provide the best patient evaluation and discharge with good follow-up care. The nursing staff should report concerns regarding patients unable to complete ADLs to the medical team. The interprofessional clinical team assists in directing the nursing home health and social work coordinators to ensure patients receive the care they need. The home health nursing staff needs to provide ongoing monitoring and report back to the clinical team should an increase in deficiency of ADLs occur. [Level 5]
Possible NANDA nursing diagnoses include altered health maintenance, defined as a "State in which an individual has no physiological or psychological energy enough to resist or complete required or desired daily activities." Other possible nursing diagnoses include risk of injury, activity intolerance, social isolation, or ineffective family coping.
The Activities of Daily Living are a series of basic activities necessary for independent living at home or in the community. They are performed on a daily basis. There are many variations on the definition of the ADLs, but most organizations agree there are 5 basic categories.
PBS.org and the AARP developed the following Checklist of Activities of Daily Living worksheet to help families. This tool helps determine which ADLs and IADLs their loved ones require assistance with and how much assistance is needed. To complete the checklist, mark one of the four categories for each of the activities listed in the left hand column. Each category indicates how much assistance your loved one needs for that activity.
For people who have difficulty completing their activities of daily living, there are technologies that can help. These technologies allow persons to complete their ADLs with more ease, as well as decrease the amount of time it takes to complete them. This assistance can allow them to maintain their independence. While adaptive equipment can be very simple, it is often the difference between living independently and requiring regular assistance.
The third goal families often have when getting an ADL assessment is to determine if a loved one is eligible for government assistance. Local Area Agencies on Aging (AAAs) often serve as the gateway to assistance programs. Many of these will provide activities of daily living assessments as part of the application process. One should contact their local area agencies on aging and inquire.
Creating an activities of daily living checklist can help with understanding what tasks your loved one can do on their own vs. what they need assistance with. It also can help determine their ability to live independently or whether they would benefit from assisted living.
Instrumental Activities of Daily Living or iADLs are activities related to living independently by themselves or taking care of a spouse, partner or child. They are not activities related to fundamental functioning.
Instrumental Activities of Daily Living: Regular maintenance tasks that ensure a person living independently can provide for themselves. (IADL examples: Shopping, cooking, managing medications, housework)
There are specific daily tasks that persons must be able to do to maintain their full independence. These daily living activities are broken into two groups: Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs). While different sources offer variations as to the tasks defined as ADLs and those defined as IADLs, there is considerable overlap. The following definitions are the most common. The ability to independently perform IADLs generally declines for seniors first, followed by ADLs.
Instrumental Activities of Daily Living
IADLs are necessary for independent living, but are not as crucial to daily functioning as ADLs. This means they do not have to be done every single day.