ADLs vs IADLs: Comprehensive Guide for Caregivers

Caregiving is a very serious and complex role because family caregivers are typically entrusted with performing an enormous range of activities that compose someone’s daily life. Such activities fall into two general categories: Activities of Daily Living, ADLs, and Instrumental Activities of Daily Living, IADLs. These terms are the same but differ in support needed and what it reflects on the degree of independence. Understanding how to care for and help patients, their caregivers, and healthcare providers is very important.

This guide describes in detail what ADLs and IADLs are, how they are different, why that is important, and how a caregiver can evaluate and support both to ensure their care allows a client to have as much independence and dignity as possible in this life.

What Are ADLs in Caregiving?

Activities of Daily Living, or ADLs, are the common everyday tasks that individuals must do daily and in their care. They form the basis of independent living and include other crucial functions such as eating, bathing, and dressing. If done unaided, when unable to do them personally, it usually requires direct care from the caregivers or doctors.

The most common ADLs include:

• Eating: The ability to feed oneself on their own. In this sense, it includes the ability to chew the food and swallow it safely and independently.
• Walking: Ability to move from one place to another, such as moving around the house or walking to the bathroom and walking outside.
• Grooming: Personal hygiene jobs, such as bathing, brushing teeth, and combing hair, help maintain hygiene.
• Toileting: Ability to use the toilet with or without assistance to get on and off the toilet, managing bathroom needs.

ADLs are self-care skills that represent basic personal functioning. Most people learn such skills as children; thus, they are the basis of daily life. Most people who have difficulty with ADLs have trouble maintaining their independence; here is where a caregiver becomes useful. The caregiver assists such individuals in achieving greater physical comfort and safety.

Caregiving begins with IADLs first because they determine right away how comfortable and safe the body of a person is.

What Are IADLs in Caregiving?

Instrumental Activities of Daily Living (IADLs) are more challenging than ADLs because they require higher cognitive ability, organization, and problem-solving skills. These activities are not essential for survival but are imperative for an independent lifestyle. IAD is an activity that allows living in the community independently while managing a personal environment. They demand more mental effort, planning, and, at times, physical, but they are not basic like ADLs.

Some of the most common IADLs are:

• Cooking: This includes cooking meals, kitchen-related tasks like chopping, boiling, and baking, and ensuring nutritious meals are prepared frequently.
• Housekeeping: The chores of keeping the house clean, including vacuuming, dusting, laundry, and organizing the living area.
• Transportation/Traveling: Navigating safely to places, including walking, driving, or public transportation, is included. One should also know how to make transportation arrangements when needed.
• Managing Money: Paying bills, budgeting, and managing involves paying money daily, such as balancing a checking account.
• Grocery Shopping involves buying groceries and other essentials, whether in person or online, to ensure that the home has everything needed.
• Keeping Relationships Alive: Keeping up with friends and family, planning and keeping up with relationships, and being there for those people when they need help.

IADLs often demand higher-level cognitive activities like memory, problem-solving, and planning. Although ADLs involve maintaining the body, IADLs define a person’s ability to care for the more extensive parts of his environment, interact with society, and engage in out-of-home activities.

For many older adults, IADLs become more difficult as the person ages or cognitive decline begins. These tasks require more attention to detail and organizational skills, and for that reason, individuals may require assistance with IADLs as they age or suffer from illness or injury.

Key Differences Between ADLs and IADLs

While both ADLs and IADLs are needed for daily living, they are very different in terms of complexity and independence level:

• ADLs are the most basic, foundational activities focusing on personal care and self-sufficiency. Such activities are required for maintaining one’s physical well-being and represent the minimum level of self-sufficiency for independent living.
• IADLs are more complex activities that allow a person to deal with his home, finances, and community participation. They depend upon higher-level cognitive abilities and need decision-making powers to maintain a person outside basic self-care capabilities.

In other words, ADLs are important components of a person’s ability to live in daily life; IADLs only add to that functionality by using better environment management and relations. Why is this so? Exactly what is the reason why IADLs are essential?

IADLs are important in providing a comprehensive outlook regarding a person’s ability to live independently. While ADLs have indicated information concerning a person’s capability regarding their physical ability to provide personal care, IADLs are important in indicating their ability to provide for day-to-day needs such as dealing with finances, shopping, preparing food, and maintaining relations and social connections. These have been important in ensuring people can continue living independently or in the least restricted environment possible.

Assessment of IADLs is a method for family caregivers and health professionals to determine the level of support needed. In cases where a person is not able to manage their IADLs, that person may not be able to live independently, although they might be able to carry out their ADLs. Therefore, caregivers can create an effective care plan, one that provides the right level of support if they understand the issues a person faces with their IADLs.

Evaluating IADLs

A key care area will encompass periodic assessment of an individual’s ability to function with IADLs. This helps identify early declines in a client’s or patient’s abilities over time. Such an early decline might occur naturally, particularly during later adult life or for those who suffer from chronic or cognitively impairing diseases.

Senior care industry professionals such as home health aides, occupational therapists, and nurses usually evaluate both ADLs and IADLs in-home visits. As they assess, they concentrate on issues like:

• Grocery shopping and food preparation
• Cleaning the home and laundry
• Transportation and mobility
• Personal finances and bill payments
• Social interaction and relationship management

The Lawton Instrumental Activities of Daily Living Scale is often used to assess a patient’s ability to perform IADLs. This simple instrument helps healthcare providers assess the patient’s ability to accomplish each IADL, typically taking 15 to 30 minutes to complete.

Changes noted among family caregivers include the individual’s capability to perform IADLs. When someone becomes incapacitated in managing issues like handling money, preparing meals, or even keeping personal appointments, the caregiver may offer help or lifestyle changes to help the individual.

Supporting Individuals Who Have Problems with IADL

When a person cannot perform IADLs, then there is an option of support care. This can be from lifestyle changes to care in the home to assisted living. It depends on their level of need and even personal preference.

Lifestyle Modifications

Sometimes, small lifestyle changes make all the difference for an individual who will soon need full-time care to be performed on their IADLs. Such changes can enable an individual to achieve much while at the same time preventing them from falling. Some good examples of lifestyle changes are:

• Installing grab bars in both bathrooms and stairways to prevent falls and add support while standing.
• Meal delivery services are available, especially if one cannot cook or determine proper nutrition.
• Home organization to try to make the home less cluttered, easier to walk around without tripping, and safe from potential hazards created.
• Use of technology, especially reminder calls on the telephone regarding medication schedules or bill payments.

In-Home Care

If lifestyle changes are not enough, then home care will be needed. Home health aides and family caregivers can help IADLs by doing the following tasks:

• Food preparation: Preparing healthy meals and grocery shopping.
• Medication management: Assisting them in remembering to take their medication and ensuring that they take the right treatment.
• Transportation: Providing or arranging transportation to appointments and activities.
• Companionship and social support: Emotional support encourages social interaction and reduces loneliness.

In-home care may allow individuals to stay in their homes but will still help with the ever-growing list of activities that cannot be managed alone.

Assisted Living

Assisted living would be the best option when a person’s needs are beyond what can be offered at home. Assisted living facilities are designed to meet their residents’ need for independence and support as they also assist in helping individuals with ADLs and IADLs. Such facilities provide a controlled environment with supervising services such as assistance with meals, transportation, and administering of medicines.

Indicators that a person needs transitioning into assisted living:

• The person falls frequently because they have mobility issues.
• They cannot manage their medications because of side effects or interactions that have put them at risk or made them miss doses.
• Social isolation is when people cannot carry out their relationships and become cut off from society.

In assisted living communities, the staff is professionally trained to help every person who requires the care and support needed to complete ADLs and IADLs.

Wrapping Up

ADLs and IADLs are useful in allowing individuals to maintain their independence and dignity. Simply put, ADLs are the basic skills that help individuals care for themselves. However, IADLs define those more complex activities meant to help individuals manage their homes, finances, and social activities.

Periodically evaluating the capability to perform ADLs and IADLs will permit family caregivers to form a multidimensional care plan considering aspects of a person’s overall well-being. By implementing lifestyle interventions, providing home care, and providing assisted living, caregivers help individuals lead independently dignified lives with a maximum quality of life.

At Learn2Care, we aim to help caregivers by providing them with the appropriate skills and knowledge to help people execute both ADLs and IADLs. We empower caregivers to provide all these services, giving them the care and support needed to lead richly fulfilling lives.