Activities of daily living

Basic ADLs consist of self-care tasks that include:[10]

• Bathing and showering
• Personal hygiene and grooming (including brushing/combing/styling hair)
• Dressing
• Toilet hygiene (getting to the toilet, cleaning oneself, and getting back up)
• Functional mobility, often referred to as "transferring", as measured by the ability to walk, get in and out of bed, and get into and out of a chair; the broader definition (moving from one place to another while performing activities) is useful for people with different physical abilities who are still able to get around independently
• Self-feeding (not including cooking or chewing and swallowing), as opposed to assisted feeding

The functional independence measure (FIM) is a tool developed in 1983 that uses a 0-7 scale to rank different ADLs based on the level of assistance they require. A 7 on the scale means the patient is independent, whereas a 0 on the scale means the patient cannot complete the activity without assistance.[11] The specific breakdown of the scale is shown below:

7 - Independent

6 - Modified Independent

5 - Supervision/Set-up

4 - Minimal Assist

3 - Moderate Assist

2 - Maximal Assist

1 - Total Assist

0 - Activity Does Not Occur

Although not in wide general use, a mnemonic that some find useful for identifying different ADLs is DEATH: dressing/bathing, eating, ambulating (walking), toileting, hygiene.[12]

Instrumental activities of daily living (IADLs) are not necessary for fundamental functioning, but they let an individual live independently in a community:[13][14]

• Cleaning and maintaining the house
• Managing money
• Moving within the community
• Preparing meals
• Shopping for groceries and necessities
• Taking prescribed medications
• Using the telephone or other form of communication

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:[15]

• 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
• Shopping

Occupational therapists evaluate and use therapeutic interventions to rebuild the skills required to maintain, regain or increase a person's independence in all Activities of Daily Living that have declined because of health conditions (physical or mental), injury or age-related debility.[16]

Physical therapists use exercises to assist patients in maintaining and gaining independence in ADLs. The exercise program is based on what components patients are lacking such as walking speed, strength, balance, and coordination. Slow walking speed is associated with increased risk of falls. Exercise enhances walking speed, allowing for safer and more functional ambulation capabilities. After initiating an exercise program, it is important to maintain the routine. Otherwise, the benefits will be lost.[17] Exercise for patients who are frail is essential for preserving functional independence and avoiding the necessity for care from others or placement in a long-term-care facility.[18]

Assisting in activities of daily living are skills required in nursing and as well as other professions such as nursing assistants. This includes assisting in patient mobility, such as moving an activity intolerant patient within bed. For hygiene, this often involves bed baths and assisting with urinary and bowel elimination.

There are several evaluation tools, such as the Katz ADL scale,[19] the Older Americans Resources and Services (OARS) ADL/IADL scale, the Lawton IADL scale and the Bristol Activities of Daily Living Scale.

In the domain of disability, measures have been developed to capture functional recovery in performing basic activities of daily living.[20][21] Among them, some measures like the Functional Independence Measure are designed for assessment across a wide range of disabilities. Others like the Spinal Cord Independence Measure are designed to evaluate participants in a specific type of disability.

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).

The Pervasive computing technology was considered to determine the wellness of the elderly living independently in their homes. The framework of the intelligent system consists of monitoring important daily activities through the observation of everyday object usage. The improved wellness indices helped in reducing false warnings related to the daily activities of elderly living.[22]