The Misconception of the “12 ADLs”
Many people search for "the 12 ADLs of daily living," but this is not a standard medical or therapeutic term. The number 12 is likely a combination of the foundational Activities of Daily Living (ADLs) and the more complex Instrumental Activities of Daily Living (IADLs). While a list of 12 may exist in some non-clinical contexts, understanding the distinction between ADLs and IADLs is far more crucial for a proper assessment of a person's functional abilities.
ADLs are the fundamental self-care tasks that people need to perform every day to live independently. They are essential for a person's health and safety. IADLs, on the other hand, are the skills needed to function within a community. They require higher-level cognitive and organizational skills. This guide will break down both sets of skills to provide a complete picture of functional independence.
The Six Basic Activities of Daily Living (ADLs)
The standard, medically recognized model of ADLs includes six core functions. These are the basic, personal care tasks that are the foundation of a person's independence. A person's ability to perform these tasks is a key indicator of their overall health and functional capacity.
1. Bathing
This includes the ability to wash oneself, whether in a tub, shower, or via sponge bath. It involves managing the process, from adjusting water temperature to safely getting in and out of the bath or shower.
2. Dressing
This refers to the ability to select appropriate clothing, put on, and fasten clothes. This can include managing zippers, buttons, and shoes. It also covers the mental capacity to choose weather-appropriate attire.
3. Toileting
This involves the ability to get to and from the toilet, use the toilet, and clean oneself afterwards. It is a critical component of hygiene and personal privacy.
4. Continence
This is the ability to control bowel and bladder movements, including the mental and physical capacity to use a toilet or manage incontinence devices, such as a catheter.
5. Transferring
This refers to the ability to move from one position to another, such as getting out of bed, rising from a chair, or getting in and out of a wheelchair. Mobility is a core aspect of transferring.
6. Feeding
This covers the entire process of eating, from getting food into the mouth and chewing to swallowing. It does not include meal preparation, which falls under IADLs.
Instrumental Activities of Daily Living (IADLs)
IADLs represent a more advanced set of skills necessary for independent living. They are often what is combined with ADLs to create the misconception of what are the 12 ADLs of daily living. A person may be able to perform all basic ADLs but still require assistance with IADLs due to cognitive or physical limitations.
What are IADLs?
IADLs are complex activities that allow an individual to live independently and manage their household and community life. They are generally more involved than ADLs and require higher-level thinking and organizational skills.
Common examples of IADLs:
- Managing Finances: Paying bills, managing a budget, and handling banking.
- Shopping: Planning a shopping list, getting to and from the store, and making purchases.
- Preparing Meals: Planning, shopping for, and cooking nutritious meals.
- Housekeeping: Performing light or heavy housework, such as cleaning, doing laundry, and home maintenance.
- Using Transportation: Driving or arranging for and using public transportation.
- Managing Medication: Keeping track of medication, remembering to take it, and refilling prescriptions.
- Using Communication Devices: Making phone calls, sending emails, or using other forms of communication.
ADLs vs. IADLs: A Crucial Distinction
Understanding the difference between ADLs and IADLs is vital for effective care planning. Here is a quick comparison:
| Feature | ADLs (Activities of Daily Living) | IADLs (Instrumental Activities of Daily Living) |
|---|---|---|
| Focus | Basic self-care | Higher-level organizational skills |
| Complexity | Simple, foundational tasks | Complex, multi-step tasks |
| Examples | Bathing, dressing, feeding | Shopping, cooking, managing finances |
| Assessment | Measures physical function | Measures cognitive and organizational function |
| Dependency | Indicates critical care needs | Indicates support needs for independent living |
How ADL and IADL Assessments Guide Care
Care professionals use ADL and IADL assessments to develop comprehensive care plans. An individual's score on these assessments helps determine the level of assistance they need, from minimal support to full-time care.
For example, an individual who can still perform their ADLs but struggles with IADLs might be a good candidate for in-home care services that provide help with shopping or medication management. Conversely, a person with difficulty in basic ADLs may require more intensive support, such as assisted living or skilled nursing care. These assessments provide a clear, objective framework for making informed decisions about a person's health and living situation.
For more information on health and aging, the National Institute on Aging is an excellent resource.
Conclusion: Beyond a Simple Checklist
In conclusion, the answer to what are the 12 ADLs of daily living is that there is no standard list by that name. Instead, there are six basic ADLs and a broader range of IADLs. These categories provide a comprehensive framework for assessing a person's functional capacity and planning for their care. By understanding the distinction between these two sets of activities, family members and healthcare providers can better identify a person's needs and ensure they receive the right level of support to maintain their quality of life and independence.
