I would like you to think through your daily morning routine. Your morning routine will most likely consist of waking up, going to the toilet, brushing your teeth, showering, getting dressed, making breakfast, and commuting to work.
All of these self-care actions are activities of daily living (ADLs) which you may currently be taking for granted. You are likely to perform these activities without a second thought. However, those who struggle to execute these tasks will feel the impact on their daily function. Understanding ADLs will enable one to recognise disability and assess the need for extra care.
What are Activities of Daily Living?
Activities of daily living (ADLs) are the activities people do throughout the day without assistance, allowing them to independently fulfill their basic needs. The Ministry of Health organizes ADLs into six categories:
- Washing: Ability to bath, shower, or do a sponge/bed bath.
- Dressing: Ability to put on, take off, secure and unfasten one’s garments.
- Feeding: Ability to feed oneself food after it has been prepared.
- Toileting: Ability to use the toilet or manage bowel and bladder function through the use of protective undergarments such as diapers or surgical appliances if appropriate.
- Walking or moving around: Ability to move indoors from one room to another on level surfaces.
- Transferring: Ability to move from a bed to an upright chair or wheelchair, and vice versa.
Why are ADLs important?
ADLs are important because they are used to determine if someone needs continued or additional care. An ADL checklist is often used prior to discharge from hospitals. If the patient cannot perform one of the activities, additional care may be sought after.
Insurance companies also use ADLs to determine the type of health care coverage someone needs. An increasing number of private and public long-term care insurance policies and programs rely on ADL measurements to allocate benefits.
Declined ADL performance
Someone is considered dependent on others for care when they cannot perform ADLs. The ability to perform ADLs can be limited due to the following reasons:
- Chronic illness
- Physical or mental disability
- Declined health from aging
This inability can be for a temporary period of time during recovery or it can be permanent due to chronic conditions.
Although a reduced ability to perform ADLs can happen to anyone at any age, these issues are most prevalent among the elderly aged 85 years and above, with the greatest recorded rates of dependency.
Managing Activities of Daily Living
Once it is determined that someone cannot perform certain ADLs, there are a couple of things you may wish to consider:
You may wish to engage a physiotherapist to improve one’s physical ability. A physiotherapist helps a person to perform ADLs through exercise therapy and improving strength and joint mobility. Physiotherapy may help to reduce the risk of falls, improve physical ability, increase handgrip strength, and improve the overall well-being of a person. The physiotherapist can also teach the use of assistive devices (such as walkers) where necessary.
As ADLs correlate to independent living,you may like to consider enlisting additional care for a person with reduced ADL function. Some examples include home care or admittance into an assisted living facility or nursing home. If staying at home is preferred, you may engage a nurse or nurse aide to assist with ADLs such as toileting, showering and feeding.
If you are someone who is mobile, the activities of daily living may seem trivial. However, they serve as valued benchmarks for determining and defining one’s ability to lead a high quality of life. Educating oneself on what activities correlate to independent living is not only humbling, but also enables you to help your loved ones who may be struggling with their day to day lives.
If your loved one has shown signs of reduced ability to perform their daily routine, do not let that stress you out. You can do your part by consulting a doctor and using online resources, such as the Katz Index of Independence in Activities of Daily Living, to assess functionality. Seek support from your family and engage additional care as you deem fit.
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