The Activities of Daily Living (ADLs) Checklist

Although there are many variations on ADLs, most organizations agree with the following:

• Personal Hygiene: Nail care, oral care, grooming, and showering/bathing
• Dressing: Dress/undress alone and make an appropriate clothing choice.
• Eating: Preparing food is not necessary, but an individual should be able to feed themselves.
• Maintaining Continence: Physical and mental capacity to use the bathroom independently.
• This includes getting on and off the toilet as well as cleaning up oneself.
• Transferring/Mobility: Getting in and out of bed, walking, moving, sitting, or standing.

Whether an individual can perform the above tasks or depends on a caregiver/nurse for help is crucial in measuring their independence.

Why Are Instrumental Activities of Daily Living Important?

As per a 2022 release by the Department of Statistics, Malaysia: The percentage of the population aged 65 and over (old age) increased from 7.0 percent in 2021 to 7.3 percent in 2022. Based on the United Nations definition, Malaysia has become an ageing society.

As your parents get older, their IADL score can help you decide whether or not they need a caregiver. Very little help may make them suffer, and too much help may make them feel like they are losing themselves. IADLs can also be used to measure cognitive skills and screen for symptoms of dementia or Alzheimer’s Disease.

Instrumental Activities of Daily Living Scale

Lawton’s Instrumental Activities of Daily Living Scale was developed to measure IADLs.

The assessment takes 10 to 15 minutes, has eight items rated from 0 (lowest functioning) to 8 (highest functioning), and can be administered through written questionnaires or interviews. The caregiver or patient can answer the questions. Those eligible for the scale include people admitted to a hospital, short-term skilled nursing unit, and old people in a community. The scale is not necessary for old adults living in nursing homes as the staff performs necessary activities for them.

There are also multiple scales available online that families can use to assess the IADL of their loved ones. They are easy to complete as they are intended for individuals with no professional knowledge. Family members answer several questions, calculate the score, and compare results with others. A detailed ADL test can be conducted by a family therapist, as it focuses more on health.

Assessment Tips for Caregivers

Here are tips that you may use to assess ADLs and IADLs:
Enquire about changes that your loved one may show from siblings and neighbours.

• Assess on a spectrum. Ask yourself whether your loved one can do a “little bit” rather than “Yes” or “No.”
• Be patient when someone is doing the task slowly; it doesn’t mean they cannot do it. Consider the timing. Many elders have great cognitive abilities in the morning.
• Consider their health. If struggling with fatigue or flu, they may be momentarily impaired.
• Find time to observe. Sometimes busy schedules can lead to wrong results. Be patient during the process.
• Understand why you are carrying out the assessment. Is it to stay prepared physically for the coming year? Is it for a Medicaid application? Is it a checklist for a long-term community?
• Look at your preconceived notions. Are they interfering with your ability to make the right decisions?
• Encourage your senior loved one’s independence by gently correcting their daily activities.

Tips on Improving Abilities Related to IADLs

Assisting your loved one to maintain IADLs can help them live in their home longer and improve happiness.

• Exercise daily. Research shows that exercising helps patients remain active, reduces healthcare costs, and also significantly reduces doctor visits. A short walk around the block can help keep seniors mobile and increase independence.
• Complete crosswords. Research published in NEJM Evidence suggests that doing crosswords on a regular basis may help to reduce the rate of decline in memory for those with mild cognitive impairment, a condition that can sometimes lead to dementia.
• Healthy Diet. Everyone benefits from healthy eating habits. It is key to longevity for elders, as good health boosts their energy and helps them maintain independence.
• Accept help. Feel free to hire a caregiver to run errands and help with activities such as cooking.
• Use assistance devices to make dressing, toileting, and bathing easier.
• Choose the right clothing. Ensure you avoid clothing with complex buttons; instead, buy ones with zippers.
• Consider therapy. Speech and rehabilitation therapies such as physiotherapy can improve an elder’s mobility and posture.
• Make activities simple. If your loved one finds eating with a fork and knife difficult, find meals which can avoid the use of those. For example, sandwiches.

One Final Word

Ageing is beautiful and scary at the same time. Our bodies cannot function the way they used to when we were younger.

Eating healthy and exercising can improve the situation. However, if things get harder, it is advisable to take an IADLs assessment to know where you stand.

IADLs results ascertain whether it is safe for you to live alone or not. If help is needed, they also determine the level of assistance required.

Contact our Care Advisors at 1300 22 8822 or drop us a message using the chat box on this page, to find out more about our caregivers and how they can help make life more convenient for your loved ones and you.

First Published on March 9th, 2023