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Activities of Daily Living

Activities of Daily Living (ADLs) are activities that are necessary for self-care by independent adults[1,2].  First proposed in the 1950's[1], the term has become a standard metric for evaluating care requirements and functional status, especially for individuals after hospitalization, surgery, or injury, for those with disabilities or cognitive impairments and for aging adults.  Children also show insufficiency for ADL skills and require care by parents until they are capable of self-care.  ADLs are commonly recorded by care provider during visits and are tracked over time.  ADLs are also as part of Medicare assessment because of the difficulty in identifying care needs solely from in-office diagnosis[1].

ADLs can be divided into two groups: Basic ADLs and Instrumental ADLs [12, 3, 4, 5].  

  • Basic ADLs include Dressing, Eating/Drinking, Walking/Ambulation, Washing/Hygiene and Toileting.  Some definitions include transferring, or the ability to get in/out of a bed/chair/wheelchair.  These can be considered the basic requirements to live alone and care for oneself without assistance.

  • Instrumental ADLs are higher level functions that go beyond basic needs. They include: paying bills, cleaning, cooking meals, shopping, buying food, taking medicines, and communicating (phone, etc).  Broader definitions include pet care, socializing, care of others, health management (doctor visits)

Basic ADLs

Walking

Ability to stand, sit and walk between locations without assistance, may include use of walker/cane.

Eating/Drinking

Ability to eat and drink, and to serve food to oneself.

Washing

Ability to perform bathing, washing, dental cleaning,
and hair care.

Toiletting

Mental and physical ability to properly use the bathroom and to avoid incontinence.

Dressing

Ability to put on and remove clothing and to select clothing appropriate to conditions.

Transferring

Ability to get in and out of a bed, chair, recliner, sofa or wheelchair, as needed, without assistance.