There’s a set list, agreed upon by the medical community and insurance companies alike. There are a total of 6 ADLs. That’s it! Only six. Here are the six ADLs:
1. Bathing—bath, shower, or sponge bathe as preferred
2. Dressing—ability to dress and remove all clothing items
3. Feeding—eating independently (not cooking, just eating)
4. Transferring—moving from one spot to another (ie: from wheelchair to the couch)
5. Toileting—the ability to get on and off the toilet
6. Continence—the ability to control bladder and bowel and be aware of the need to toilet
You will notice that transportation, e.g. driving, is not on the list. If you are interested in learning more about driving and dementia click here.
As you can see from the list, the ADLs cover the most necessary elements of daily living. These are also the most personal and intimate forms of daily activity and care. You want to remain capable of these six ADLs for as long as possible.
Alongside ADLs are IADLs — Instrumental Activities of Daily Living. Instrumental activities are those tasks which support the basic six ADLs. For instance, cooking is an IADL. Someone might have their ADL of eating — they can still feed themselves independently — but without food to eat, they cannot utilize their ADL. Instrumental ADLs are all the things you do throughout the day to support the six ADLs. Cooking, cleaning, laundry, grocery shopping, etc. are all IADLs.
A caregiver’s role is to complete IADLs so that clients can retain their ADLs. A caregiver may do the laundry so that a client has fresh, clean clothes to put on. If assistance is necessary, then of course, the caregiver will help with dressing but encouraging independence is crucial. Even if dressing takes four times as long when the client does it, it is worth it to help them protect that ADL.
If you don’t use it you lose it.
You’ve heard the saying before, “if you don’t use it you’ll lose it” and that is certainly true. It is called learned helplessness. Someone learns that they can sit back and wait for a caregiver to take over and do the task for them. Eventually, their ability to complete the task will diminish.
Caregivers should always encourage clients to complete their own ADLs and only assist as necessary to prevent learned helplessness from occurring. There are only 6 basic ADLs so protect them at all costs!