Many people think that they only need to start looking for additional care for their aging family members when problems arise. However, the first signs that your aging family member may need help is when they start needing additional assistance with their IADLs. If you’re not sure what ADLs and IALDs are, this one is for you. We’re going to cover what they are, why they matter, what options are available, and where you go when your loved one needs more help than you can comfortably provide for them.
When someone talks about ADLs, they’re referring to Activities of Daily Living. Basically, it’s talking about the main things that you have to do during the day to stay independent in your home. They usually divide this up into six broad categories. These are the things you learn as a child to take care of yourself, and they include:
- Bathing– Bathing means that you’re able to get up and wash your face every morning. You’re also able to take a shower or a bath and wash your body by yourself without fear of slipping and falling.
- Dressing and Grooming – You’re able to pick out your clothing for the day and put it on by yourself. You’re also able to perform basic grooming procedures like brushing your hair, brushing your teeth, and generally managing your appearance.
- Feeding– This doesn’t necessarily mean that you cook your own food. But, you’re able to transfer the food you get to your mouth on your own. You could have a meal delivery service in place that still allows you to independently feed yourself.
- Toileting – Are you able to use the toilet on your own? This encompasses getting to and from the toilet, using the toilet appropriately, and being able to clean yourself when you finish on the toilet.
- Transferring – A slightly broader category, transferring means that you can move your body from one position to another, and this includes being able to move yourself from your bed to a wheelchair or chair. It also encompasses being able to stand up from the bed on your own to get to your walker.
- Waking – The technical term for walking is ambulating, and it simply means that you’re able to get around your home or outside without a great degree of difficulty. It includes moving independently or with a walker.
The second category that you may hear people in the medical community refer to is a person’s IADLs, or their Instrumental Activities of Daily Living. Generally, this includes skills and self-care things most people learn when they’re a teenager. Each of the IADL tasks require more organizational and complex thinking skills to perform, and they’re usually one of the first indicators that an aging loved one needs additional help. The six broad categories include:
- Housekeeping and Routine Home Maintenance– You should be able to clean up the kitchen after you prepare a meal, straighten up your living space, so it isn’t messy, and perform simple routine maintenance tasks like sweeping, washing your glass surfaces, and keeping your home in good general repair.
- Managing Communication– Keeping the lines of communication open is essential, and you should be able to correspond through email or phone regularly. This includes both answering your phone or email and making routine calls.
- Managing Finances – If you have a checkbook, you should be able to balance it and keep track of your finances. This category also includes things like paying your bills on time each month, knowing when your bills are due, and managing any financial assets you may have like loans or credit cards.
- Managing Medications– Depending on the number of medications you take daily, you should know how to set your medications up and when to take them. This also covers ordering and filling new medications when your old ones are going to run out.
- Managing Transportation – You should be able to manage your own transportation when you need it to ensure that you get to your appointments and to the store. You can do this by either driving yourself or setting up another means of transport to get you to and from your destinations.
- Shopping and Meal Perpetration– To be independent, you should be able to write out a grocery list, go shopping for the groceries you need, put the groceries away, and put your ingredients together to prepare a meal. You also have to be able to do the general shopping you need for paper products, clothing, and necessities.
Understanding the Level of Care Needed
Understanding what your loved one can and cannot do when it comes to ADLs and IADLs is essential to being able to tailor a plan to help them stay independent as long as they possibly can. It’s a way to open up the lines of communication between your family and your loved one, and it can help you realistically see how much help you’ll have to source for your family member. The following charts make the process simple and straightforward.
Activities of Daily Living Chart (ADLs)
|ADLs Activity||Independent||Needs Help||Dependent||Cannot Do|
|Dressing and Grooming|
Instrumental Activities of Daily Living Chart (IADLs)
|IADLs Activity||Independent||Needs Help||Dependent||Cannot Do|
|Shopping and Meal|
Why ADLs and IADLs Matter
There are several essential reasons why ADLs and IADLs matter. However, the two main reasons fall into two broad categories. Aside from helping you open the lines of communication, ADLs and IADLs can help you better understand your loved one’s needs. The reasons include:
Helps to Determine the Correct Care Levels
- When you’re helping decide what care levels your loved one needs, it’s critical that you sit down with them and really go over all of the specifics involved in day-to-day care. This is where ADLs comes in. If you have a loved one that needs assistance with any of the six categories on the ADLs list, you can get someone to help them. This could be a spouse, another family member, or someone you hire to come in daily to help out.It’s important that you realize that some ADLs will need less care and supervision than other ADLs. When your loved one reaches the point of having to have assistance with several ADLs activities, or when your loved one needs help with something that requires multiple instances of assistance through the day like toileting, it’s up to you to figure out full-time care. Knowing what your loved one needs help with can help you tailor a long-term care plan.
Helps to Determine the Correct Insurance Coverage Levels
- Although one of the biggest reasons ADLs and IADLs matter pertains to helping families get the correct levels of care for their loved one, a second large reason is to ensure that your loved one has the correct insurance coverage levels. Insurances like Medicare and Medicaid look at a person’s needs when they determine their coverage levels, and you want to ensure that you get enough coverage to give your loved one all of the support they need.Under Medicare and Medicaid, the amount of ADLs that a person needs assistance with is a defining factor that lets the insurance companies know if they qualify for coverage that can help pay for assisted living, in-home care, or a nursing home. For several long-term types of insurance like Medicare and Medicaid, the point where they typically start paying for stays in an assisted living community or nursing home is when the person has trouble performing two or more ADLs by themselves.
Talking to Your Loved One About ADLs and IADLs
Communication is essential between your loved one and your family because it’s usually the family that will either help set up assistance for their loved one or take it over themselves. This can be difficult because many elderly people have difficulty talking about and accepting the fact that they may need a little help. Fear is the common motivator in this, and they’re afraid of losing their independence or their home. There are two big things you can do to talk to your loved one, and they include:
Look for Signs of Having Difficulty Performing ADLs
The first step you take is to start spending more time with your loved one and simply observe if they’re having trouble around the house. You can look for more obvious signs that they’re having difficulty like weight loss due to not being able to shop or having difficulty cooking meals. Another sign is wearing mismatched clothing or wearing clothing that isn’t buttoned correctly if they used to be very particular about their clothing.
You should ask direct questions like when they last took a bath or what they ate that day. This is also a great time to volunteer to help them run errands or go shopping together. Also, take a look around their home. Did they pride themselves on a clean home, and now you see dust piling up or dirty dishes left in the sink? If so, these are obvious signs that your loved one may not be able to keep up with all of their basic household tasks.
Sit Down and Have a Direct Conversation
This will be a difficult conversation, but it’s worth having to keep your loved one safe. If you’ve started to find problems that lead you to believe that your loved one may need help with ADLs, it’s time to talk. If your loved one denies, it, you can gently point out the issues or problems you noticed. It’s essential that you don’t make the conversation about you being right and them being wrong. Instead, the conversation should be about how you have concerns for your loved one’s well-being, and you want to see them safe and comfortable.
This conversation will open the door to discussing the types of care available to your loved one. You’ll also get a good understanding of what you need to do to ensure that your loved one’s needs are met.
Tailoring Care to Your Loved One’s Needs
You’ll quickly realize that there is a multitude of care options available for your loved one to help them stay safe and comfortable. Not all of them provide the same levels of care, so it’s important to understand the differences between the most common types of care.
In-Home Health Aides
- In-home care is very popular with seniors because they can stay in the home they love and maintain a higher level of independence. It’s usually a slightly more affordable option because it’s not around the clock care. For this to be a feasible option, your loved one has to be able to perform most of the ADLs and some of the IADLs tasks by themselves. Your in-home health aide is there to fill in any gaps you may have.
- The next step up is moving your loved one into an assisted living community or program. It usually offers meals, personalized support services, and housing without offering skilled nursing care. Assisted living is tailored toward people who need more help with their IADLs and a few ADLs like housekeeping, medication reminders, getting around, and getting dressed each day. The assisted living center usually provides several meals a day, transportation to and from appointments, and programs that encourage social interaction.
- One of the highest levels of care programs available are nursing homes. They offer comprehensive support and care in an environment that comes designed to minimize agitation and confusion. They help your loved one with bathing, dressing, grooming, meals, laundry, housekeeping, and skilled nursing care. They schedule and track medications, and staff is around 24 hours a day to provide support.
Contact Park Terrace Today!
If you have a loved one that needs more care, or if you’d like to take a tour of our comfortable and beautiful facilities, contact us! We’re ready to answer any of your questions, address any of your concerns, and work with you to help ensure that your loved one gets the care they deserve throughout their lives!