In short
Activities of daily living, or ADLs, are the basic self-care tasks: bathing, dressing, toileting, transferring (moving from bed to chair), continence and feeding. Care teams check which ones a person can do alone. Needing hands-on help with ADLs is what usually separates help at home from assisted living or nursing home care.
The six ADLs
The six activities of daily living
- Bathing
- Washing in a tub, shower or by sponge bath
- Dressing
- Choosing and putting on clothes
- Toileting
- Getting to the toilet, using it and cleaning up
- Transferring
- Moving in and out of a bed or chair
- Continence
- Controlling bladder and bowel
- Feeding
- Getting food from plate to mouth
These are the six functions in the Katz Index of Independence in Activities of Daily Living, which the Hartford Institute for Geriatric Nursing describes as the most appropriate instrument for this kind of assessment.
Why ADLs matter for care decisions
- Level of care. The National Institute on Aging describes most home-based care as help with everyday activities like bathing, dressing and eating. More ADL needs usually mean more hours, or a setting with staff on site.
- Coverage. Medicare does not pay for custodial care, meaning help with ADLs, when that is the only care needed. Long-term care insurance and Medicaid programs often look at ADL needs to decide eligibility.
- Tracking change. The Hartford Institute notes ADL checks are most useful when compared over time, starting from a baseline when the person is well.
ADLs and IADLs
ADLs are self-care. IADLs are the tasks of running a household, such as shopping, cooking, managing money and medicines. IADL trouble often shows up first.
Check your parent's ADLs
Our ADL and IADL checklist covers both lists and prints a summary you can take to the doctor.
Questions families ask
How many ADLs are there?
Six are commonly used: bathing, dressing, toileting, transferring, continence and feeding, as in the Katz Index.
What is the difference between ADLs and IADLs?
ADLs are basic self-care. IADLs are more complex household tasks such as housework, shopping, finances and using the phone.
Does Medicare pay for help with ADLs?
Not when it is the only care needed. Medicare says it doesn't cover custodial care such as help with bathing, dressing and eating.
Who assesses ADLs?
Nurses, doctors, occupational therapists, social workers and care managers. Assisted living communities and Medicaid programs also do their own assessments.