Activities of Daily Living (ADLs): Meaning, How to Measure – NerdWallet

Activities of daily living (ADLs) are routine tasks such as eating, moving, toileting, dressing, hygiene and continence. They indicate someone’s ability to care for themselves independently. ADL measurement can help determine whether someone is eligible for government assistance such as Medicare and Medicaid or long-term care insurance benefits.

Someone who can’t perform basic ADLs may be at a higher safety risk and may experience reduced quality of life. ADL measurement can predict a person’s need for daily assistance, such as in a nursing home. Medical professionals also measure ADLs to determine a patient’s care needs or sometimes their progress in rehabilitation after an illness or injury.

What are the 6 main ADLs?

Exact checklists and categories of ADLs vary, but activities of daily living typically include six basic skills.

1. Mobility: The ability to move from one position to another, such as getting in and out of a bed, and to walk independently. May also be called “ambulating” or “transferring.”

2. Eating: The ability to feed oneself, which does not include cooking, grocery shopping or other food preparation.

3. Personal hygiene: The ability to bathe or shower, as well as other maintenance tasks such as brushing your hair and teeth and trimming your nails.

4. Dressing: The ability to choose appropriate clothes, put them on and take them off.

5. Continence: The ability to use the toilet by controlling bladder and bowel function.

6. Toileting: The ability to get on and off the toilet and clean oneself.

Instrumental activities of daily living (IADLs)

There are six additional “instrumental” ADLs that require more complex thinking and organizational skills than the basic ADLs^[0]

1. Shopping: The ability to get groceries and other necessities, which includes the ability to get to stores by driving or using other transportation.

2. Meal preparation: The ability to plan and prepare daily meals.

3. Home maintenance: The ability to keep one’s home clean, including dishes and laundry.

4. Financial management: The ability to pay bills and maintain bank accounts or other financial assets.

5. Communication: The ability to contact others when needed, including using the telephone and managing mail.

6. Managing medications: The ability to obtain prescriptions and other medications and to take them as directed, without supervision.

Whether you can perform ADLs can affect your eligibility for disability, Medicare and Medicaid coverage. Here are some of the effects certain ADLs can have:

• The Social Security Administration (SSA) requires you to report your ADLs, called a Function Report, when you apply for Social Security Disability Insurance (SSDI) benefits. The SSA typically asks about your daily routine, your ability to drive and perform household tasks, your ability to perform basic ADLs and how your condition affects your sleep and ability to work.

• Medicare does not cover the custodial care some people need if they cannot perform basic ADLs. Seniors in a nursing home may still receive medical care covered by Medicare, but the nursing home itself is not covered.

• Medicaid does cover custodial care for low-income patients who struggle with ADLs.

• Long-term care insurance can be a helpful alternative if you don’t qualify for Medicaid. With most policies, you become eligible for benefits once you can’t perform at least two of the six basic ADLs.

Several methods can determine whether a person can or cannot perform an ADL. Nurses often perform these assessments in a medical setting, but self-evaluation is common when applying for SSDI or other government assistance.

The most common checklists are the Katz Index of Independence in Activities of Daily Living and the Lawton Instrumental Activities of Daily Living (IADL) Scale.