Understanding assessments
Activities of Daily Living (ADLs) Explained
ADLs and IADLs are the standard way of describing what someone can and cannot do on their own.
In-home care · 6 minute read
The short answer
Activities of daily living, or ADLs, are basic self-care tasks like bathing, dressing and eating. Instrumental activities of daily living, or IADLs, are more complex tasks like managing money, cooking and getting around town. Home care programs and insurers use both lists to describe, in a consistent way, how much day-to-day help someone actually needs.
What ADLs are
Activities of daily living, usually shortened to ADLs, are the basic, physical self-care tasks most people do every day without thinking about them. They are the foundation of independent living.
- Bathing and grooming
- Dressing
- Eating
- Moving from a bed to a chair, and around the home
- Using the bathroom
- Walking or getting around safely
What IADLs are
Instrumental activities of daily living, or IADLs, are more complex tasks that involve thinking, planning and being out in the world. They are usually the first things to become difficult, often well before ADLs are affected.
- Managing money and paying bills
- Preparing meals
- Housekeeping and laundry
- Managing transportation, including driving
- Using the phone and handling correspondence
- Keeping track of the schedule the doctor set for a health condition
How they are assessed
An assessment usually involves someone, often a nurse, social worker or care coordinator working with a program, asking a series of questions or observing the person directly to see what they can do without help, what they can do with some help, and what they cannot do at all.
For each ADL or IADL, the assessor typically rates the person as independent, needing some assistance, or fully dependent on someone else for that task. The pattern across all the tasks builds a picture of overall need, rather than any single task deciding the outcome.
Why programs and insurers use this framework
ADLs and IADLs give everyone, families, agencies, insurers and government programs, a shared, consistent language for describing need. Without it, one person's normal weekly routine and another person's description of hardly getting by could describe the exact same situation.
Many long-term care insurance policies, for example, require a certain number of ADLs to be impaired before benefits apply. Programs and insurers vary in their specific thresholds, so it is worth checking directly with the specific policy or program rather than assuming how many ADLs are required.
How this connects to home care
A home care plan is often built directly around ADLs and IADLs: which tasks the person can still do independently, which ones need a helping hand, and which ones need to be done for them.
This is also why the medication schedule matters here without being medical care itself. Caregivers follow the schedule the doctor set, notice when something looks different, and report it the same day. Kinstead caregivers do not manage medications, but keeping an eye on the daily routine around medications is part of how ADLs and IADLs are supported day to day.
Using this framework for your own family
You do not need a formal assessment to start thinking this way. Walking through the ADL and IADL lists yourself, honestly, for your mother or father, can clarify what kind of help is actually needed before you even talk to an agency or a program.
It also gives you specific, concrete language to use when you do talk to a doctor, an insurer or a home care agency, rather than a general sense that things have gotten harder.
Questions people ask
Common questions
- What is the difference between an ADL and an IADL?
- ADLs are basic physical self-care tasks like bathing and dressing. IADLs are more complex tasks like managing money, cooking and transportation, and they often become difficult earlier than ADLs do.
- Do I need a professional assessment or can I judge this myself?
- You can walk through the ADL and IADL lists yourself as a starting point, but a formal assessment from a doctor or care coordinator gives a more consistent picture, especially if it will be used for a program or insurance policy.
- How many ADLs does someone need help with to qualify for a program?
- This varies by program and by policy. Check directly with the specific insurer or program, since thresholds are not standard across the board.
- Does struggling with IADLs but not ADLs still mean someone needs help?
- Yes. Many people need real support with things like meals, money and transportation well before they need help with basic self-care, and home care can be built around exactly that gap.
- Will a caregiver help track medications as part of ADL support?
- Caregivers follow the schedule the doctor set, notice when something looks different, and report it the same day. Kinstead does not manage medications.
- How does this apply to my mother in Concord who lives alone?
- Look at whether she is managing meals, bills, transportation and housekeeping on her own, and whether bathing, dressing and moving around the home are still easy for her. That combination points to what kind of home care, if any, would help most.
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