What Are ADLs and IADLS?

ADLs and Occupational Therapy

Putting on shoes
Getting dressed is an integral part of an ADL routine.. GettyImages

If you spend time in a health care facility, you may hear the term "ADL" used by staff. ADL is medical shorthand for "Activities of Daily Living." Learning this shorthand and what it entails can help you advocate that your basic needs are addressed in a medical situation. 

ADLs are the essential tasks that each person needs to perform, on a regular basis, for basic survival and well-being. The term helps health care professionals quickly communicate the level of assistance an individual might need or how their health is impacting their day-to-day life.


What Are The 9 ADL Areas? 

One standard for defining the areas of Activities of Daily Living is the Occupational Therapy Practice Framework, which defines ADLs as "activities that are oriented toward taking care of your own body." The activities are broken down into nine areas. 

  • Bathing/Showering
  • Toileting and Toilet Hygiene
  • Dressing
  • Eating/Swallowing
  • Feeding- Note that feeding is separate from eating, as feeding refers to setting up, arranging and bringing food to the mouth. 
  • Functional Mobility- Functional mobility refers to getting from place to place while performing ADLs, such as getting into the tub, getting out of bed, moving from room to room. Functional mobility can refer to getting from place to place under your own power or with the assistance of a wheelchair or other assistive device. 
  • Personal Device Care- Personal device care refers to utilizing essential personal care items such as hearing aids, contact lenses, glasses, orthotics, walker, etc. 
  • Personal Hygiene and Grooming 
  • Sexual Activity 

You may also hear the term bADLs, which refers to Basic ADLs. bADLs are the essentials of the essentials. The term typically indicates these five areas: 

  • Dressing
  • Feeding
  • Bathing/Showering
  • Personal Hygiene
  • Toileting

What Are IADLS?

You may look at the list about and think that even if you could safely do those nine items, there are still quite a few things that contribute to your quality of life.

Don't worry, there is an extension to the list. 

Instrumental Activities of Daily Living (IADLS) refer to activities that support daily life and are oriented toward interacting with your environment. IALDs are typically more complex than ADLs. They are important components of home and community life, but can be easily delegated to another person. 

  • Care of Others 
  • Care of Pets
  • Child Rearing
  • Communication Management- 
  • Driving and Community Mobility
  • Financial Management
  • Health Management and Maintenance
  • Home Establishment and Management 
  • Meal Preparation and Clean Up
  • Religious and Spiritual Activities and Expressions
  • Safety Procedure and Emergency Responses
  • Shopping

There is also an extension to the extension. The Occupational Therapy Practice Framework also refers to the below areas of activity, which are sometimes included in ADL and IADLS lists. 

  • Rest and Sleep
  • Education
  • Work 
  • Play 
  • Leisure
  • Social Participation

Why ADLs Are Important

ADLs can be an important factor in medical decision-making. Here are some examples:  

  • When discharging from a hospital, the discharge team will work to ensure you will be able to safely perform these tasks at your next location. 
  • If pain or another medical condition is impairing your ability to perform an ADL, that can be a signal that intervention is warranted. 
  • If you do undergo a procedure, an important mark of its success is whether it will improve your ability to perform ADLs. 
  • If a loved one needs additional care, the amount of help he/she needs with ADLs will help determine what level of care is required. For example, some assisted livings do not offer assistance with bADLs.

How ADLS Relate To Occupational Therapy

Occupational therapists assist their clients in engaging in meaningful and purposeful daily tasks. For many OT, helping their clients perform ADLs are the bread and butter of their services. Your occupational therapist may take the lead in assessing your ability to perform ADLs and work with you and your health care team, so all of these basic needs are met. 

Occupational Therapy Practice Framework: Domain and Process (3rd Edition)
American Journal of Occupational Therapy, March/April 2014, S1-S48. 

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