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What Are Activities of Daily Living?


Individuals who are turning 65 have a 70% chance of needing some form of long-term care during their remaining years. While the majority of these care needs fall under a short-term care plan, about 25% of these individuals will need care for longer than a year. When applying for long-term care insurance, your provider will ask if you can perform certain tasks. They’re commonly referred to as activities of daily living (ADLs). Your ability or inability to complete these tasks can determine whether you’re eligible to receive care and assistance under your policy. Here’s what you need to know about the activities of daily living.

What Are Activities of Daily Living?

Typical long-term care insurance policies define six tasks as ADLs, and require policyholders to be unable to complete at least two of them for their benefits to kick in.

ADLs are self-care activities that can include but are not limited to:

  • Mobility, which may include being able to transfer between a wheelchair and a bed.
  • Bathing and/or showering.
  • Using the lavatory, which includes getting on and off the toilet.
  • Continence – the ability to control bowel and bladder functions.
  • Dressing, which includes dressing in appropriate attire.
  • Eating.

ADLs are the basic activities you complete after waking up each day. As you age, it becomes more of a struggle to complete daily tasks that were once simple. Specific health conditions such as an accident or a stroke can make completing these tasks very challenging.

What Are Instrumental Activities of Daily Living?

Instrumental activities of daily living (IADLs) are activities not necessary for basic functionality but may prohibit an individual from living an independent life. Essentially, they may need to live in a community environment in order to complete their IADLs. Typically, these tasks are more complex than ADLs.

IADLs are activities that include, but are not limited to:

  • Laundry, housekeeping, and other home maintenance tasks.
  • Money management.
  • Shopping for groceries.
  • Using technology such as a phone or computer.
  • Medication management.
  • Cooking or meal preparation.
  • Moving or changing residences.

Activities of Daily Living Assessment

There are many different evaluation tools insurance providers and other professionals use to asses ADLs and IADLs. A functional evaluation that provides objective data is one of the best ways to measure a decline and offer improvement to an individual’s needs.

One evaluation tool commonly used is the Katz Index of Independent Activities of Daily Living or the Katz ADL Index. This evaluation tool ranks proficiency of performance in six functions and/or activities (bathing, dressing, continence, and feeding). Subsequent measurements are then compared to a baseline to determine if the individual’s needs have increased or decreased.

While the Katz ADL Index is a great measurement tool to show health status decline, it falls short when assessing incremental improvements often due to rehabilitation. Additionally, since the Katz ADL Index only measures ADLs, there is a separate scale to measure IADLs.

Activities of Daily Living in Senior Care

activities of daily living
ADLs and IADLS together make up the skills needed for an individual to live a safe and secure life while maintaining independence. Essentially, an individual’s ability or inability to complete certain tasks will determine their care and/or therapy needs. Assessing their needs will help ensure that an appropriate plan is available to meet all of their needs.

Individuals who need assistance can choose to hire in-home care or nursing home care. Some families often hire in-home workers to provide ADL assistance when an individual requires some form of care but not assistance with all ADLs. In-home care professionals can also help individuals take care of their IADLs such as grocery shopping or taking the proper medications. Depending on an individual’s health care policy, some of the costs of hiring an in-home worker may warrant compensation. Other costs may receive coverage by a long-term care insurance policy.

While Medicare and Medicaid do not pay for the cost of an assisted living residence (room and board), they may cover some costs of care as well. It’s important to note that care assistance can vary from state to state. Similarly, Supplemental Security Income (SSI) or Optional State Supplements (OSS) may cover part of assisted living expenses. These benefits will also depend on the state you live in.

The Bottom Line

activities of daily living
Since most Americans will need some form of long-term care as they age, it’s important to understand what type of care and assistance is available. Knowing the tasks you may need assistance with will help you select the best insurance policies available. If you haven’t done so already, start researching your long-term care benefit options. By educating yourself on the care options, you can better prepare financially. This will enable you to have the appropriate long-term care policies in place.

Long-Term Care Tips

  • Consider consulting a qualified financial advisor. These professionals can help you manage money and investments properly. Managing your assets properly can help fund a long-term care facility that meets your needs or those of a loved one. Finding a financial advisor doesn’t have to be hard. SmartAsset’s free tool matches you with up to three vetted financial advisors who serve your area, and you can interview your advisor matches at no cost to decide which one is right for you. If you’re ready to find an advisor who can help you achieve your financial goals, get started now.
  • Make sure your investment portfolio is properly diversified. If you’re close to moving into a long-term care facility, you may want to be more invested into fixed income securities – or even cash (i.e., a high-yield savings account or certificate of deposit). Additionally, if you have considerable time until you anticipate needing this coverage, though, you have the ability to take on increased risk. If you’re new to this, you can use our asset allocation calculator. It gives you a glimpse of what a proper portfolio may look like based on your risk tolerance.

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