How Will I Know When I Need Help? IADL's and ADL's

Hi Readers, one of the most common questions I am asked is related to independence.... "How will I know when I need help?"  The key to remaining independent is healthy aging and there are tons of articles here on the blog about that.  What I want to discuss here are Independent Activities of Daily Living [IADL] and Activities of Daily Living [ADL].  These are best described as "checklists" but they are actually standardized instruments used by geriatricians for measuring functionality and independence.

In order to live independently in the community... in a private residence...older adults must be able to perform the IADL's and ADL's.  Sometimes, family members or friends may assist with one or more of these.  As you can see from both lists below, the key to retaining independence is mobility and cognitive functioning.

IADL's:

• Use the phone [requires speaking]
• Shopping
• Preparing food
• Housekeeping [cleaning up]
• Doing laundry
• Using transportation
• Handling medication [and taking it as prescribed]

ADL's are self-care activities that a person must perform daily.  People who are unable to perform ONE or more of these activities need caregiver support from 12-24 hours per day.  I recommend assisted living for any older adult not able to perform TWO or more of the ADL's:

• Feeding
• Continence [I exclude this, as we now have adult diapers widely available]
• Transferring [this means moving from one place to another without the help of another person]
• Toileting [older adults must be able use the toilet without the help of another person[
• Dressing
• Bathing
• Handling finances

When a placement is required, I suggest hiring a CERTIFIED gertiatric care manager.  They are in most regions of the United States and can be found at www.caremanager.org  

Moving into assisted living is a difficult transition.  However, it does not have to be traumatic.  Certified geriatric care managers are aging specialists in longterm care placement and/or hiring essential caregivers to retain independence for as long as possible.  Dr. Jan Vinita White