IADLs Vs. ADLs: What's the Difference?

Among professionals in the medical industry, more confusing terms and acronyms are used on a daily basis than one can even imagine. If you're not professionally trained in the field of medicine, it can sound like a completely different language. Two acronyms are frequently referred to with respect to healthcare for older adults. These are as follows:

• ADLs – activities of daily living
• IADLs – instrumental activities of daily living

But what could possibly be so different about these two terms? Let's look closely at IADLs vs ADLs. First, a little bit of history.

ADLs/IADLs: A Little Bit of History

As long as humans have been around, ADLs have as well. In the 1950s, at Cleveland, Ohio’s Benjamin Rose Hospital, a team led by Dr. Sidney Katz precisely defined "activities of daily living". To evaluate the ability of independent function of patients, specific activities were monitored. More or less, they were basic functions like bathing, dressing, toileting, transferring, and eating.

However, it seemed to Dr. Katz and his team that certain important aspects of everyday life were absent from the list of basics. This is particularly the case when trying to determine the ability for independent function. So, the IADL (instrumental activities of daily living) list was created. The team felt, to assess functional health tasks, that more than just the basics were needed (such as doing housework and laundry, doing shopping and running errands, socializing and/or finance handling, etc.).

ADLs

These are some things each of us does every day, with no issues, provided we are able. Ordinarily, most people don't give much thought to these activities, particularly when they are more than capable of doing them. Should someone need assistance with the following, personal contact will be required.

Many of today's aging adults have problems with one or more of these, requiring precise levels of care. ADLs are defined as the following:

• Mobility/transferring (being able to move one's self to a standing position from a seated one and/or the ability to walk from one location to another and/or get in and out of bed)
• Maintain continence (have both the physical and mental capacity to use a restroom, which includes cleaning oneself and getting on and off the toilet)
• Eating (this doesn't necessarily have to do with being able to prepare food, but the person must have the ability to feed themselves)
• Dressing (not only the ability to undress and dress one's self, but the ability to make appropriate decisions where clothing is concerned)
• Personal hygiene (catheter/ostomy care, oral care, nail care, grooming, showering/bathing)

IADLs

Included in IADLs are the following:

• Medication management (this includes taking medications as directed and obtaining medication)
• Communication management (this can include the mail and/or the telephone)
• Transportation management (this can mean organizing some means of transportation or actually driving)
• Financial management (managing financial assets, paying bills, etc.)
• Meal preparation
• Light housekeeping
• Transportation (to concerts, the community center, appointments, etc.)
• Errands such as grocery shopping and more

Depending on the capabilities of the person in question, by various service providers, some of these ADLs may have to be managed. An accounting firm (or someone comparable), for example, might manage finances. While some of the above-listed need to be executed by registered nurses, certified nursing assistants/caregivers can handle others.

Depending on the results of an ADL or IADL assessment, it can be determined what type of care is needed for an aging adult: i.e., assisted living, long-term care, etc.

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