The 7 Activities of Daily Living (ADLs)

Sometimes the seemingly simple things stop being, well, simple.

Activities of daily living (or ADLs, as they’re known) are the basic functions we all need to perform to take care of ourselves. As we age, these activities can become more difficult. This can happen for several reasons: an injury, a lingering illness, fatigue.

Whatever the case may be, if you find it difficult to perform one or more ADL, it’s probably time to consider home care.

Let’s be clear about one thing: needing help with ADLs is completely normal. And while it may feel like you’re giving up part of your independence by seeking help, a person-centered care approach will ensure the assistance you receive respects your dignity and sense of self as much as possible. You can receive help and still be you.

Below, we’ve outlined the eight primary ADLs: what they are, why they’re important, and how person-centered home care can help you maintain your sense of independence within each of them.

The gist:
Being able to bathe and shower independently is important for both your personal hygiene and physical health. It also promotes self-esteem and an overall sense of well-being; feeling freshly groomed can make you more likely to go out, thus enriching your social life. 

The person-centered care approach:
Allow you to groom yourself how you want.

It can be difficult asking for assistance with bathing. However, under person-centered care, you’ll continue doing as much of your own bathing as possible ­­— depending on your needs, a caregiver will only help you with the essentials. Your personal style and grooming preferences — what types of shampoos and conditioners you use; how you prefer to comb your hair; what type of music you like to listen to while you shower — will all be present and top-of-mind.

 “I think of bathing and showering assistance as mostly a safety thing,” says Brian Kelley, PT, DPT, MHA, a clinician and operator in the older adult post-acute space. “As a caregiver, we want you to do as much as you feel comfortable doing. We’re just there to help with the other stuff.”

The gist:
Being able to dress yourself — safely, without falling — is an important aspect of independence and self-care. Like bathing, it helps promote a sense of dignity and confidence. How we dress is an essential component in how we express ourselves. 

The person-centered care approach:
Help you wear what makes you feel great.

When it comes to assistance with dressing, the clothes you like to wear — the items that make you feel confident — are the top priority. Feeling good about the clothes you’re wearing can have positive impacts on your overall self-esteem, and you shouldn’t be resigned to wearing a certain type of clothing because of a physical limitation.

 “I can’t tell you how many times I’ve heard people say something like, ‘Ah, I used to love wearing this sweater, but the arthritis in my shoulders makes it too hard to put on,’” says Kelley. “As long as it’s safe for you to wear, and you feel good wearing it, we — the caregivers — will make sure to assist you in putting it on.”

The gist:
Being able to feed yourself is critical to maintaining your health and wellness. It’s important to have a healthy diet and stay hydrated, especially as you age. It’s also important to enjoy the food you eat ­­— that has huge implications on your quality of life.

The person-centered care approach:
Treat you like a foodie.

What’s your favorite type of food? What type of food do you hate? These are the types of questions a person-centered caregiver will ask you to make sure you’re eating the types of food you enjoy. The priority is buying the ingredients of foods you like and not forcing you onto a diet you don’t want.

Some people who have issues with swallowing will be told they should only eat pureed food. That can understandably be difficult to accept. A person-centered care approach will address whether there are other ways to limit potential issues of swallowing while still giving the recipient the food they love, served how they love it. 

“Overall, we don’t stop at just sustenance,” says Kelley. “The experience should also be about enjoying food.”

The gist:
Being able to control your bowel and bladder functions and use the toilet are essential for personal hygiene and skin integrity. They also help you avoid discomfort and potential embarrassment.  

The person-centered care approach: 
Determine your comfort level. 

When it comes to continence assistance, there are multiple ways to manage it; most will vary by person. The first step to a positive person-centered care approach is for the care recipient and caregiver to figure out a comfort level that works for them. 

Some care recipients might not care about receiving help; some might be a little more uncomfortable.   

If someone veers more on the uncomfortable side, a good method is to set a schedule: an agreed-upon time, maybe once an hour, where the recipient will visit the bathroom. It might seem simple, but this helps maintain a sense of modesty and independence. 

The gist: 
Getting to and from the toilet, getting on and off the toilet, performing associated personal hygiene, and caring for clothing.

The person-centered care approach: 
Again, determine your comfort level. 

Much like with continence, the first step should be to establish with your caregiver what level of assistance is comfortable for you. 

The gist: 
Being able to move around inside and outside your residence, whether it’s walking or using assistive devices — like walkers or lifts — is essential for maintaining physical health and preventing falls.

The person-centered care approach: 
Set you up for success.

If you have trouble moving around, assistive devices can be extremely helpful. However, Kelley says, it’s sometimes possible to become too reliant on them. It’s important to continue giving someone the chance to move on their own, acting as more of a spotter (while, of course, making sure it’s safe). To him, that’s the best way to help someone maintain a sense of independence and improve. 

“I was once helping a care recipient get ready to go outside, and I instinctively got on the floor to tie their shoes,” he says. “I realized that I was robbing them of an opportunity for functional mobility. I wasn’t setting them up for success the best way possible.” 

The best person-centered care approach to mobility is to allow you as much mobile opportunity as possible — whether it’s crossing the room or putting on their shoes. 

The gist: 
Being able to transfer yourself from one position to another, such as from a bed to a chair, helps ensure a sense of independence.

The person-centered care approach: 
Stay within an arm’s reach.

As with mobility, it’s important to allow you as much mobile opportunity as possible. An easy way to accomplish this is for your caregiver to act as your spotter, staying within arm’s reach as you move from, say, your bed to your chair. You’ll still get the independence of doing it yourself, but somebody is standing by to help in case you stumble. 

Additionally, there are separate functions known as instrumental activities of daily living (or IADLs). These include more organizational-focused exercises and softer skills, like medication management, housekeeping, and communicating.

Remember: it’s 100% normal to need help with ADLs. Most people will eventually need assistance at some point in their life.

The best thing you can do is to be honest with yourself about what type of help, if any, you may need. By choosing a caregiver who specializes in person-centered care, you can rest assured knowing that your preferences, goals, and values — and safety — will stay top-of-mind.