ADLs versus IADLs

DEFINITIONS

By Staff Reporters

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Activities of Daily Living (ADLs)

According to Leslie Kernisan MD MPH, these are the basic self-care tasks that we initially learn as very young children. They are sometimes referred to as “Basic Activities of Daily Living” (BADLs). They include:

  • Walking, or otherwise getting around the home or outside. The technical term for this is “ambulating.”
  • Feeding, as in being able to get food from a plate into one’s mouth.
  • Dressing and grooming, as in selecting clothes, putting them on, and adequately managing one’s personal appearance.
  • Toileting, which means getting to and from the toilet, using it appropriately, and cleaning oneself.
  • Bathing, which means washing one’s face and body in the bath or shower.
  • Transferring, which means being able to move from one body position to another. This includes being able to move from a bed to a chair, or into a wheelchair. This can also include the ability to stand up from a bed or chair in order to grasp a walker or other assistive device.

If a person is not fully independent with ADLs, then we usually include some information about the amount of assistance they require. ADLs were originally defined in the 1950s by a geriatrician named Sidney Katz, who was trying to define what it might look like for a person to recover to independence after a disabling event such as a stroke or hip fracture. So these measures are sometimes called the “Katz Index of Independence in Activities of Daily Living.”

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Instrumental Activities of Daily Living (IADLs)

These are the self-care tasks we usually learn as teenagers. They require more complex thinking skills, including organizational skills. They include:

  • Managing finances, such as paying bills and managing financial assets.
  • Managing transportation, either via driving or by organizing other means of transport.
  • Shopping and meal preparation. This covers everything required to get a meal on the table. It also covers shopping for clothing and other items required for daily life.
  • Housecleaning and home maintenance. This means cleaning kitchens after eating, keeping one’s living space reasonably clean and tidy, and keeping up with home maintenance.
  • Managing communication, such as the telephone and mail.
  • Managing medications, which covers obtaining medications and taking them as directed.

Because managing IADLs requires a fair amount of cognitive skill, it’s common for IADLs to be affected when an older person is having difficulty with memory or thinking. For those older adults who develop Alzheimer’s disease or a related dementia, IADLs will usually be affected before ADLs are.

IADLs were defined about ten years after ADLs, by a psychologist named M.P. Lawton. Dr. Lawton felt there were more skills required to maintain independence than were listed on the original Katz ADL index, and hence created the “Lawton Instrumental Activities of Daily Living Scale.”

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Gerontologist V. Geriatrician?

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PODCAST: Will Your Health Care Directives Protect You?

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Financing LONG-TERM CARE Needs?

AGING AND RETIREMENT

Long-term care (LTC) may not be the first thing individuals or couples think about as they approach retirement, but the costs for those who needs it can disrupt and derail retirement security. A good plan for long-term care requires many decisions over an extended period of time, and well before retirement.

In this article, Milliman consultant Robert Eaton discusses the major considerations and options for financing LTC needs in retirement.

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On Aging and Getting Better with Age

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Consumer Reports on Health

By Rick Kahler CFP® http://www.KahlerFinancial.com

Rick Kahler CFP

How old is “old?” I don’t know exactly, but after my recent birthday I can say that it’s much older than 58. My 12-year-old son told me, “Dad, I’ve always thought of people who are over 60 as being really old. I don’t think of you as really old, so guess I will need to redefine what is old.”

Old Enough?

Still, I am old enough to know from personal experience that the body begins to slow down and fall apart as we age. I also know from working with clients that aging can be expensive. One of the biggest threats to a retirement nest egg, besides the possibility of outliving it, is the high cost of medical care for increasing health needs.

All this leaves me wondering if there is anything good about getting older.

Consumer Reports on Health

Well, yes, there is. A recent article in Consumer Reports on Health found there are some things that actually get better with age:

1. You get wiser.

This one seems intuitively obvious to me, but as I once heard a researcher say, “If you can’t measure something, it doesn’t exist.” Research conducted by the Universities of Texas and Michigan found that significantly more older people ranked in the top 20% in wisdom performance and the group with an average age of 65 consistently outperformed younger participants. Maybe there’s some truth to the joke about parents seeming to get smarter as their kids get older.

2. You have fewer difficult emotions.

A Gallup survey found that people in their 70’s and 80’s reported less stress, worry, and anger than younger respondents. I found it curious that stress peaks at age 25 and steadily declines, dropping rapidly from age 60 to 73. I guess that leaves me something to look forward to in a couple of years.

3. You become happier.

This was a surprise, especially given my projection that increasing aches and pains probably increase unhappiness. Again, the devil is in the definition of “happiness”. I suggest that we often equate happiness with well-being, which can be broken into three segments: physical, emotional, and financial. Stanford University found that aging is actually associated with increased emotional well-being. The article didn’t mention physical and financial well-being. Based on my experience, I expect that physical well-being decreases with age and financial well-being is dependent upon a complex host of variables.

4. Your marriage gets better.

The Journal of Social and Personal Relationships found that older couples experience greater satisfaction and positive experiences with each other. The report also says happily married older people have better health, quality of life, and relationships with their children and friends. I think that is another one of those intuitively obvious facts that researchers still feel they must validate.

5. Your relationships get deeper and richer.

While younger people have more friends, the quality of older people’s relationships becomes richer. A study done by Case Western Reserve University found that volunteering was the most consistent predictor of cognitive well-being in people over age 72.

Assessment

Even with all these positives, old age isn’t exactly something to look forward to. Yet it doesn’t mean our golden years will necessarily be overridden with tarnish and rust. Living a healthy lifestyle and planning financially for retirement can certainly help make aging more comfortable. And clearly, aging is better than the alternative of not being around to grow old; especially when we factor in one last advantage of aging.

I haven’t yet experienced this personally, but I hear plenty about it from clients and friends. According to these sources, the best thing about aging is grandchildren.

Conclusion

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