26 May How to Evaluate the Independence of a Loved One and Determine if Care Assistance is Needed

Posted at 10:17 pm in by

Judging when a loved one needs assistance living in their home can be a difficult task. You want to believe that they can continue on living how they have been for the years past, but you may sometimes see them struggling to complete ordinary tasks.

Activities of daily living (ADL) and instrumental activities of daily living (IADL) are these ordinary tasks. When a loved one cannot perform more than one of these activities, it may be time to visit care options. To help you identify when it may be time to evaluate care options, we’re breaking down what the ADLs and IADLs are, and how you can use them to judge when your loved one needs assistance.

What are ADLs and IADLs?

According to Senior Living, activities of daily living are “the basic self-care tasks an individual does on a day-to-day basis. These activities are fundamental in caring for oneself and maintaining independence.” ADLs are used by health professionals as a sort of checklist to evaluate an individual’s functional status.

Instrumental activities of daily living are not essential for an individual’s basic functioning, but they do allow them to live independently. Being able to perform both ADLs and IADLs plays a key role in seniors living independently, safely, and successfully. If an individual is not able to perform an activity without special assistance or equipment, they are deemed to have a limitation in that activity.

Activities of Daily Living

ADLs are related to self-care and performed on a daily basis. The Centers for Medicare and Medicaid Services identify six major ADLs, which are found below and expanded upon.

  1. Personal hygiene — This includes bathing oneself, grooming, oral health, and nail care.
  2. Dressing — The individual is able to select appropriate attire and physically put it on themselves without assistance.
  3. Transferring — No assistance needed to get in and out of bed or move oneself from seated to a standing position (or vice versa).
  4. Walking — The individual is able to move from one place to another independently.
  5. Maintaining continence — Able to get on and off the toilet and clean oneself.
  6. Eating — The individual is able to feed oneself. This doesn’t necessarily mean they have the capability to prepare food, however.

Instrumental Activities of Daily Living

Instrumental activities of daily living are generally more complex than basic ADLs. There are numerous IADLs, but the CMS lists the five below as the main activities.

  1. Preparing meals — All aspects of meal preparation can be performed — planning, cooking, clean up, storage, use of kitchen equipment/appliances, etc.
  2. Managing money — The individual is able to plan out budgets and stay within those means, along with consistently paying bills on time, and paying for goods and services.
  3. Shopping — Groceries and other necessary items are purchased independently and when needed.
  4. Housework — Home care chores such as laundry, vacuuming, and cleaning dishes can be performed.
  5. Basic communication — The individual has the capacity to use basic means of communication — telephones, email, or the internet.

Evaluating Your Loved-One

Evaluating your loved one for their ability to perform all of these tasks will allow you to much more accurately judge if they need assistance. The Katz Index of Independence in ADLs and the Lawton-Brody IADL Scale are both great resources clinicians use to help you evaluate your loved one. Here at Bluebird, we use them as well to help you evaluate if additional care is needed.

If and when you do decide it’s time for care assistance, it may be tough to choose between in-home care and assisted living. We broke down the difference between the two and how you can choose in our latest blog.


Bluebird Homecare can help with all activities of daily living and more. Contact us today for a free consultation and see how we can improve the life of your loved one!