Causes of Decline in Activities of Daily Living (ADLs)

When you wake up in the morning, do you think about how to wash your hair or brush your teeth? Chances are that activities like these are so routine that you don’t really put much effort into thinking about them. This is the case for many of us, especially those who are younger and without physical limitations. However, for those with different abilities and those who are aging, these activities, also known as activities of daily living (ADLs), can be quite difficult to perform. 

What are Activities of Daily Living?

Activities of Daily Living (ADLs) generally describe the skills needed to care independently for oneself. ADLs are typically broken down into 2 different types: basic ADLs (BADLs) and instrumental ADLS (IADLs).

Basic ADLs, also known as physical ADLs, include the following categories:

  • Ambulating – the ability to move from one place to another using the legs.
  • Continence the ability to control bowel and bladder function.
  • Dressing – the ability to select clothing and put the clothes on.
  • Feeding – the ability to consume food.
  • Grooming – the ability to perform oral hygiene and hair and nail care.
  • Personal hygiene –  the ability to bathe, keep face and hands clean, and perform adequate cleansing after toileting. 

Instrumental ADLs are more complex activities and include such activities as:

  • Managing communications – handling phone calls, mail, and/or email communications.
  • Managing finances – paying bills and managing assets.
  • Managing medications – obtaining medication, understanding its use, and taking it as prescribed.
  • Food preparation and shopping – procuring, storing, preparing, and consuming food needed.
  • Housekeeping and home maintenance – keeping the living area tidy and performing general household maintenance.
  • Transportation – maintaining a vehicle driving safely, or arranging for needed transportation.

Causes of a Decline in ADLs

Aging naturally causes a decline in our ability to perform ADLs and conditions that affect neurological, sensory, circulatory, or musculoskeletal function make these activities even more challenging. In the elderly, diseases that cause severe cognitive impairment, like dementia and Alzheimer’s, are the biggest causes of decline in the ability to perform ADLs Other factors that may hinder someone’s ability are medications, the home environment, and social isolation. Overall mental health plays a large role in one’s ability to even have the desire to do these activities, let alone do them.

Measuring the Decline in ADLs

There are several scales to measure if someone is able to maintain their activities of daily living. The most common are the Katz Index of Independence in Activities of Daily Living and the Lawton Instrumental Activities of Daily Living (IADL) Scale. Typically, as family members, we allow medical professionals to determine an actual change in ability and we just know that as we observe them, we see a decline. Our observation is often what sparks the need for an assessment. 

Regardless of whether we have a professional diagnose the decline or not, if you feel that your loved one’s quality of life is impacted by an inability to perform these activities, it’s important to get them help. Our caregivers at Shepherd’s Staff In-Home Care can provide as much or as little assistance as is needed. During an in-home assessment, we will discuss your loved one’s needs with you and provide the best plan of care.

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