Activities of Daily Living or ADLs are the routine tasks needed to take care of one's self. The IADLs or Instrumental Activities of Daily living are more complex and involve tasks needed to live independently and operate within the community.

An elderly person's ability to carry out day to day activities efficiently is the starting point to establish whether they require long term care to assist them with ADLs (Activities of Daily Living).  

When they get to a point that they are unable to complete their essential activities, it is time to assess how much help they need. It is also a good time to consider the future, as help required will likely increase with time.

ADLs are very important to seniors' wellbeing as they need to be able to dress, make use of the bathroom, prepare meals, do housework, and remember to take their medications. This is the starting point for living independently.

Initially, only a little help may be required. Often people are still capable of completing their ADLs, but it may not be efficient. Time is the limiting factor, not ability. Assistance with more time intensive activities such as meal prep and/or laundry may allow for increased independence with all other activities.

What are some of the Activities of Daily Living?

Drawing answering the question "What are the ADL's?"
Activities of Daily Living

There are 5 ADL's and 7 IADL's.


The IADL's are likely to require assistance prior to ADL's. They take longer to complete and require more planning and higher level cognition.

A few hours of assistance per week may be enough initially to reduce the burden of self care on your loved one and allow them to maintain their functional independence within the home and community.

As difficulties with ADLs increase, so will the amount of supervision or hands-on care needed to ensure an older person lives comfortably.   

For each of the above-listed ADL categories, people's needs will vary regarding how much help they need. They may require part-time or full-time assistance by an in-home caregiver. An occupational therapist and physical therapist would be able to make recommendations regarding level of assistance required.

IADLs Requiring Assistance by In-House Caregivers

There are certain instrumental activities of daily living tasks that we have completed all our lives, but find these become more of a strain to keep up with as we age. Below are examples of assistance that can be provided by family or a caregiver.   

Some of these include:  

Catering to ADLs Through Assisted Living or In-Home Care  

What are the ADLs? Woman starts with window cleaning

It can be difficult to determine how much care is needed as people tend to try to hide their deficits. Careful observation and planning ahead will set your loved one up for success and give them the care needed.

Below is a brief rundown of two different options.  For more in depth information check out Aging in Place vs. Step up in care model.

In-Home Assistance for ADLs  

Families will more often than not hire home health workers to assist with an ADL when their loved ones need some help with tasks, but do not require total care.

The carers would render assistance by administering medication, shopping, and going along when your elderly loved one goes for a walk. Health insurance many cover some of the expenses. Check with their provider. Skilled services provided for ADLs training through physical or occupational therapy may also be covered when ordered by their primary care physician.

Getting care at home is usually the first option. Seniors who are able remain within their own homes live much happier and healthier lives. It is also more economical. The fewer ADLs require assistance, the less it should cost for a caregiver. In-home care can provide either temporary (respite care) or on a more consistent basis.   

Assisted Living for Seniors  

Assisted living facilities (ALFs) offer a combination of personalized support services, meals and residential housing. However, they do not include skilled nursing care. ALFs offer services designed for older adults who may need help with medication reminders and housecleaning while having the security of personal assistance 24/7. Meals are generally provided as well as transportation services and other community programs.   

Professional Caregivers Benefits  

There are numerous advantages to enlisting the services of trained caregivers for seniors. As a whole, the caregivers are able to provide the help needed when family is unable to do so.   Professional caregivers can also provide invaluable advice that includes steps to safeguarding the elderly person's home to prevent them from falling.   

With a small investment from family members or the person concerned, their home can be more comfortable and safer to use.   

Modification Ideas to Assist with ADLs  

Home safety is the number one concern for elderly people who wish to live independently. Even in the case of in-home care, certain home modifications will improve activities for daily living and ensure the person cared for is safe. As people get older, the possibility of falling increases and prevention of falling become much more important.

Bathroom safety is just as important as there are various sharp corners and hard surfaces around. All it takes is a few modifications to make certain elements more senior-friendly.  

It pays to consider in-home care where comprehensive support is needed by seniors and disabled individuals who require assistance with ADLs. Caregivers make a huge difference in this regard. 

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The activities of daily living or ADLs as they are commonly referred to are the basic tasks a person needs to perform every day. In the case of seniors, health care providers will gauge their ability to carry out these tasks as a guideline to determine how much daily care they require. If you are a bit concerned about your loved one's capability to complete their ADL's, there is training and equipment that can improve their ability to live independently.

Various basic activities form part of the activities of daily living that are necessary for maintaining independence to age in place within a community or at home. These are performed daily and at times require the assistance of a caregiver. What are the activities of daily living?  

There are five basic ADLs:  

Activities of Daily Living Examples?

Man performing vacuuming as instrumental activity of daily living.

Picture the typical start to your day. Wake up, rollover, sit up and get oriented. Then stand and walk to the restroom. Brush teeth, use the toilet and shower. Then either dress for the day or a house coat until after breakfast. 

When it comes to breakfast, lunch and dinner, menu planning is needed, shopping for food and meal preparation. Assuming this has been completed, you can sit down at the table to eat your breakfast and clean the kitchen and wash dishes once finished.   

What we described over here all form part of the activities of daily living. And that was really just the morning routine.

Healthcare professionals refer to basic self-care tasks performed by seniors who live independently as activities of daily living or ADLs. These are fundamental in maintaining their independence and caring for themselves.   

As you get older, ADLs become progressively more difficult to carry out on your own and involve a lot more time to perform. Then there are specific health issues such as falling, strokes, changing cognition, and a host of other things that affect your ability to accomplish ADLs.   

Activities of Daily Living Nursing Assessment  

If you feel your loved one needs assistance with ADL's to continue living at home, it may be helpful to see if their Primary care physician will refer them for home health physical and/or occupational therapy. They would have an evaluation to gauge just how much care or therapy is necessary. Healthcare service models would utilize an ADL assessment tool for elderly like the Katz ADL Index to evaluate their proficiency. Appropriate care plans would then be drawn up to ensure your elderly family member get the care they need.   

Recognizing the ability to carry out basic activities of daily living is very important. Medical personnel, like qualified nurses and doctors, physical and occupational therapists can identify these properly. If you suspect your loved one may be having a bit of difficulty managing the day to day routine, an expert's recommendations should help navigate these changes.

activities of daily living carried out by elderly women dressing

Loss in daily living skills activities can be set off by:  

According to the National Library of Medicine, ADL's are used used to show whether a person can function independently. The inability to do so results in the individual becoming dependent on other persons, using mechanical devices, or both.   

The inability to perform certain daily activities can be unsafe and lead to poor life quality. Measuring a person's ability with ADLs is important as it will indicate the need for further assistance to safely age in place and prevent hospitalization. For more information refer to the Complete Guide to Aging in Place.

During hospitalization, nurses are often the first to notice a patient's inability to function properly. Therefore, regular ADL screening is needed and should be carried out on hospitalized patients. Especially if the person is submitted due to a chronic or acute illness that would influence their ability to sustain their independence at home.

Mechanical Devices That Help with Specific ADLs  

Technologies play their part in individuals who find it difficult to carry out activities of daily living successfully. Certain mechanical devices allow the individual to complete ADLs with ease and takes far less time. This way, they can maintain their independence for longer.   

Following are some examples of these assistive technologies:  

As children or family members of an elderly loved one, we need to pay special attention to factors influencing activities of daily living. Often the elderly adult, our parent's physical capabilities alter as they age in that their muscular structure weakens, they become immobilized and suffer from memory loss or have shortness of breath. All of these would influence their ability to perform ADLs.

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Anyone with an aging parent or grandparent may be concerned about urinary tract infections (UTI) and be on the lookout for UTI symptoms in the elderly. The condition should not be confused with dementia and special attention must be given to how strong their immune system is. Caregivers or family members need to know what they are up against, which is discussed below.  

If you have an aging parent, the chances are good that they may struggle with UTIs. After all, the risk of this type of infection increases from 5% to up to 16% in those over 65 years of age and to 20% in those over 80 years old. This is why it is important for you to recognize UTI symptoms in the elderly.

Bear in mind that urinary tract infection symptoms can be confused with dementia and are not always as clear cut like some would believe it to be. It is important to differentiate between these two to ensure the right treatment is given.   

Fortunately, our immune systems play a major role in urinary tract infection, which can be treated at any stage. As we age, our immune system becomes less effective and is at least partially responsible for increases in incidence of UTI.

When an older person does not know they are have an infection with their urinary tract, it may lead to serious health problems and discomfort in both men and women. 

lady experiencing UTI symptoms in the elderly.

What are some of the UTI Symptoms in the Elderly?  

Symptoms of UTI include:  

In addition to these symptoms, the elderly may also experience, delirium, confusion, or changes in their behavior such as; hallucination, agitation, social withdrawal, restlessness.  

How UTI's in Seniors get Started

The effects of aging make it challenging to detect urinary tract infections and at times, hard to cure. Their immune systems are generally weaker and make it hard for their defense systems to fight rapidly multiplying fungus or bacteria.  

The moment bacteria makes its way into the urinary tract, the chances of developing UTI symptoms exist. The inside of the bladder is an environment made for bacteria to reproduce as it is dark, warm, wet and full of nutrients.

Many seniors struggle with weakened bladder and pelvic floor muscles, which can lead to incontinence. This is often a precursor to bacterial issues inside the urinary tract.   

Bladder prolapse is a common condition among the elderly where the bladder drops down to the extent that the elderly person is unable to fully empty their bladder. The urine left behind creates favorable conditions for bacteria to multiply.   

Be on the lookout for signs of a UTI in the days following a hospitalization. This is especially important in cases where a catheter was inserted during their stay. Catheterization significantly increases the risk for UTI as it can be a direct pathway for germs to enter the bladder.

The main culprits that play a major role in urinary tract infections in the elderly would be bacteria called staphylococci or enterococci. These multiply speedily. The aging's immune systems are weaker and often fail to fight infection as effectively as during their younger years.   

Other medical conditions that often result in UTI in seniors include; poor hygiene, diabetes, immobility, and complications from medicine.   

Senior caregivers often find that the elderly person they care for cannot verbally communicate their pain. In this case, observation and changes from baseline can be the first UTI symptoms to become noticeable in the elderly. Be on the look out for symptoms including poor motor skills, dizziness or unsteadiness with walking.   

Other physical UTI symptoms in the elderly may present as burning pain with urination, frequency of urination, a low-grade fever, night sweats or chills, or foul-smelling urine.   

Bacteria shown to be cause of most UTI symptoms in the elderly.

How Do Your Treat UTI in the Elderly?  

One of the first things to do when you notice signs of a urinary tract infection is to make an appointment with their physician. It very unlikely to vanish on its own, and is more likely to become worse with every passing day. This is especially true when it is a senior with a weakened immune system. 

Their doctor will most likely prescribe an antibiotic. As a caregiver, be sure your loved one takes their medication as prescribed to be sure to get rid of the infection. They should be encouraged to drink plenty of water as it will help to clean the urinary tract and avoid dehydration, which can make UTIs more common.   

Do not take any signs of UTI in the elderly lightly once you notice any of the symptoms mentioned previously. This is especially important with more debilitated individuals. It is an infection that can turn ugly and complications may arise.   

Urinary tract infections in the elderly may lead to major health problems such as chronic kidney infections. This can cause serious damage to your kidneys if ignored for any length of time.

How to Prevent UTI Concerns in the Elderly  

Once there are no more signs of urinary tract infection, preventative measures need to be put in place to reduce risk of future UTIs. Setting up a schedule to urinate every 2 hours or so will reduce the risk. It is also very important to maintain proper hygienic practices.

Ensure they regularly change their underwear or diaper/pads. Also if assistance is required for toileting and peri care, wiping a female individual from front to back should always be the technique.

The key thing to remember with aging individuals is that they will ultimately lose certain abilities that were natural to them at one stage. This is where a caregiver or relative can step in to render assistance and regularly be on the lookout for UTI symptoms in the elderly. 

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It sure is challenging caring for the aging at home. Even more so when a loved one resists help, find out what you need to know about understanding their resistance and ways to encourage them to cooperate.   

Aging is part of life, and not something you can wish away. It affects families from all walks of life. Adult children may not fully understand to what extend their once energetic parents are aging and the effects it will have on them later on.   

Their loved ones may still be in good health and live independently, resulting in no immediate concerns regarding dramatic changes any time soon.   

Having said this, the time will arrive when the effects of aging will be more evident and mean you have to think about long term care for them.  

Knowing When to Step in Caring for the Aging  

Man sitting on couch discussing caring for the aging.

It can be emotionally challenging once you realize someone close to you struggles but stubbornly refuses any help. Your loved one may be dealing with cognitive changes, physical decline, or the loss of a spouse. Coping with the loss of independence is not ever easy. 

Accepting help from other family members or a paid caregiver will mean they may have to give up some of their privacy and independence and adjust to different routines. Therefore, they may feel vulnerable and frightened. Understandably, they may put up a fight. At times there can also be declining cognition, and they may not realize they need the help.   

Show you care by spending as much time as possible with your loved one to obtain an accurate picture of what they need help with before you focus on finding assistance within the home.    

Loved ones often do not ask for help, so you need to observe and ask all the right questions without coming across too strong. It is a case of recognizing the signs that they are indeed in need of extra help.   

What are some of the things to look out for that show that caring for the aging is becoming necessary?  

The following signs show that caring for the elderly at home should be a priority:  

Let's face it; our aging loved ones' well-being is first and foremost in our minds. We wish for nothing more than that they are able to live out their remaining years to the fullest with minimal difficulty.   

Caring for the aging means we consider a family member's physical, emotional, and mental well-being.  

Do not wait until you realize they find it difficult or impossible to care for themselves, to look for help. Start out small with providing assistance. Whether you are caring for them yourself or finding someone who is qualified to do so.

Two to three hours of help one day a week may feel like a luxury instead of an imposition. Facilitate help with laundry, house cleaning or grocery shopping whichever feels like the biggest chore to your loved one.

Give them this time to do something they enjoy. Reading, hobbies or spending time with grandchildren can be a reward to letting go of a chore that is increasingly difficult.

Other ways would be to invest in accessories and equipment to help them carry out specific tasks independently and with greater ease.   

Elderly Care Tips in Caring for the Aging


Elderly man who needs some assistance at home with Activities of daily living.

There are all sorts of ways family members can ease the burden of daily living activities. Not all of these are necessarily fundamental, but will surely help a great deal.   

Below are some helpful tips for taking care of the elderly:  

It is important to determine what would help a loved one overcome various obstacles and difficulties.   

We spoke about an aging parent showing resistance. How would one manage to overcome an aging parent's resistance to care? 

How to Encourage a Loved One to Accept Help

There are several ways to encourage a loved one to accept help from a caregiver. Here are some suggestions:  

Whatever you and your family decide to do when it comes to caring for the aging, remember always to involve your loved one when decisions are to be made about his or her care.

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