What are IADLs & ADLs? Differences, Examples, and More

When considering senior living options for yourself or a loved one, a common question arises: “How do I know when it’s the right time?” The answer is different for everyone. Some seek an easier way of life without the responsibilities of owning a house. Others want a more active lifestyle surrounded by people their own age.  For others, the ability to manage Instrumental Activities of Daily Living (IADLs) and Activities of Daily Living (ADLs) serves as a key indicator. But what exactly are IADLs and ADLs? In this article, we will delve into the distinctions between these two sets of activities, how to recognize if you or your loved one may be facing challenges with them and how senior living communities can provide the necessary support.

The Differences, Explained.

Roger Landry, MD, MPH, author of Live Long, Die Short, explains that the main difference between Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs) is their level of complexity and the skills required to perform them.

“ADLs refer to the basic, everyday self-care activities that most people perform without assistance, such as bathing, dressing and eating, he says. “In contrast, IADLs encompass more complex tasks, like managing finances, cooking and transportation.”

Dr. Landry adds that ADLs represent the basic activities that people must be able to accomplish to live independently, but they must often be combined to complete one IADL. “For example, while eating is an ADL, the ability to plan and prepare meals, shop accordingly and eat a healthy diet is an IADL. To clean and maintain a home, a senior must be able to walk on their own, he says.”

Understanding the differences between ADLs and IADLs is crucial for figuring out how well someone can manage daily life and what kind of care they might need.

What Are Activities of Daily Living (ADLs)?

ADLs are essential for day-to-day functioning and independence. If someone begins to struggle with one or more ADLs, it may be a sign that additional support or a change in living arrangements is needed. Common ADLs include:

• Personal Hygiene – Bathing, showering, grooming, nail care and oral care.
• Dressing – Making appropriate clothing decisions and the ability to physically dress and undress independently, including fastening zippers, buttons and ties.
• Eating – Being able to feed oneself (though not necessarily the capability to prepare food). This includes the use of utensils without the assistance of another person.
• Toileting – The ability to get to and from the bathroom, use the toilet properly, and manage personal hygiene afterwards.
• Transferring/Mobility – Moving from one position to another, such as standing from a sitting position, getting in and out of bed and walking independently with or without the use of a mobility aid, such as a walker or cane.
• Continence – The ability to control bladder and bowel functions.

Why do ADLs Matter?

“ADLs are critical for assessing the ability to manage essential self-care,” says Dr. Landry. “Deficits in ADLs often indicate a need for direct physical assistance or supervision. Inability to perform ADLs typically requires more intensive care, such as personal care aides or nursing support, to ensure basic health and hygiene. ADLs are closely tied to immediate safety and health. For example, inability to transfer safely can lead to falls, necessitating immediate intervention.”

What Are Instrumental Activities of Daily Living (IADLs)?

These activities are more complex than basic Activities of Daily Living (ADLs) and are essential for independent living. Common IADLs include:

• Meal Preparation – Planning meals, assembling ingredients, cooking, and setting out food and utensils.
• Housekeeping – Cleaning, tidying up, organizing possessions, washing dishes, cleaning floors and furniture, and arranging for home repairs/maintenance.
• Managing Finances – Paying bills on time, adhering to a budget, balancing accounts, handling money, and managing assets.
• Medication Management – Taking prescribed medications correctly, monitoring for side effects, and requesting refills as needed.
• Communication/Phone Use  – Using phones, emails, and other communication devices to stay in touch with others and handle necessary affairs.
• Shopping  – Acquiring groceries and other necessities, which may involve transportation and budgeting skills.
• Transportation  – Driving or using public transit to run errands, attend appointments, or engage in social activities.
• Laundry – Washing, drying, folding, and putting away clothes and linens.

Why Do IADLs Matter?

Dr. Landry says that IADLs often build upon ADL skills and require higher levels of thinking, organization and strategic planning. “Understanding an older adult’s IADL capabilities can help families gauge how much support their loved one needs and plan accordingly. Healthcare providers use IADL assessments to evaluate overall health status and functional capacity, which can inform treatment plans and interventions.”

Assessing ADLs and IADLs

ADLs and IADLs are essential tools in evaluating functional status, identifying care needs and developing comprehensive personal care plans that enhance independence, safety and overall quality of life.

• Assessment of Independence – ADLs and IADLs provide a comprehensive view of a senior’s ability to live independently.
• Early Detection of Health Issues – Difficulties with ADLs and IADLs can indicate underlying health problems, including cognitive decline, physical impairments or chronic conditions. For instance, problems with IADLs often precede difficulties with ADLs and can be early signs of cognitive issues such as dementia.
• Personalized Care Planning – Understanding capabilities in ADLs and IADLs helps healthcare providers and caregivers develop personalized care plans.
• Safety – Assessing ADLs and IADLs helps identify safety risks. For example, if a senior struggles with medication management, they may be at risk of incorrect dosing. Identifying such issues allows for interventions to mitigate risks, such as setting up medication reminders or arranging for supervised medication administration.
• Quality of Life – Maintaining independence in ADLs and IADLs contributes significantly to quality of life. It fosters a sense of autonomy, dignity and overall well-being.

Activities of Daily Living Checklist

Use this ADL Checklist as a guide to determine whether having access to qualified, professional help every day would promote a better quality of life. Download checklist here.

The Lawton-Brody Instrumental Activities of Daily Living (IADL) Scale

The Lawton=Brody IADL Scale assess an individual’s ability to perform complex daily tasks necessary for independent living in the community. An example of the assessment can be found here.

How Senior Living Supports ADLs and IADLs

Senior living communities are designed to support residents with both ADLs and IADLs. For ADLs, such as bathing, dressing, and eating, staff members provide personalized assistance to ensure that residents can maintain their personal care and dignity. When it comes to IADLs—like managing medications, cooking, and transportation—the community offers services such as meal preparation, housekeeping, and transportation, as well as help with managing finances and medical appointments. This support helps residents maintain as much independence as possible while ensuring their needs are met. Assisted living communities provide a greater range of services to support individuals who need more assistance with ADLs and IADLs compared to independent living communities.

Use our Community Locator Tool to find an independent or assisted living community that is right for you.

Where You Live Matters

Where You Live Matters is powered by the American Seniors Housing Association (ASHA), a respected voice in the senior housing industry. ASHA primarily focuses on legislative and regulatory advocacy, research, and educational opportunities and networking for senior living executives, so they can better understand the needs of older adults across the country.

_{Originally Published: February 21, 2020 – Updated On: August 27, 2024}