In this blog series, we examine the differences between activities of daily living (ADLs) and instrumental activities of daily living (IADLs), and what happens when they become difficult for a person.
As we grow older, one of the clearest measures of a person’s ability to live independently is how well they manage activities of daily living (ADLs). ADLs are the routine tasks needed to care for oneself and move safely through each day. When someone begins to struggle with ADLs—either because tasks become unsafe or harder to complete—it’s often a sign that additional support should be considered.
Whether you are deciding to stay in your current home or thinking about moving to a retirement community where help is available, it helps to understand exactly what ADLs involve and how limitations can affect senior living options.
What are ADLs?
The phrase “activities of daily living” describes the essential self-care tasks that most healthy adults perform every day without assistance. ADLs typically include eating, dressing, bathing or showering, toileting and managing continence, transferring (for example, getting in and out of bed or a chair), and basic mobility like walking or moving around the home.
ADLs are a reliable indicator of how well someone is functioning independently. When one or more of these tasks become difficult or unsafe, maintaining full independence at home becomes more challenging and may require changes to the living situation or additional support services.
The difference between ADLs and IADLs
To clarify the difference: ADLs are fundamental personal care activities. Instrumental activities of daily living (IADLs) are more complex tasks needed to live independently in the community. IADLs include managing medications and finances, grocery shopping, driving or using public transit, and household chores like cleaning.
In many cases, IADLs decline before ADLs, but a loss of ADL ability often represents a more immediate need for personal care or assisted living services. Later posts in this series will explore IADLs in more detail.
Why the ability to perform ADLs impacts independent living
Being able to perform ADLs safely and reliably is fundamental to staying at home, whether alone or with limited support. These tasks matter for several reasons:
- Safety: Difficulty transferring in and out of bed or a chair increases fall risk. Problems with bathing or toileting raise the chance of skin issues, infections, and accidents.
- Quality of life: Struggling with ADLs can reduce daily routines and social engagement, leading to isolation. Loss of independence often forces greater reliance on others for basic dignity and comfort.
- Early warning sign: Limitations with ADLs are commonly used in aging and long-term care research to predict the need for home care, a move to assisted living or a skilled nursing facility, and higher hospitalization risk.
- Planning for future support: Knowing current ADL ability helps families plan appropriate supports, from home modifications and part-time caregivers to transitioning to a residence that includes personal care.
>> Related: Aging at Home or in a Senior Living Community: The Freedom of Choice
When ADL difficulty begins impacting safety or living arrangements
Noticing that a loved one’s—or your own—ability to perform ADLs is declining is important. Planning ahead usually leads to smoother decisions than acting during a crisis. Practical signs that it may be time to seek assistance include:
- Needing help or supervision to transfer safely in or out of bed or a chair, or moving about the home slowly and carefully
- Bathing, grooming, or dressing taking much longer or posing a fall risk
- Relying on someone else for toileting, managing incontinence, or cleaning after toileting
- Eating and self-feeding becoming harder—perhaps the person can eat but cannot prepare food comfortably or tires while eating
- Mobility becoming limited (avoiding outings, increased confinement at home, or near-falls)
- Growing dependence on others for IADL tasks such as shopping, paying bills, or driving, which often coincides with worsening ADLs
>> Related: Considering The Push-Pull Factors of Senior Living Moves
The next steps when ADLs become a challenge
How well someone performs ADLs is one of the most practical measures of whether they can safely remain at home. As ADL difficulties increase, so too do risks, burdens, and the need for support—either from family caregivers or paid services. Early recognition allows for calmer, better-planned decisions about home adaptations, caregiving support, or moving to a residence that offers personal care.
In the next post in this blog series, we will look at the options people have when performing their ADLs becomes difficult or unsafe, and how to decide on the ideal time to make a senior living move.