Introduction to Instrumental Activities of Daily Living
What are Instrumental Activities of Daily Living?
- Instrumental Activities of Daily Living (IADLs) are activities that are important to being able to live independently but require more complex organizational and thinking skills. Instrumental activities of daily living are also referred to as life skills.
Some common examples include:
- Household chores
- Taking medications
- Using a telephone
- Managing personal finances
- Using transportation
- Shopping
The diagram below provides a quick recap of the factors that may affect a person’s ability to participate in IADLs.
Personal factors
The following examples demonstrate how IADLs can be influenced by a range of personal factors, including a person’s body functions, the health conditions they have, as well as their belief in being able to participate in the activities.
- Health conditions
The following are examples of health conditions that can affect a person’s engagement in IADLs.
- Osteoarthritis
- Stroke
- Lower limb amputation
- Fractures/Trauma related injuries
- Chronic Obstructive Pulmonary Disease
- Low Back Pain
- Heart failure
- Dementia
- Limitations in functioning associated with old age
- Body functions (eg. mobility, strength, joint movement, cognition, vision)
Household chores – A person’s strength and mobility, as well as their thinking skills and ability to see all affect their ability to undertake activities such as cooking, making the bed, dish washing, doing laundry, gardening etc. For example,
- Doing laundry can requiring bending, lifting, reaching, carrying, and the ability to see clothes and washing detergents, as well the ability to plan and sequence tasks.
- Cooking meals requires dexterity and coordination to prepare food (Such as chopping and stirring), the ability to pay attention, sequence tasks, and recognize risks and avoid injuries, and the ability to see and read a recipe, measure quantities, and monitor how food is cooking.
- Making the bed requires strength and mobility to reach, pull, and lift the mattress to tuck sheets.
Taking medications – Taking medications requires good thinking skills to remember what medications to take when in what quantities, as well as measuring the correct dose. Administering the medication also takes motor skills, and the ability to swallow without aspirating (when the substance goes down the airway towards the lungs)
Using a telephone – In order to use a telephone, a person requires good vision and dexterity to dial numbers or type a message, and the ability to find or remember phone numbers, as well as being able to hear the person on the other line (if talking).
Managing personal finances – Managing personal finances requires good thinking skills to remember accounts, inflows and outflows of money, and do basic calculations. It can also require reasoning and judgement to make good financial decisions. Furthermore, motor skills and the ability to see may be needed to visit a bank, use a computer or ATM, or write a cheque.
Using transportation – Being able to use transportation also requires good muscle strength, joint movement, the ability to move, think and see well. All these skills enable the person to engage in activities surrounding transportation such as:
- Arrange their own transportation
- Get on and off transportation without falling
- See and adequately observe road signs
- Travel using private and public transportation
- Remember where to get on or off transportation and the right transportation to use
Shopping – During shopping, good muscle strength, mobility, joint movement, vision and thinking skills also play an important role in for example:
- Move around in the shopping area
- Carry items that are purchased
- See and shop for what is required
- Remember the shopping items that need to be purchased
- Confidence in their abilities
A person’s beliefs and insight into their own strengths and limitations can have an influence on their performance of IADLs. For example, a person who believes they are capable of learning some compensatory strategies in order to use the telephone is likely to participate more enthusiastically in rehabilitation. Conversely, if a person with impaired mobility does not believe that they need a walking cane in order to go out and shop, they are more likely to experience falls.
How the environment affects IADLs
The following are examples of how a person’s physical and social environment, as well as their access to assistive products, can influence their ability to engage in IADLs.
- Home environment
If a person’s kitchen has items stored on high shelves or in low cupboards, they will be required to bed and reach to access items. Similarly, if there is a lot of clutter in the home, they are at a greater risk of falls or injuries when attempting to clean.
- Family and community
Family members, friends and community members (paid or volunteer) can assist with IADLs by either helping the person perform them, or completing part of the activity that are not able to do themselves. For example, a family, friend or community member may accompany the person when they go grocery shopping to help them find, pay and transport items, do they cooking so that they only have to re-heat meals, or support them with their banking by helping them read and understand bank statements and make transactions and payments.
- Assistive products
Household chores– Non-slip matting can be used to open bottles or jars whencooking or doing other housekeeping chores
Taking medications– A pill organizer can help a person remember the right medications and dosage
Using telephone – Using a smart phone with accessibility functions can makes it easier for a person to use their phone to make calls, while other applications such as alarms and lists can assist with memory.
Managing finances – Simple memory supports can assist a person to keep track of their finances
Using transportation – A person with visual impairment can benefit from using a white cane to navigate transportation
Shopping – A walker with a seat can allow a person with reduced mobility, shortness of breath, or fatigue to rest while shopping. Question
Remember Tevita?
Tevita is an elderly woman who is frail, has osteoarthritis of the knees and diabetes for which she takes medications. Due to her frailty, Tevita’s hands usually shake when she attempts to hold cutlery to eat or a cup to drink. Her osteoarthritis makes it difficult for her to stand and take her bath, do house household chores or move around.
Tevita also easily forgets the things she needs to do and does not remember the bus she needs to take for shopping, the items she needs to buy when shopping or how to retrieve phone numbers on her mobile phone easily. Her friend who occasionally visits for tea assists her with her household chores.
1. List the Instrumental Activities of Daily Living that Tevita has problems with.
2. What are the factors in Tevita’s personal life and environment that can affect her Instrumental Activities of Daily Living?
You have completed Lesson one!
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