What are Activities of Daily Living?

 

Activities of Daily Living (ADLs) are a series of basic or routine activities performed by individuals on a daily basis in order to take care of themselves and assist with independent living at home or in the community.

 

Some common examples of ADLs included in this module are:

• Bathing and maintaining personal hygiene
• Dressing
• Feeding oneself
• Toileting, including bowel and bladder management

 

Remember that an individual’s personal factors as well as environmental factors play an important role in their ability to perform ADLs.

Do a quick recap with the diagram below:

Personal factors

ADLs 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. Some examples are shown below:

 

• Body functions (e.g., mobility, strength, and joint movement, cognition, vision)

 

1. Bathing and personal hygiene – Good muscle strength, mobility and joint movement are required to sit, stand or move in the bathroom environment,holdonto soap or a towel, and brush the teeth.

   Cognition is important  for remembering where the items for bathing and maintaining personal hygiene are, for knowing how to clean or wash the body adequately and in the right order, as well as for concentrating during these activities to prevent accidents.

   Good vision can also be helpful in seeing where bathing and personal hygiene items are, seeing which parts of the body to clean appropriately and being able to navigate the bathroom environment. 

2. Dressing – Basic dressing tasks such asputting on a dress, zipping up or buttoning clothing and tying shoe laces require a good level of dexterity and coordination, as well as muscle strength and joint mobility. Good cognitive skills are also important such as for sequencing and orientating clothing items. In addition, being able to recognize colours, look for clothing, and put them on appropriately  require good vision.

3. Feeding oneself – Various activities involved in feeding oneself such as cutting up food, gripping a cup or cutlery and bringing food to the mouth require muscle strength and joint mobility.  Paying attention while eating or drinking in order not to spill food also requires good cognition. Good vision also has a role to play, such as when recognizing and cutting  food.

4. Toileting, including bowel and bladder management – Good muscle strength, mobility and joint movement play an important role in getting to the toilet on time to prevent accidents, getting on and off the toilet, cleaning, and manipulating incontinence products such as pads and catheters. Bladder and bowel control also require cognition, and good vision can also assist in being able to clean oneself after using the toilet.

 

• Health conditions

The following are examples of health conditions which can affect how a person engages in ADLs.

• Osteoarthritis
• Stroke
• Lower limb amputation
• Fractures/Trauma related injuries
• Chronic Obstructive Pulmonary Disease
• Low back pain
• Heart failure
•   Limitations in functioning associated with old age

 

 

• Confidence in their abilities

A person’s belief in their strengths and limitations can influence their ability to participate in ADLs. For example, a person who accepts that they are frail and therefore may need a shower chair in order to bath will be motivated to use it. A person who does not understand their limitations and is frail may however end up experiencing falls without the use of a bathroom chair.

 

 Environmental factors

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.

 

• The Home environment

 

Bathing and personal hygiene – Because bathrooms are often tiled and wet, they can expose a person to a greater risk of falls, especially if they are required to step over ledges or a bath. A walk-in shower with a hand-held hose may make a bathroom more accessible for a person with limited mobility, and increase independence with bathing.

 

Dressing – Dressing can be facilitated by ensuring that the person can easily reach and access their clothes, and has a place to sit when dressing

 

Toileting including bladder and bowel management – Access to the toilet may be hindered by stairs, a narrow doorway, or lack of a turning circle for somebody using mobility aids, such as a wheelchair or walking frame. Grab bars or a raised toilet seat may assist with transfers on and off the toilet, while a commode by the bedside can help the person avoid the need to access their bathroom during the night.

 

• Family and community

A person’s family and the community they find themselves in can influence their participation in all ADLs. For example, having family members, friends or volunteers who can assist with feeding, toileting, and bathing may enable the person to remain in their own home for longer.

• Assistive products

• Bathing and personal hygiene –  Grab bars, bath boards, or shower chairs as well as long-handled aids can enable a person to be bath and attend their personal hygiene more safely and independently, including reducing their risk of falls.
  
• Dressing – Long-handled dressing aids such as a dressing stick, long-handled shoe horn, or sock aid can reduce the need for a person with reduced mobility or balance to bend and reach when dressing.
• Feeding – Adapted cutlery can assist a person’s grip, while non-slip maps and adapted plates and bowels can also increase their independence with eating.
• Toileting including bladder and bowel management – Continent products, like pads and liners, for example play an important role in coping with bowel and bladder accidents.