What are activities of daily living?

Activities of daily living are the basic self-care tasks a person does every day, such as bathing, dressing and eating. The National Institute on Aging explains that most home-based long-term care is help with these everyday activities, which it describes as including bathing, dressing, eating and taking medications, along with supervision to make sure the person is safe. Long-term care exists to meet these needs when a person can no longer do them alone.

The six activities of daily living are bathing, dressing, toileting, transferring (moving in and out of a bed or chair), continence and feeding. They come from the Katz Index of Independence in Activities of Daily Living, which the Alzheimer's Association's care planning toolkit recommends for measuring how independently an older adult manages basic self-care. Each of the six is scored as independent or not, so a score of 6 means full function.

Instrumental activities of daily living, or IADLs, are the more complex tasks needed to live independently, such as managing money, housekeeping, shopping for groceries, making telephone calls and taking medication. A 2020 systematic review of assessment tools describes them as activities that support daily life within the home and community, while basic activities of daily living are those oriented toward taking care of one's own body.

In long-term care, activities of daily living are the basic personal tasks that care is mostly designed to help with, such as dressing, bathing and using the bathroom. Medicare.gov explains that because most long-term care is this kind of non-medical help, Medicare and most health insurance do not pay for it. People may qualify for it through Medicaid if they meet their state's rules, or through private long-term care insurance.

Dementia usually affects the more complex instrumental activities first, such as preparing meals and managing money, and the basic activities of daily living later. The Alzheimer's Association's care planning toolkit notes that functional changes show up earlier in tasks that need higher thinking ability, so tracking them over time helps a clinician plan care and decide how to adapt the home to keep the person safe.