The Activities of Daily Living (commonly known as ADLs) and the Instrumental Activities of Daily Living (known as IADLs) are some of the most important concepts in senior living and senior care. First, programs that help pay for senior care and senior living, such as long-term care insurance and state Medicaid programs, often base the senior’s eligibility in part on the senior’s ability to accomplish their ADLs (with the threshold commonly being that a senior applicant is eligible for care coverage when they can no longer accomplish 2 or more of their ADLs on their own). In addition to often being the trigger for senior care coverage, it’s important to keep ADLs and IADLs in mind to always be aware of your or your senior loved one’s health status so that you can always stay on top of when it’s time to look for senior living or other forms of senior care. 

While ADLs and IADLs are common concepts in the world of senior living and senior care, there is no single, standardized way of measuring and assessing ADLs and IADLs. Not only do many states have their own way of defining and measuring a senior’s ability to accomplish their ADLs, there also exist several methods of measuring ADLs and IADLs throughout the medical community. To learn more about all the different ways in which ADLs and IADLs are measured, continue reading our guide below or reach out to the Sunbound team to learn more. 

ADLs v. IADLs overview

Before diving into the different ways that ADLs and IADLs are measured, it’s helpful to first do a quick overview of what specifically ADLs and IADls are and what the difference is between the two measures. ADLs are considered to be the most basic daily activities that seniors need to be able to accomplish in order to lead a fully independent life. Specifically, the 6 ADLs are: eating, continence, dressing, toileting, bathing, and transferring (meaning the ability to get in and out of furniture like chairs or bed). If you or your senior loved one is having trouble accomplishing any of the six basic ADLs it’s important to start thinking about senior care, whether provided in a community setting or at home.

IADLs, on the other hand, are activities that, while still important to leading an independent life, are slightly more involved and complex activities. IADLs include tasks like managing your finances, handling your own transportation to do things like go shopping, and being able to successfully manage taking and keeping track of medication. Just like with ADLs, failure to accomplish one or more IADLs can serve as an important warning sign that it is time to start thinking about longer term senior care.

Measuring ADLs and IADLs

As noted above, there are several different tests that are used to measure a senior’s ability to accomplish their ADLs and IADLs. Because it is quite likely that you or your senior loved one will see one or more of these tests while applying for and receiving senior care, it’s important to know how the different tests function, what they measure, and what their scores indicate. Some of the most common tests of ADLs and IADLs are explained in further detail below.

Katz Index of Independence in Activities of Daily Living

The Katz Index of Independence in Activities of Daily Living is a tool used to evaluate an individual's ability to perform basic self-care tasks necessary for daily living. It assesses six essential ADLs, including bathing, dressing, toileting, transferring, continence, and feeding. The Katz Index assigns a score of 0-6, with higher scores indicating greater independence in performing ADLs. This index is widely used in healthcare settings, particularly in geriatric care, to assess an individual's functional status and determine the need for assistance or intervention. The Katz Index is a valuable tool for healthcare professionals to develop care plans, track progress, and ensure that individuals receive appropriate care and support to maintain their independence and quality of life.

Lawton-Brody Instrumental Activities of Daily Living

The Lawton-Brody Instrumental Activities of Daily Living (IADL) test is a tool used to assess an individual's ability to perform complex activities necessary for independent living. It evaluates an individual's ability to complete tasks such as using the telephone, managing medications, handling finances, preparing meals, and using transportation. The Lawton-Brody IADL test consists of eight items and assigns a score of 0-8, with higher scores indicating greater independence in performing IADLs. This test is commonly used in healthcare settings to assess the functional status of older adults and individuals with disabilities.

Klein-Bell Activities of Daily Living Scale

The Klein-Bell Activities of Daily Living scale assesses a senior’s ability to perform the 6 basic ADLs by examining 170 different items. Each item is measured on a scale of 1-3 depending on the the item’s important to overall health, how long it takes to perform that task, the difficulty that non-disabled persons have with the task, and finally how burdensome it is to provide care for that task. These 170 different items then produce a score between 0 and 313 which then yields a percentage number signifying the senior’s ability to perform their ADLs.

Bristol Activities of Daily Living Scale 

The Bristol Scale measures a combination of both ADLs and IADLs and is commonly used to assess the degree to which a senior may be suffering from dementia. The test consists of 20 questions, with each question having 5 answers that range from being able to fully engage in the activity to not being able to engage in the activity at all (with a final option for stating that the activity is not applicable to the senior). Scores for the Bristol Activities of Daily Living Scale range from 0 to 60.

Barthel Index for Activities of Daily Living

The Barthel Index is a tool used to assess an individual's ability to perform activities of daily living (ADLs). It evaluates the individual's ability to complete ten essential ADLs, including feeding, bathing, grooming, dressing, transferring, toileting, stair climbing, and bowel and bladder control. The Barthel Index assigns a score of 0-100, with higher scores indicating greater independence in performing ADLs and a score of 100 indicating complete independence. This index is widely used in healthcare settings, particularly in rehabilitation and geriatric care, to assess an individual's functional status and determine the level of care and support needed. The Barthel Index is a valuable tool for healthcare professionals to develop care plans, track progress, and ensure that individuals receive appropriate care and support to maintain their independence and quality of life.

To learn more about how Sunbound can help make senior living more affordable for you or your loved one, send us an email at info@sunboundhomes.com or request more information on Sunbound. Sunbound is the best way to pay for senior living and is on a mission to make senior living affordable for everyone.