Activities of Daily Living (ADL)

Activities of daily living are routine activities people do every day without assistance. There are six basic ADLs: eating, bathing, getting dressed, toileting, transferring and continence. The performance of these ADLs is important in determining what type of long-term care and health coverage, such as Medicare, Medicaid or long-term care insurance, a person will need as he or she ages. 

Nearly half of Americans who turn 65 -- a common retirement age -- will eventually enter a care facility because they are unable to perform specific ADLs. While the majority of care facility admissions will be for the short term (less than a year), about a quarter will stay longer than one year. Typically, long-term care insurance coverage for nursing costs requires an individual who is unable to perform two or more of the six ADLs. 

Being able to perform ADLs while aging is directly linked to independent living, as physicians and adult care social workers use ADLs to determine if a person needs assisted living or placed in a nursing home. Why are ADLs so important? Because these skills affect a person's ability to do housework, prepare his or her own meals, go shopping, drive or use public transportation and take prescription medication.

Those who need assistance with ADLs can opt for in-home, assisted living or nursing home care. In some cases, families can help those in need to make the decision between transitioning to an assisted-living community or opting for in-home care. In extreme cases, families may have to transition a person into a care facility without consent. 

Families often hire home-health workers to provide ADL assistance when the person resides at home or in an assisted-living community and needs some, but not total care. Home-health workers help a person engage in ADLs and support independent living by helping with daily activities such as going shopping, reminding him or her to take the correct medication, and accompanying him or her on walks. Health insurance may cover some or all of the cost of hiring licensed home-health workers, depending on the person's policy, and most licensed home-health workers are state-certified nurse aides.

Those who transition to nursing homes do so because they can only engage in few, if any, ADLs on their own. In most situations, when an individual transfers to a nursing home, a team of physicians, nurses and health aides supervises around-the-clock care at the facility.