IADLs: Juggling Instrumental Activities of Daily Living in Middle Age

I’ve had some new insights about the instrumental activities of daily living (IADLs), the activities that we do each day that allow us to maintain an independent life. These tasks include things like driving, balancing a checkbook, cooking, and using the computer. From my perspective, after working with a parent who was ill with stroke-induced dementia, I’d also add exercising.Activities of Daily Living

In 2009, when my husband’s mother was quite ill, I wrote a post called ADLs and IADLs: What’s the Difference?  I wrote this post because I had not heard of these two types of activities — measures of a person’s independence. At the time, as I observed my mother-in-law’s decline, I associated them with aging — and aging only.

Now I know a bit more, and I realize that any of us can lose, temporarily, our capacity for IADLs — the ability to perform those all-important tasks of independent daily living.

I’ve written about the my retina problems over the past two years. What has surprised me at various points — unexpectedly — is the loss of my ability to perform many of the IADLs.  At times, due to various treatments, I’ve been unable to use a computer, drive, exercise, or even cook efficiently, and I’ve not been at all happy about loosing my cherished independence. OK, at times I’ve been resentful. On another level, however, my experience offers me a bit more perspective on the adult child-aging parent relationship.       Continue reading

Dementia Reality Tour

Click to visit the slide show.

An article in the San Jose Mercury News describes a multi-sensory experience that simulates the perceptions and struggles of a person suffering from dementia. In Santa Clara ‘Dementia Reality Tour’ Shows What It’s Like to Live with the Affliction, Mercury News reporter Helen Shen describes how the simulation asks caregivers to complete routine activities of daily living (ADLs) while wearing gloves, goggles, socks, and certain accouterments that approximate the perceptions of a person with the brain disease.

Rick Carson of Immersion Reality Education designed the activities for family members to give them a sense of what it’s really like. The article includes reactions from many family members who find that the activities are helping them gain more understanding of their family member with dementia.

Read the story and take a few minutes to look at the slide show of participants completing the various tasks.

Caring About the Patient While Caring for the Patient – UChicago

Click here to visit the U of Chicago announcement site and watch a video.

The Bucksbaum Foundation has donated $42 million to the University of Chicago to create an institute that concentrates on clinical excellence with a focus on partnering with patients. What a common-sense, and timely idea. Disclosure: I have a graduate degree from U of C.

As university president, Robert J. Zimmer comments in the press release:

This generous gift offers the opportunity to bring a new level of rigor to the study of the doctor-patient relationship and clinical judgment. The Bucksbaum Institute for Clinical Excellence provides an important complement to the biological research and clinical strengths of this institution.

The main focus? Developing the environment for better communication thereby ensuring better patient care (and better outcomes when it comes to recovery). Adult children who are helping older senior parents through medical care often find that communication gaps occur frequently and are complicated by information overload and reticence of older patients to ask questions.

According to the announcement on the website: Continue reading

Aging Seniors: What a Difference a Word Makes #2

Words matter, especially words that describe people who are aging. In every day conversation, disrespectful phrases such as “old people” or “old folks,” are commonly used. My parents and many of their friends detest these comments.

This week I listened to a podcast of a panel discussion, produced by a well-known media outlet, and buried in the interesting content were comments such as “too old” and “not all there.” So many of these words emphasize the gap between older and younger people. The problem is ageism, plain and simple.

Virginia Mennonite Retirement Community Supportive Language Card, Side 1

Growing old is a normal part of life, and while it can be hard work, most people manage it quite well with intellects intact.

Yet keeping a sense of self, not to mention pride, is a daily challenge so rigorous that perhaps it should even be added to the activities of daily living (ADL’s). Older seniors navigate a minefield of unintentional (my dad calls them tacky) comments and references designed to trivialize. The International Longevity Center, founded by the late Dr.Robert N. Butler (NY times Obituary), posts this short article, Old Age has Value in Today’s Youth-Oriented Society by Ithaca College Gerontology Professor John A. KroutDr Krout also heads the Ithaca College Gerontology Institute.

Some communities are trying to address the problem. Continue reading

Senior Parents: What a Difference a Word Makes

Words matter, especially words that describe people who are aging. In every day conversation, disrespectful phrases such as “old people” or “old folks,” are commonly used. My parents and many of their friends detest these comments.

This week I listened to a podcast of a panel discussion, produced by a well-known media outlet, and buried in the interesting content were comments such as “too old” and “not all there.” So many of these words emphasize the gap between older and younger people. The problem is ageism, plain and simple.

Virginia Mennonite Retirement Community Supportive Language Card, Side 1

Growing old is a normal part of life, and while it can be hard work, most people manage it quite well with intellects intact.

Yet keeping a sense of self, not to mention pride, is a daily challenge — maybe this challenge should even be added to the activities of daily living (ADL). Older seniors navigate a minefield of unintentional (my dad calls them tacky) comments and references designed to trivialize, and it’s no small challenge. The International Longevity Center, founded by the late Dr. Robert N. Butler (NY times Obituary), posts this short article, Old Age has Value in Today’s Youth-Oriented Society by Ithaca College Gerontology Professor John A. Krout. Dr Krout also heads the Ithaca College Gerontology Institute.

Some communities are trying to solve the problem.

Continue reading

Activities of Daily Living — Declining Proficiencies

What signs illustrate a person’s increasing difficulty performing the activities of daily living (ADLs)?

At first they are not obvious. Instead a series of events and behavior changes gradually appear. Observed individually, each change doesn’t seem to represent much, but the trick is to view each observation as a puzzle piece that fits together with other observations and puzzle pieces. The complete picture can also be obscured by confusing resistance with skill difficulties –because the distress of a parent often manifests itself as irritation with others who are around in a living environment. Decisions about driving and assisting with finances -which had already occurred –were easy compared to understanding and acting on the discrete daily activities that made our parent’s daily life increasingly complet.

As much as a year can pass — what it took us — before an adult child puts together enough evidence to conclude that a parent’s ability to handle the activities of daily living is on the decline. In our experience, and that of people with whom we have spoken, an adult child’s lack of familiarity with the skill changes delays the decision to arrange additional support, and this delay appears to hasten a person’s difficulty with the activities of daily living –so things get worse faster. We wish that somewhere we had encountered something similar to the information below to help us understand more clearly what was happening to our parent.

Below we have reconstructed the order of the decline.

Continue reading