ADL’s and IADL’s: What’s the Difference?

Links to other postings about ADL’s are at the bottom.

In an earlier post I was not as accurate as I should have been about activities of daily living. The functional tasks in the daily lives of older seniors are divided into two parts, activities of daily living (ADL’s) and instrumental activities of daily living (IADL’s).

Activities of daily living are the tasks that are required to get going in the morning, get from place to place using one’s body, and then close out the day in the evening. They involve caring for and moving the body.

walking
bathing
dressing
toileting
brushing teeth
eating

Instrumental activities of daily living are the activities that people do once they are up, dressed, put together. These tasks support an independent lifestyle. Many people can still live independently even though they need help with one or two of these IADL’s. They include:

- cooking
- driving
- using the telephone or computer
- shopping
- keeping track of finances
- managing medication

This article, Measuring the Activities of Daily Living: Comparisons Across National Surveys was jointly written by social scientists at the Brookings Institution and the U.S. Department of Health and Human Services. It appeared in the Journal of Gerontology: SOCIAL SCIENCES (Vol. 45, No. 6, S229-237). The article focuses mostly on policy, but it gives a good overview of activities of daily living and the wide-ranging research that has been conducted.

IADL’s are the most difficult to discuss with parents. In essence, from the adult child’s point of view, it feels like we are telling parents that they are not doing a good job with the things that make and keep them independent (and in some ways if we are initiating a conversation it is because we are concerned that things are not going quite right). Every adult child who have spoken to comments about feeling like an intruder on their parents’ turf when issues of driving or finances need to be addressed. The intergenerational communication process that involves parents gradually ceding responsibilities and adult children accepting them is complex.

We are fortunate that both sets of our parents have been exceedingly clear. They have encouraged us to learn (albeit slowly, carefully, and not too assertively) about their lives, finances, and end-of-life plans. Yet it is a delicate process requiring deftness and tact on both sides and not without tension.

No one willingly gives up independence.