Activities of daily living (ADLs)

Activities of daily living (ADLs) is a term used in healthcare to refer to people’s daily self-care activities. 

A person’s ability or inability to perform ADLs as a measurement of their functional status. 

ADLs now include some measure of mobility.

ADLs are more inclusive of the range of activities that support independent living.

ADLs are often used in the care of people with disabilities, people with injuries, and elderly people.

Younger children often require help from adults to perform ADLs.

Common ADLs include feeding oneself, bathing, dressing, grooming, work, homemaking, cleaning oneself after urinating and defecating, and leisure.

Some factors that influence peoples’ perception of their ADL function level include culture and education.

ADLs are categorized into basic, self-care tasks acquired starting from infancy, and instrumental, tasks learned throughout adolescence.

A person who cannot perform essential ADLs may have poorer quality of life or be unsafe in their living conditions.

Individuals may require the help of other individuals and/or mechanical devices: electric lifting seats, bathtub transfer benches, and ramps to replace stairs.

Basic ADLs consist of self-care tasks that include:

Bathing and showering

Personal hygiene and grooming 


Toilet hygiene: getting to the toilet, cleaning oneself, and getting back up.

Functional mobility, transferring, as measured by the ability to walk, get in and out of bed, and get into and out of a chair; moving from one place to another while performing activities.


The functional independence measurement (FIM) tool developed uses a 0-7 scale to rank different ADLs based on the level of assistance they require. 

A 7 on the scale means the patient is independent, whereas a 0 on the scale means the patient cannot complete the activity without assistance.

7 – Independent

6 – Modified Independent

5 – Supervision/Set-up

4 – Minimal Assist

3 – Moderate Assist

2 – Maximal Assist

1 – Total Assist

0 – Activity Does Not Occur

Instrumental activities of daily living (IADLs) are not necessary for fundamental functioning, but allow  an individual live independently in a community:

Cleaning and maintaining the house

Managing money

Moving within the community

Preparing meals

Shopping for groceries and necessities

Taking prescribed medications

Using the telephone or other form of communication

The American Occupational Therapy Association identifies 12 types of IADLs that may be performed as a co-occupation with others:

Care of others

Care of pets

Child rearing

Communication management

Community mobility

Financial management

Health management and maintenance

Home establishment and maintenance

Meal preparation and cleanup

Religious observances

Safety procedures and emergency responses


Occupational therapists evaluate and use therapeutic interventions to rebuild the skills required to maintain, regain or increase a person’s independence in all Activities of Daily Living that have declined because of health conditions, physical or mental, injury or age-related debility.

Physical therapists use exercises to assist patients in maintaining and gaining independence in ADLs. 

The exercise program attempts o improve walking speed, strength, balance, and coordination. 

Slow walking speed is associated with increased risk of falls. 

Exercise enhances walking speed, allowing for safer and more functional ambulation capabilities. 

Exercise for patients who are frail is essential for preserving functional independence and avoiding the necessity for care from others or placement in a long-term-care facility.

There are several evaluation tools, that capture basic activities of daily living.

Most models of health care service use ADL evaluations in their practice.

ADL evaluations are used increasingly in epidemiological studies as an assessment of health in later-life that does not necessarily involve specific ailments. 

ADL is measured on a continuous scale, making the process of investigation fairly straightforward.

Currently there is no good evidence to suggest ADL skills programs are effective for people with chronic mental illnesses. 

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