IADLs vs ADLs: What is the Difference?

In health support services, terms are used to help evaluate a person’s ability to perform tasks related to everyday life. Two of the most common terms are IADL and ADL. When you hear these terms, this is what they refer to:

What are IADLs?

• IADL is an acronym for Instrumental Activities of Daily Living. IADLs aren’t considered to be necessary for human survival, but they do support a high quality of life. Instrumental Activities of Daily Living are more complex than ADLs. They involve multiple steps, often requiring a level of learned skills, the ability to focus, having patience, and more.
• IADLs exist in many aspects of daily life. As life becomes more complicated, the number of IADLs that a person may need to complete may grow. In fact, when people talk about simplifying their lives, it often includes elimination of one or more IADLs.
• IADLs often involve stressors. This is because IADLs often include the need to be with others, interact with others or to participate in an environment that is outside of the individual’s control. For example, operating a motor vehicle is an IADL. Most people have experienced feelings of frustration while driving or being caught in heavy traffic. For individuals who are sensitive to stress or triggered by stress, engaging in an IADL such as driving may eventually become impossible. For others, mastering the skills needed to safely operate a motor vehicle may not be possible due to cognitive challenges.
• Not all IADLs are practical or possible for some people. This is why the services of an organization like ours are so helpful for so many people.

Examples of IADLs

To better understand what IADLs are and to get a clearer picture of what is involved in IADLs, it’s helpful to review common examples.

Examples of IADLs include tasks such as:

1. Managing Finances

This IADL involves things such as paying bills on time, adhering to a budget, understanding cash flow, balancing a checking account, handling pocket money, understanding currency, using primary math skills, managing assets, etc.

2. Home Maintenance

This IADL involves tasks such as monitoring home repair needs, washing dishes, cleaning floors and furniture, tidying up, organizing possessions, arranging for professional repairs/maintenance, operating a thermostat/air conditioning unit, etc.

3. Communication

Communication is an IADL that covers a broad range of activities, such as calling utility companies, banks, landlords and more. Also included is the ability to communicate with doctors and to express problems or ask questions in a coherent manner. Today, it also involves the use of technology such as emails, texting and using a smart phone. It also includes being able to communicate with medical emergency agencies if needed.

4. Medication Management

Medication management is an IADL that includes being able to take prescribed medication on time and at the correct dosage. Also, keeping track of when medication has already been taken, self-monitoring for reactions/side effects, requesting refills before running out of medication, and even keeping prescription medication in a safe place where visiting relatives—such as children—can’t access it.

As you can infer from these examples, these IADLs and others require advanced abilities that go beyond simple, everyday tasks, such as ADLs.

What are ADLs?

ADL is an acronym that stands for Activities of Daily Living. This category of activities relates to self-care that is more connected to health and survival.

Unlike IADLs, ADLs are essential aspects of daily life. They consist of a minimum of tasks that must be completed in order for an individual to be healthy and have their basic needs met. Most people engage in ADLs every day without even thinking twice about their ability to do so. By the time a person has reached the kitchen in the morning, they’ve typically already:

• checked the time/turned off the alarm clock
• used the bathroom
• brushed their teeth
• considered their list of tasks to accomplish that day

For others, completing ADLs requires more effort, concentration and/or assistance. Our nonprofit provides individuals with ADL services when needed.

Examples of ADLs

To better understand ADLs and to get a clearer idea of their importance, it’s helpful to consider the most common examples.

Examples of ADLs include activities like:

1. Mobility

Being able to move from one place to another, using whatever means is possible. This may mean walking, using a walker, a cane or a wheelchair. This ADL also includes the ability to roll over/change position in bed or in chair to provide for physical comfort. Mobility is crucial for many reasons, including keeping joints active, movement of the body, accessing food and water, reaching out for help via telephone or a door buzzer, accessing toilet and bathing facilities and even leaving a room where the person’s life is in danger (i.e., a fire breaks out, etc.)

2. Eating

This ADL entails the ability to open the mouth, chew and swallow nutritious food. It also entails the ability to keep the food down to allow the body to properly digest it.

3. Drinking

This ADL entails the ability to ingest liquids from a cup, straw or spoon, and the ability to swallow liquids and to keep the liquids down.

4. Bathing

This includes the ability to use soap and shampoo to wash the face, body, and hair. It also includes having the physical capability to bend and stretch limbs and hands in order to reach the areas of the body that need to be washed.

5. Dressing

This ADL entails being able to manipulate textiles in a manner that the person can dress themselves. This includes using buttons and zippers, pulling a garment over the head, pushing arms through sleeves, etc.

6. Using the Toilet

This ADL encompasses the ability to sit on a toilet seat, extract bodily fluids and waste, and clean the private bodily parts afterward.

7. Grooming

Grooming is an ADL that involves brushing teeth, cleaning and inserting dentures and/or bridges, combing or brushing hair, clipping fingernails and/or toenails, cleaning ears, applying deodorant as needed, etc.

8. Minor Sickness Self-Care

This category of ADL is often overlooked, but it includes managing minor conditions such as a light cold that does not require a doctor’s care. It includes the ability to use a tissue to blow the nose, wipe the eyes, apply a compress to the forehead for a headache, etc.

What is the Difference between IADLs and ADLs?

There are distinguishing differences between IADLs and ADLs, as outlined in the lists of examples above.

IADLs are activities that are commonly associated with adulthood and personal responsibility. For example, children do not need to engage in IADLs because they are taken care of by parents or guardians. For that reason, IADLs are not considered to be mandatory in life. However, IADLs enable an individual to have a level of freedom and independence, in addition to personal growth, without help from others.

That is not to say that individuals who can’t manage IADLs cannot have those things. IADLs are not considered essential to daily life, because it is possible to get assistance with IADLs.

Those who can’t manage IADLs can still enjoy freedom, independence and personal growth. The difference is that those individuals will need support from an organization like ALSO. ADLs are activities that are considered indispensable for survival. Without ADLs, an individual would certainly need disability support services.

The Significance of IADLs and ADLs in the Lives of People with Disabilities

Evaluating IADLs and ADLs in persons with disabilities is a crucial step in determining what services they need. This type of assessment helps physicians, caregivers, family members and outside agencies to make decisions that will directly impact the individual’s quality of life and access to needed resources.

IADLs and ADLs assessments are even used by agencies such as Medicaid, Medicare, and insurance companies to inform which services will be paid for in full or in part.

Therefore, IADL and ADL determinations have great significance for people with disabilities and their loved ones.

Disability Support Services at ALSO

At ALSO, we support individuals with developmental and intellectual disabilities in a variety of ways, including both IADLs and ADLs. We adhere to what we call a “wrap around” approach to supporting an individual’s needs. Another way to look at it is comprehensive, whole health support where needed.

Our services include, but are not limited to:

• personal assistance
• camaraderie
• transportation
• medical support
• medication management
• in-house living support
• behavioral health support

We do not subscribe to a “one-size fits all” approach. Instead, we work closely with medical professionals and family members to tailor a customized support program that best matches a person’s needs at that time.

An important aspect of the disability support services at ALSO is the ongoing re-evaluation of needed support. It’s very common for needs to change and grow or decrease over time. An individual may gain skills that mean they no longer need certain services. Minimizing support in that area is important to allow for increased confidence and feelings of independence for that individual.

On the other hand, as a disabled individual’s condition progresses, either through aging or progression of a disease, they may need more services as time goes on.

ALSO is ready to pivot, adjust and be flexible to an individual’s changing needs. This is what we mean when we say we are ready to help as needed. We believe in choice. We believe in supporting independence and freedom as much as possible. We believe in our mission to promote the full inclusion of people experiencing disabilities in the life of their community, and we believe that everyone has a right to quality of life.