In this blog series, we will examine the differences between activities of daily living (ADLs) and instrumental activities of daily living (IADLs), and what happens when they become difficult for a person.
In part one of our blog series “ADLs vs. IADLs,” we defined activities of daily living (ADLs) as the key self-care tasks, like bathing and dressing, a person must be able to perform in order to live independently, and in part two, we discussed the various options when ADLs become challenging. But it is also important to understand that there is a difference between ADLs and instrumental activities of daily living (IADLs).
What are IADLs exactly?
Instrumental activities of daily living, or IADLs, are the everyday, sometimes complex tasks that let a person live independently in the broader community. Some examples of IADLs include:
- Managing money and bills
- Shopping for groceries
- Preparing meals
- Using transportation or driving
- Managing medications and appointments
- Using a phone or technology
- Keeping the home reasonably clean
Occupational therapists and geriatric clinicians use IADLs as a gauge to understand how well someone can cognitively and physically handle such day-to-day tasks that allow them to remain safe, healthy, and self-sufficient.
The difference between ADLs and IADLs
Sometimes people confuse IADLS with ADLs, but there are important distinctions between the two terms.
ADLs, or activities of daily living, are the basic personal care tasks like bathing, dressing, toileting, transferring, eating, and mobility that a person must be able to safely and effectively complete in order to live on their own. IADLs, or instrumental activities of daily living, on the other hand, are the more complex tasks needed to manage a household and live independently in the community — again, things like shopping, paying bills, and managing medications.
Importantly, it is common for an older adult’s ability to accomplish IADLs to decline before their ability to perform ADLs diminishes, so trouble with IADLs can be an early signal that extra support or care services may soon be needed.
How IADLs affect safe, independent living
Being able to manage IADLs safely and effectively is what separates “living alone” from truly living independently. Even if a person can dress and feed themself (good ADL function) they may struggle to remain living independently if they can’t do the grocery shopping, manage medications, or navigate transportation in order to stay healthy and connected.
Population studies show IADL limitations are common and closely linked with chronic conditions and cognitive decline, which in turn increase health risks, emergency room visits, and even unplanned moves to higher-level care settings such as assisted living. Indeed, consider the potential for health issues due to missed medications or poor nutrition, financial troubles from unpaid bills, and/or social isolation due to poor mobility or difficulties with driving or using mass transit.
Early signs that IADLs are becoming a problem
Healthcare professionals like occupational therapists and nurses are trained to assess a person’s cognitive function and physical capabilities to ascertain if IADLs are becoming challenging, necessitating certain care services or even a move to a long-term care community.
But even if you aren’t a trained expert, there are certain indicators that you can watch for to determine if a loved one may be struggling with IADLs. Take note of issues like:
- Unpaid bills or confusion about finances
- Missed or incorrect medications, or difficulty understanding dosage directions
- Skipped grocery shopping, reliance on processed meals, or unintended weight changes
- Avoiding driving or missing appointments because transportation is difficult
- Falling behind on basic home upkeep and safety measures (e.g., piles of unopened mail, spoiled food, or unsanitary living conditions)
- Trouble using the phone or managing appointments, leading to social isolation or neglected health care
Confronting IADL red flags head-on
As we age, it’s normal to occasionally miss a dose of medication or forget to mail a bill on time. However, if issues with these or other IADLs become common, it’s important to recognize that they’re not just “inconvenient.” They’re tangible, quantifiable warnings that a person may soon require new or additional support.
In next week’s blog post, the fourth and final installment in our “ADLs vs. IADLs” series, we will examine the most common options when IADLs become difficult for you or a loved one, as well as some practical steps you can take to assess and address long-term IADL needs.
By myLifeSite