Activities of Daily Living (ADLs)
Whether a person needs long-term care and what care she needs are determined by a healthcare professional, such as a physician, nurse, or medical social worker experienced in long-term care. An important part of the process is an assessment of the person’s ability to perform activities of daily living (ADLs) — basic functions required for a person to take care of herself. The inability to perform ADLs is the most reliable and objective indicator of the need for long-term care services.
The following six ADLs are commonly used to assess this need:
| ADL | Description |
|---|---|
| Bathing | Washing oneself by sponge bath or in a tub or shower, including getting into and out of the tub or shower |
| Dressing | Putting on and taking off all clothing and any necessary braces, fasteners, or artificial limbs |
| Toileting | Getting to and from the toilet, getting on and off the toilet, and performing associated personal hygiene |
| Transferring | Moving into or out of a bed, chair, or wheelchair |
| Continence | Being able to maintain control of bowel and bladder function or, when unable to maintain control, being able to perform associated personal hygiene (including caring for a catheter or colostomy bag) |
| Eating | Feeding oneself by getting food into the body from a receptacle such as a plate, cup, or table, or by a feeding tube or intravenously |
Cognitive Impairment
The inability to perform ADLs constitutes functional (or physical) impairment. However, some people can perform all ADLs but still need long-term care because of a cognitive impairment — a condition (such as Alzheimer’s disease) that causes a significant diminishment of reasoning, intellectual capacity, or memory and results in confusion, disorientation, impaired judgment, or memory loss.