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Understanding Everyday Care Needs

ADLs and IADLs Explained

Learn the similarities and differences of both, along with Levels of Assistance, also known as "Level of Care" or "Acuity". See how they matter to your family, Long Term Insurance reimbursement, VA Eligibility and your own care needs.

Levels of Assistance Also known as "Level of Care" or "Acuity"
Your Family
Long Term Insurance
VA Eligibility
Your Care Needs
Senior receiving assistance with activities of daily living
Understanding ADLs Basic self-care tasks used to understand independence and care needs.
Activities of Daily Living

What are Activities of Daily Living?

Activities of Daily Living (ADLs) are a standardized set of basic self-care tasks that are essential for an individual’s ability to live independently.

ADLs typically include fundamental or basic functions such as:

01
Bathing Showers or sponge baths
02
Dressing Choosing appropriate clothes and putting them on
03
Eating Feeding oneself or need to be fed
04
Toileting and Continence Using a toilet
05
Ambulating Walking, need for a walker or wheelchair
06
Transferring Moving from bed to chair, or standing

These activities are commonly used in healthcare, rehabilitation settings, LTC Insurance, the VA, and social services to assess a person’s functional status and determine the level of assistance or care they may require.

Instrumental Activities of Daily Living

What are IADLs?

Instrumental Activities of Daily Living (IADLs) are more complex daily tasks that allow a person to live independently in a community setting. Unlike basic self-care activities, IADLs require higher-level thinking skills such as organization, planning, and decision-making.

Senior receiving assistance with instrumental activities of daily living
Independent Living Support
Everyday Independence IADLs involve planning, organization and decision-making.
Recognizing Changing Care Needs

Difficulty with IADLs can be an early sign that someone may need additional support, even if they are still able to perform basic Activities of Daily Living (ADLs) independently.

Daily Independence

IADL tasks typically include:

01
Managing Finances
02
Transportation Driving or using public transit
03
Shopping Shopping for groceries or necessities
04
Preparing Meals
05
Managing Medications
06
Using Communication Devices Using phones or computers
07
Maintaining the Home Cleaning, laundry, basic upkeep, repairs
IADLs & Independence These more complex activities help show how well someone can manage everyday life within their community.
Understanding Care Needs

What are Levels of Function or Levels of Care?

These are the 4 Basic Levels of Functionality:

01
Independent
02
Hands on Stand-By Assistance
03
Requires Assistance Can be partial or full
04
Dependent
Levels of Functionality Support increases as an individual requires more assistance with ADLs and IADLs.
Expanded Definitions

Levels of Functionality Expanded with Definitions

01
Level 1

Independent

Can perform a care task by themselves without direction or prompting

02
Level 2

Stand-By Assistance

Requires a caregiver to stand-by when a client is performing ADLs or IADLs, may require hands-on intervention or prompting

03
Level 3

Requires Assistance

Can be partial or full

Minimal Assistance (Companion Care)

Hands-on care with minimal assistance with ADLs or IADLs

Moderate Assistance (Personal Care)

Provides hands-on assistance with ADLs and IADLs, such as bathing, dressing, grooming, toileting, meal prep, and medication reminders

04
Level 4

Dependent

Requires ongoing, daily support with all ADLs and IADLs, often required for individuals with advanced Alzheimer’s or dementia or bedridden.

Understanding ADL Evaluations

What Long Term Care Insurance and the VA look at When Evaluating ADLs?

Basically, most LTC insurance or a VA Nurse evaluates the client to see if they require assistance with at least 2 out of the 6 ADLs. Some LTC insurance companies will either send out a nurse or if the agency uses nurses for evaluations they may ask for the Initial Assessment or the latest Evaluation.

2
ADL Evaluation Assistance with at least 2 out of the 6 ADLs

This is what most LTC insurance or a VA Nurse evaluates when reviewing a client’s level of assistance.

Evaluation Documents Initial Assessment or Latest Evaluation

Some LTC insurance companies may send out a nurse or request an Initial Assessment or the latest Evaluation when the agency uses nurses for evaluations.

Levels of Assistance

What Qualifies as Assistance?

The following levels of support may be considered when evaluating assistance with ADLs.

Assistance Level 01 Stand By Assistance 01
Assistance Level 02 Requires Assistance Partial or Full Assistance 02
Assistance Level 03 Dependent 03
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