top of page

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 Long Term Insurance reimbursement, VA Eligibility and your own care needs.

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:

​

  1. Bathing (showers or sponge baths)

  2. Dressing (choosing appropriate clothes and putting them on)

  3. Eating (feeding oneself or need to be fed)

  4. Toileting and Continence (using a toilet)

  5. Ambulating (walking, need for a walker or wheelchair)

  6. 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.

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.

 

IADL tasks typically include:

  1. Managing finances,

  2. Transportation (driving or using public transit),

  3. Shopping for groceries or necessities,

  4. Preparing meals,

  5. Managing medications,

  6. Using communication devices like phones or computers,

  7. Maintaining the home (cleaning, laundry, basic upkeep, repairs).

 

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.

​

-post-ai-image-1809.png

What are Levels of Function or Levels of Care?

These are the 4 Basic Levels of Functionality:

  • Independent

  • Hands on

    • Stand-By Assistance

    • Requires Assistance (can be partial or full)

  • Dependent

Levels of Functionality Expanded with Definitions

​​

  • Level 1: Independent: Can perform a care task by themselves without direction or prompting

  • 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 

  • 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

  • Level 4: Dependent: Requires ongoing, daily support with all ADLs and IADLs, often required for individuals with advanced Alzheimer’s or dementia or bedridden.

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.

​

What qualifies as assistance?

  • Stand By Assistance

  • Requires Assistance (Partial or Full Assistance) 

  • Dependent

​​

bottom of page