Written by: patrick on June 24, 2010 @ 8:42 pm
In many of our past articles, we have mentioned ADL’s or Activities of Daily Living. Assisted Living was created to help people who have trouble with these ADL’s, but what are they, exactly? Well, that is the topic of this informative, if long article.
Depending on who you talk to, there are six, seven or even eight basic ADLs. The basic activities of daily living consist of self-care tasks: Every one agrees on these six…
Eating, bathing, dressing, toileting, transferring and continence
A seven or eight activity matrix will also include walking, grooming or both. I think the easiest way to identify and examine a basic ADL is to look at the day in a life of a human being.
On awakening we sit up in bed. The physical act of uncovering ourselves, swinging our legs out of bed and moving ourselves into a sitting position is, believe it or not, an activity of daily living. We are in the process of transferring ourselves from one position of rest to another. Whether we now move ourselves to a wheelchair or stand with or without a cane or walker, we are transferring. Can this be done without assistance? If not we definitely have a need. How about in a year? Will we still be able to? We must, as loving family members, be cognizant of the future needs as well.
Please note how easy it is to evaluate a person’s ADL needs by just imagining (or watching) them perform these activities that are common to us all. Okay now we are up. Heading to the bathroom; how are we getting there? Can we do it on our own? Do we need a walker? Are we in danger of getting lost or falling down? We are now looking into the ADL of walking or ambulating (ambulate – To walk; to relocate one’s self under the power of one’s own legs with or without aids, such as braces and crutches). Maybe we cannot walk but we can move ourselves independently with a wheelchair. Here we are still independent, even though we have lost walking ADL because we maintain the transferring ADL.
Just a little more on ambulation and seniors before we move on. Impaired mobility is a major concern for older adults, affecting fifty percent of people over 85 and at least a quarter of those over 75. As adults lose the ability to walk, to climb stairs, and to rise from a chair, they can become completely disabled. Trouble with ambulation is the number one reason people come to us for help. Becoming non-ambulatory is an instant and automatic need that has to be addressed.
Once we are in the bathroom we are going to have an opportunity to evaluate a number of ADLs. First let’s look at the possibility of accidents. As uncomfortable as it can be to talk about the fact is that many seniors face loss of bladder and bowel control. It is, unfortunately, common and just another of those things we have to deal with. Continence is voluntary control over urinary or fecal discharge, and if I become incontinent then I have needs that have to be addressed.
We are now in the bathroom and faced with toileting. A little confusing maybe but here we are talking about the ability to groom ourselves; to care for our appearance and to make neat. This ALD covers brushing teeth, shaving, hair and skin care, nails etc. Can I do these by myself or do I need help. Maybe I can do them but I need someone to remind me. Maybe I just need some supervision occasionally.
Okay, while I am in here, maybe now is a good time for bathing. Am I in danger of falling; do I no longer bath because I am scared? Do I just need someone to offer stand by assistance in case I loose my balance? Do I need reminders? This is a difficult ADL and in many cases this can be the first ADL which gives us difficulty. It is important to note when doing a needs assessment that the bathroom and especially the tub or shower can be a place of great danger. Be realistic when evaluating a loved ones safety in bathroom.
Now we are out of the bathroom, and we are ready to dress. Do I remember to put on clean clothes? Do I choose appropriate clothes? Can I tie my own shoes? Am I in danger of falling? Am I capable of independent dressing or is this one of my needs. This is a pretty strait forward need but do not forget to assess not only the physical ability but the mental capacity. Note that we said “remember to put on clean clothes” and “appropriate clothes”. The need to be supervised is just as much a need as a physical need.
Finally we have eating. This ADL is not concerned with the preparation of food so much as the actual mechanics of getting the food to my mouth, chewing and swallowing. Am I capable of moving food and consuming it without assistance? Can I cut food? Can I choose foods that are healthy for me and meet my personal dietary requirements?
One thing that we hope has been impressed upon you is similarity between physical inability to perform ADLs versus mental incapacity to plan and execute ADLs. Either shortfall establishes the same need. Having the physical ability to perform an ADL is not enough. We also must have the mental capacity to plan and navigate the ADL as well as the physical ability or we are incapable of performing without assistance.
I cannot stress enough the need for families to be honest and realistic when evaluating a loved ones needs. It is natural for us, as family members, to wish that loved ones conditions were better than they are and sometimes we can even fool ourselves into believing this. But an unrealistic needs assessment hurts everyone, especially the senior.
Tags: Activities of Daily Living, Assisted Living, assisted living education, assisted living placement, dementia care, Senior Citizen Needs, Senior Citizens
Catogories: Assisted Living Information, From the President, Senior Citizen Needs, assisted living education
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