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When it becomes obvious that a loved one can’t get through a day without assistance, the logical next step is to begin looking into resources that can provide the support they need. One of the first things a long-term care insurance company, home care company, adult day care center or assisted living facility will ask about is the senior’s ability to perform activities of daily living (ADLs). But what are ADLs, and why are ADLs important?

What Are Activities of Daily Living?

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Every field has its jargon and the long-term care industry is no exception. In the business of providing care, the phrase “activities of daily living” is used often and for good reason. Activities of daily living refer to the basic skills needed to properly care for oneself and meet one’s physical needs in six areas: eating, dressing, bathing, toileting, continence and mobility.

What Do Activities of Daily Living Measure?

ADLs are used as indicators of a person’s functional status. Of course, a senior’s functional abilities aren’t necessarily identical across all six areas. A person may be totally independent, require minimal or moderate assistance, or be completely dependent on another person in each area. These finer details are used to determine the level of care a senior requires and what supportive services their care plan should include.

How Do Age and Health Conditions Affect One’s Ability to Perform ADLs?

“A decline in the ability to perform ADLs is often due to a medical condition or general weakness that has increased with age,” explains Carmel Froemke, a statewide outreach coordinator at the Community Action Partnership of North Dakota. “Most family members pick up on a loved one’s decline through secondary signs of a problem, such as changes in their routines or appearance. These red flags typically indicate there is a more serious underlying issue that is interfering with their ability to perform self-care.”

Read: How to Determine an Aging Parent Needs Help at Home

Advancing age can naturally cause a decline or impairment in physical functions in otherwise healthy individuals. Health conditions that affect musculoskeletal, neurological, circulatory or sensory systems can also affect a senior’s ability to perform ADLs. Other more subtle factors, such as social isolation, medication side effects and certain characteristics of a senior’s home may make self-care increasingly difficult and unsafe as well.

For instance, if an older adult is wearing the same outfit each time you see them, it may be because they have lost the flexibility or dexterity needed to put on and fasten other clothing items they own. Simply switching from conventional clothing to adaptive clothing might allow for more independent dressing. Solutions could include bottoms with elastic waistbands, shoes with Velcro fasteners instead of laces or buckles, or shirts with magnetic front closures instead of pullovers and button-downs. In other cases, these symptoms may indicate changes in balance, coordination, energy levels and/or cognitive function, and a need for assistance with dressing.

Another common example is significant changes in personal hygiene practices. If a fear of falling in the shower or bath is the driving force behind a senior bathing infrequently, the solution could be as simple as implementing appropriate home safety measures, such as grab bars, non-slip floor mats or a shower chair. If durable medical equipment and home modifications for aging in place still do not solve the problem, then hands-on care from a family member or bath visits from a home health aide may be in order.

Most seniors want to maintain their independence for as long as possible, so they are often reluctant to tell someone they are having increased difficulties. They may fear having to move away from their home and comfort zone. However, Froemke points out that an honest evaluation of an elder’s ability or inability to perform ADLs will allow for the here development of a customized plan of care that will enable them to continue living as safely and independently as possible while ensuring their needs are still met.