If you are searching for the right senior living community for yourself or your loved one, the first step is to determine what type of care or support is best for your current and future needs. For independent, active older adults, independent living retirement communities are often the best option, as they offer extensive amenities and services. However, retirement communities also offer limited caregiver support, which means if you need some type of assistance, independent living is likely not your best choice.
Instead, you might find yourself searching for assisted living, memory care, or skilled nursing communities. But how can you know which one provides just the right amount of caregiver support that you need? Understanding activities of daily living, or ADLs, is your first step.
What are Activities of Daily Living?
Activities of daily living, or ADLs, are tasks that we all do to care for ourselves. Activities of daily living include:
- Bathing or showering
These are all personal care tasks that we must do daily to stay healthy and safe. Because we all do these ADLs, it makes activities of daily living an excellent assessment tool for many senior living communities.
What are Instrumental Activities of Daily Living?
Instrumental activities of daily living, or IADLs, are more complex tasks that allow us to live independently in our homes and communities. IADLs include:
- Food preparation, including planning, shopping, and preparing
- Managing finances and a budget
- Housekeeping and household upkeep
- Transportation, whether driving or scheduling transportation
- Medication management
- Managing communication with others, including operating a telephone
Instrumental activities of daily living are more complex and require more critical thinking than other ADLs. This makes IADLs an excellent benchmark for assessing adults living with cognitive decline due to Alzheimer’s disease or another type of dementia.
How Senior Living Communities Use ADLs and IADLs
As you begin to research senior living communities, you will find that they will ask about ADLs and IADLs as they get to know your loved one. Before any resident moves into their community, a representative will review the older adult’s medical history and assess their ability to perform ADLs. They will determine if the older adult can do each ADL independently, with minimal assistance, with maximum assistance, or with complete assistance. This feedback will help the senior living community determine if they are able to provide the care that the adult needs to stay healthy, safe, and comfortable.
Assisted Living and ADLs
Assisted living communities typically excel at providing assistance to adults who need some type of support with no more than 3 activities of daily living. This means if your loved one needs some support with showering, grooming, and transferring, they might be a good fit for assisted living. In contrast, if your loved one needs complete assistance with showering, dressing, grooming, and transferring, they would likely not be a good fit for services provided in an assisted living community, unless the community allowed you to pay additional fees for the additional support.
For a memory care community that operates under an assisted living license, residents will typically need some support with up to 3 activities of daily living.
Many state regulatory bodies do not allow assisted living communities to care for residents who have complex and complete care needs.
Skilled Nursing and ADLs
Skilled nursing facilities have more licensed staff available and can care for residents who require maximum or complete assistance with their activities of daily living. If your loved one requires maximum or complete support with multiple activities of daily living, skilled nursing might be your best choice.
Understanding Your Situation
In order to know what type of senior care to search for, it can be helpful to begin by looking at the type of support you or your loved one need for each activity of daily living. Here are some questions to ask yourself when considering this:
- Can your loved one independently take a shower? This includes knowing when to take a shower, knowing how to safely operate the shower, and how to independently wash themselves. If they need help, what type of help do they need? Minimal help, such as a reminder from you that it’s time to take a shower or you to stand by the bathroom door in case of emergency? Complete assistance would include a caregiver needing to do all tasks for the person.
- Can your loved one independently dress and groom themselves? This includes knowing when to change into clean clothing, choosing appropriate clothing, and taking care of their shaving, oral care, and hair care. Minimal assistance might include you laying out clothing or supplies for them while maximum assistance would be needing a caregiver to do all tasks for them.
- Can your loved one go to the bathroom independently? This includes knowing when it is time to go to the bathroom and performing hygienic tasks. Minimal assistance would be needing someone to stand outside the bathroom door in case of emergency while complete assistance would mean a caregiver needs to perform pericare. If your loved one uses incontinence products, can they take care of those independently or do they need assistance?
- Can your loved one transfer from bed to chair, chair to chair, or chair to standing? Minimal assistance means a caregiver providing hands on support while complete assistance means a caregiver needing to use a mechanical lift.
- Can your loved one get from place to place in the home independently? Minimal assistance would mean you might need to hold their elbow while they move from the living room to the kitchen. Complete assistance would mean that a caregiver needs to push them in a wheelchair to and from places in the home.
- Can your loved one eat and drink independently? This does not include meal planning or preparation, but the physical act of eating and drinking. Complete assistance would include a caregiver feeding the senior.
If you aren’t sure what type of support your loved one needs, ask them. You can also speak with your loved one’s physician to get a better idea of what type of ADL assistance they might need now and in the future. The physician will be happy to help and can provide more detailed information that can help you narrow down your senior living search.
The Glen is a Life Plan Community and offers the full continuum and levels of living: independent living, assisted living, memory care and skilled nursing. To learn more, visit www.theglen.org.