It is never easy for an adult child to know when it is time for their parent to move to an assisted living or long-term care community. It’s tough to know what to look for and how to evaluate your parent’s ability to live on their own. After all, you’re their child, not their doctor.
One of the ways in which someone’s suitability for an assisted living or long-term care community is evaluated is through an activities of daily living (ADLs) assessment.
Here’s how an ADL assessment works, who can perform an ADL assessment and how you can use some of these tools to get answers.
Why (And How) ADLs Are Measured
Activities of daily living are exactly what they sound like: they’re the things you do from day to day as an independent adult.
Researchers and medical professionals have spent decades defining ADLs and figuring out how to measure them in senior patients. Evaluating ADL ability provides a more concrete way of answering an abstract question — is it okay for this person to be living on their own? They’re also helpful in determining the best way to provide any necessary assistance to seniors.
“ADLs are one of the most important measurements used to determine the level of care an individual requires and what their care plan should entail,” author Carol Bradley Bursack writes in her article, Activities of Daily Living: Why This Measure Matters.
In terms of who provides ADL assessments, your parent can be assessed by their physician, or they may be referred to an occupational therapist. Additionally, if you’re considering an assisted living community or a long-term care community, trained professionals on staff can oftentimes provide an assessment or assist in finding someone who can.
“It is best to have a complete needs assessment conducted by a specialist (geriatric care manager, nurse, occupational therapist or social worker) to fully identify all problems, their root causes and potential solutions,” aging life care professional Carmel Froemke advises.
Activities of Daily Living Assessment for Your Parent
As we mentioned above, an ADL assessment should be completed by a professional. However, if you are wondering whether you should consult your parent’s doctor, there are some standard questions you can ask yourself and your parent to determine if it’s time to call a professional.
If Mom isn’t cooking anymore, how do you know if that’s a sign she needs assisted living or just a simple shift in her interests? If Dad keeps forgetting to take his medicine, does that mean he needs long-term care or is it just a normal sign of aging? Is that something you should go to his doctor about?
If you struggle with those kinds of doubts, you can use these resources to get a better idea of your parent’s needs.
Evaluating Basic ADLs
Initially, it’s important to know that there are two types of ADLs: basic and instrumental.
Basic activities of daily living are physical self-care tasks such as bathing, dressing, toileting and continence, transferring and feeding/eating.
Instrumental activities of daily living are a bit more complex. They include cooking, medication management, shopping, communicating via telephone, managing money and finances, performing housework, laundering clothing and driving or using public transportation.
Here’s a checklist to help evaluate your parent’s basic ADL ability. For each activity, check the column that best fits your parent:
| Activity | Can complete without supervision or assistance | Can only complete with assistance |
| Bathing | ||
| Dressing | ||
| Toileting | ||
| Transferring (getting out of bed or chair) | ||
| Continence (control of bladder and bowel) | ||
| Feeding (food may be prepared by someone else) |
Give one point for every check in the left column. If the check is in the right-hand column, give zero points. People with a score closer to six are more independent. However, if your parent ends up with a score closer to 0, it may be time to talk to a health professional.
How to Evaluate ADLs
As we all know, living on your own involves more than feeding and clothing yourself. If you’re trying to decide whether your parent is okay living on their own or if they need more assistance in a senior living community, you also need to evaluate their ability to complete instrumental ADLs.
You can use this IADL worksheet if you want to see what a medical professional will look at when they assess your parent. Here’s what you should ask yourself when thinking about your parent’s living situation:
- Can my parent make phone calls on their own to both familiar numbers and numbers they’ve looked up?
- Can my parent complete their own grocery and clothes shopping?
- Can my parent prepare or buy their own healthy meals?
- Can they keep their house acceptably clean on their own?
- Can they do their own laundry?
- Can they travel independently?
- Can they consistently and accurately take their medications?
- Can they manage their financial matters?
If you answered yes to all or most of these questions, your parent is likely still able to live independently. But if they need assistance with some or most of those tasks, that’s when you should talk with your parent about meeting with their physician.
Is Assisted Living or Long-Term Care Necessary?
After your parent’s doctor or another medical professional has evaluated your parent’s ADL ability, it may be time to start looking into assisted living or long-term care options for your parent.
If the doctor feels this is the case, there are a lot of helpful resources to assist in determining which community is the best for your parent. Learn more about the differences between long-term care and assisted living at the MacIntosh.
We hope this has been helpful! As always, contact us with any questions about long-term care or assisted living options at Optalis.
