Understanding Instrumental Activities of Daily Living

Activities of daily living relate to personal care and are central components of day-to-day living. At times, instrumental activities of daily living are lumped together with activities of daily living. Technically speaking, there is a difference. Instrumental activities of daily living are more complex tasks that are vital to truly independent living.

Examples of activities of daily living include:

  • Bathing
  • Dressing
  • Grooming
  • And similar basic tasks

On the other hand, there are eight recognized instrumental activities of daily living. Instrumental activities of daily living are used to assess a senior’s ability to be self-sufficient and aid in determining what supportive services would assist a senior in living independently.

Instrumental activities of daily living tend to weaken during the earlier stages of an illness or cognitive decline. On the other hand, activities of daily living often weaken in the middle of later stages of impairment.

What Are the Eight Instrumental Activities of Daily Living?

The eight instrumental activities of daily living are:

  • Cooking: Is a senior able to plan, prepare, and serve adequate, nutritious meals?
  • Managing Medications: Is the senior capable of taking the correct doses of medications at the right times? Is the individual capable of those above if their medications are organized in different dosages in advance?
  • Shopping: Is the senior able to independently shop for all needs, including clothing, personal care items, and groceries?
  • Communicating Via Telephone: Can the senior operate a telephone and look up and dial telephone numbers?
  • Managing Money and Finances: Is the senior able to independently make and follow a budget, write checks, pay bills, make trips to the bank, and monitor their income and expenses?
  • Performing Housework: Can the senior maintain an acceptable level of cleanliness throughout their home?
  • Driving or Using Public Transportation: Is the senior able to drive, use public transportation, or arrange for a taxi service?
  • Laundering Clothing: Can the senior wash and dry their laundry?

Assistance With Instrumental Activities of Daily Living

If a senior is capable of tending to his or her personal care, to tend to basic activities of daily living, he or she may still need assistance with the more complicated instrumental activities of daily living. In the United States, a family member is the most common caregiver for a senior who needs assistance with instrumental activities. When it comes to that type of caregiver, the family member most commonly assisting is either a spouse or an adult child.

Beyond family members, professional in-home care agencies are an option for instrumental activities of daily living.

In-home care is non-medical assistance with instrumental activities of daily living (as well as basic activities of daily living, if necessary). This assistance is provided in the comfort of a senior’s own home.

This type of assistance is for seniors who want to remain at home and do not want to move at this time to a senior living facility. These people need minimal support to maintain their independence and can benefit from the added support of an in-home caregiver.

In-home caregivers are sometimes called professional caregivers or private-duty aides. A professional caregiver’s assistance can include helping with household and personal tasks. It can also have support from family members so that a senior can continue living at home as they grow older. As a senior’s needs increase, in-home care plans can be updated to provide increasing levels of care as necessary.

In-Home Care Contrasted With In-Home Health Care

There are times when in-home care is confused with in-home health care. As mentioned previously, in-home care (whether to assist with activities of daily living or instrumental activities of daily living) does not involve providing medical support or assistance to a senior.

In-home health care is defined as:

In-home Health Care is assistance for a senior prescribed by a physician to treat illness or injury or aid recovery at home. There can be some overlap between home care and home health care. All of the services that a professional caregiver or personal care aide provides can be provided by an in-home care agency. However, the medically necessary components of care can only be provided by a licensed home health provider.

Examples of Specific Duties of a Home Health Aide

Examples of the types of assistance provided by an in-home health aide include, but are not limited to:

  • In-home care for illness or injury
  • Post-operative rehab
  • Assistance with the transition from hospital to home
  • Dispensing medication and medication management
  • Monitoring vital signs
  • Assistance with medical equipment like portable oxygen, blood glucose monitors, and ostomy bags
  • Health education
  • Wound care
  • Physical, occupation, or speech-language therapy
  • End-of-life care and hospice support
  • Private duty nursing

10 Signs Your Aging Parent Needs Help at Home

If you are the adult child of an aging parent, you may be unsure of what to look for regarding the need for your parent to obtain assistance at home with activities of daily living, instrumental activities of daily living, or in-home assistance with medical matters. Professionals in the field of geriatric care have identified 10 key signs that your senior parent may need assistance at home or may want to consider a transition to assisted living. These 10 signs are:

  1. Increased confusion
  2. Increased memory loss
  3. Poor hygiene
  4. Changes in weight
  5. Neglected household
  6. Neglected finances
  7. Decreased mobility
  8. Increased falls or bruising
  9. Behavior changes
  10. Loneliness, isolation, and loss of interest in previously enjoyed activities

In summary, if you are the adult child of a senior parent who is legally competent, the decision to engage the services of an in-home care aide is his or her own to make. You can certainly discuss the issue with your senior parent to encourage your parent to consider engaging the services of an in-home care aide. If it is medically necessary for the form of a home health aide, this can be something your parent’s physician requires as a precondition for your parent to come home following surgery or because of some other medical issues.