Activities of Daily Living

Activities of daily living (ADLs) are most broadly described as those tasks that are commonly completed by most persons in a culture, often habitually or done repeatedly at regular intervals, and often serve as prerequisites for other activities (e.g., laundering clothes or taking them to the dry cleaners in order to have clean clothes to wear to work or for leisure activities). ADLs may be perceived as routine, but they may in fact be quite creative endeavors (e.g., choosing clothes to wear to create a certain “look,” or cooking a meal in which ingredients are selected for complementary flavors and color). In particular, ADLs are important for the roles they serve in maintaining social life and connections with other persons.

ADLs are distinguished from productive activities such as paid employment, volunteerism, and education and also from leisure, recreational, and social activities. ADLs are sometimes divided into basic or personal activities of daily living (BADLs or PADLs) and instrumental activities of daily living (IADLs). The distinction may be somewhat vague and academic, although ADLs (or PADLs or BADLs) are more often activities that are related to taking care of one's own body while IADLs are more often activities that support others in addition to self and are often thought to be more “complex” in nature. Whether ADLs are distinct categories or simply two ends of a continuum remains open to debate, particularly among those involved in development of instruments that measure a person's performance on these activities.

ADLs (or BADLs or PADLS) include, but are not limited to, activities such as washing oneself, bathing and showering, bowel and bladder management, caring for one's own well-being and comfort, communication and communication device use, dressing, eating, feeding, functional mobility, personal devise care, personal hygiene and grooming, sexual activity, sleep/rest, and toilet hygiene. IADLs include activities such as caregiving, care of pets, child rearing, community mobility, financial management, health management, procuring and caring for necessities, procuring and maintaining a home, meal preparation and cleanup, and safety procedures.

It should be clear from the preceding lists that deciding whether an activity is an ADL or IADL can be quite arbitrary. For example, meal preparation could be regarded as part of self-maintenance, and communication and communication device use are just as often considered as ADLs as IADLs. In addition, while the concept of ADLs is distinct from productive, educational, and leisure activities, the categorization of particular activities is less clear. For example, some ADLs and IADLs may be performed for remuneration (such as grooming, home maintenance, child care) or for leisure (such as cooking, shopping). While activities may be broadly categorized as ADLs and IADLs, whether a particular activity is considered as such for a particular individual is much more dependent on the context and meaning of that activity for that individual.

Society often has expectations of how ADLs should be performed, and they are often used to describe what a person can or cannot do, what they need assistance with. These culturally accepted forms of performance are often based on how able-bodied persons might complete the task. This is of particular consequence because unacceptable performances of ADLs and IADLs are all too frequently invoked as indicators of disability. Particularly in Western cultures, inability to perform ADLs, particularly self-care activities, without assistance is a strong indication of disability.

...