Typically, there is a measurable order to the progressive decline of a person’s ability to care for themselves. In the health continuum, the ADL Hierarchy Scale — which includes ADLs (activities of daily living) and IADLs (instrumental activities of daily living) — helps describe and categorize an individual’s functional capabilities.

Activities of daily living (ADLs) is a term that describes the most basic functions that are essential for human survival and self-care. Most of these tasks are performed on a daily basis, and most healthy individuals can perform them independently without assistance.

ADLs include:
  • Dressing – getting dressed or undressed
  • Eating – transferring food from plate to mouth
  • Grooming – brushing one’s hair, clipping finger/toenails
  • Personal hygiene – washing one’s hands and teeth, bathing and showering
  • Toileting – using the toilet, getting to/from and on/off the toilet, cleaning oneself
  • Mobility – walking, getting out of bed, or moving from one place to another

Instrumental activities of daily living (IADLs) are more complex functions that are not essential for survival, but which individuals must perform to live independently. IADLs are generally the first activities with which individuals losing independence will need assistance.

IADLs include:
  • Meal preparation
  • Housework, cleaning, laundry
  • Shopping for groceries and necessities
  • Managing medications
  • Paying bills/ managing finances

The concept of ADLs and the activities of daily living index was developed by Dr. Sidney Katz in 1950 and has become an internationally recognized system. In the realm of healthcare and geriatric care, the ability to perform ADLs and IADLs is widely used as a measurement to determine the health and functional status of an individual — primarily older adults and those with disabilities or chronic conditions — to determine whether professional support, home care, or long-term services are needed.

If your loved one is struggling with performing ADLs or IADLs, and you’re unsure if extra help is needed, try using this checklist.