Instrumental Activities of Daily Living (IADLs) should not be confused with activities of daily living (ADLs). If not familiar with ADLs, please see a previous article written by this author, Elder Care - Activities of Daily Living. These two categories are assessed separately but are actually very connected as far as ability to perform the activities.
This is why IADLs are important to elders and why they need to increase their knowledge on this subject. Understanding these actions may mean the difference between independent living and assisted living out of the home.
IADLs are any actions that we perform on a daily basis that requires the use of an instrument. The use of the word instrument throws most people off because of the multiple meanings. But there really is not a better word to describe all the different items that are included in this category. I'll explain. IADLs include: transportation, shopping, laundry, telephone calls, food preparation, handling finances, housekeeping and managing medicine. With a little thought it's apparent that there is an instrument involved in each one of these activities.
The daily activities performed using an instrument are measured very similar to the method used to evaluate general activities of daily living. The medical professional or case manager uses a chart with headings such as: Always, Frequently, Sometimes, Never. Now let's apply this categorizing to the actual IADLs.
Transportation - This does not mean there is or is not the ability drive. That's a possibility, but it could also mean a person has the ability to understand and use different types of transportation. It's important to understand that if a person is creative and informed enough to find an alternative to an IADL that they are starting to experience difficulty performing, it doesn't mean you have lost the ability; it's just done a different way. For instance, if using a bus instead of a car because a person no longer drives; they would be scored as always able to perform this activity as long as it's independently accomplished.
Shopping - Is the individual able to manage their way through the grocery store, push a cart, carry a basket, select food, and get through the check out process by themselves.
Laundry - In this case the instrument is the washing machine and dryer or clothes line.
Telephone calls - Using the telephone as we age becomes more and more difficult largely due to changing eyesight and advances in technology. There are ways to cope with both of these. Get a phone with bigger numbers; they're inexpensive and available everywhere. Don't let other people force a present of a new telephone with tons of gadgets for you to have to learn when you really aren't interested.
Food preparation - The stove, oven, microwave, refrigerator, and general small kitchen appliances are the instruments here. Again if any of these items start to become difficult to use, make adjustments. For instance, if your short term memory is giving your problems use a loud timer every single time the stove is used.
Handling finances - This requires the ability to calculate, write checks, use debit cards, handles cash, schedule and pay bills, and create a budget. Most people of all ages have some problem with this but specifically for elders the difficulty starts to arise with the short term memory. Use calendar. This is not trite, place a calendar where you can see it and put all of your bill payment due dates on it as soon as you receive the bill. Many elders pay a bill the minute they receive it because they are afraid they'll forget later. This is a really good way to get ripped off. Everything that appears to be a bill in your mail may not be so.
Housekeeping - The vacuum is the big instrument here. The act of vacuuming is difficult for anyone, much less a person who may become frail.
Managing medicine - The instruments in this category include the medicine bottle, medicine box, or an automated medicine box.
This is a very basic introduction to the instrumental activities of daily living; a discourse not only meant for elders but for everyone. Either you are an elder, know an elder, or are going to hopefully become an elder. If you want to stay at home as long as possible become educated on these types of issues.
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