As they age, people may have more difficulty performing the daily tasks we all do in order to live. To be able to assess a person's ability, or rather, where there is difficulty so changes, accommodations, or adaptations can be made, requires the assessor to be able to look at the details or steps it takes to do each task.
For instance, it usually will require 40 or more steps to actually brush your teeth. If you miss some steps, it is no big deal but some steps if missed, can have serious consequences. Most people will create their own adaptations or accommodations to problems they are having. Like not being able to see well at night, they do all of their appointments and errands during the day - thus no problem in continuing to live independently but there is actually a problem. Most accommodations and adaptations can be made easily and inexpensively and creativity goes a long way. Many catalogs now, cost effectively, offer products that can help an elderly person continue to function independently.
To assess a person's independent living skills, you will need to record your findings and then, several months later, go back and do it again to see if there has been a change. It is important too that your aging parent or senior adult is honest in what they report to you and/or you see or they demonstrate how they do a particular activity. Please you good judgment and good communication skills in how you approach doing an assessment.
Activities of Daily Living Guide/List
• Laundry:
• Flooring/carpeting clean, how often done:
• Counter tops clean in kitchen and bathrooms? How often, with what?
• Are the sinks, drains, shower/tub and toilets clean? How often, equipment used and cleaner? Check the back top of the toilet and around the base (for urine especially), look at the faucets and spouts (many times toothpaste and soap scum accumulate there and may not get cleaned).
• Closets, drawers and cabinet organized or has it changed?
• How often are dishes done, cleanliness and with what?
• Any maintenance needs to be done and if so, how long has it been in its current state?
• Is anything missing from the house?
• Trash containers clean, emptied or overflowing?
• Magazines/newspapers - organized or piled up, a fire hazard? Can the person get them outside for trash?
• Are devices such as walker/wheel chair/scooter/cane clean? How often? Repair needed?
• Overall bathing? Cleanliness? Safety in doing it?
• Oral care? Cleanliness? Are dentures/plates worn?
• Toilet? How often are hands washed throughout the day? Are they washed such as after going to the bathroom, touching raw meat, cleaning the litter box, etc.?
• Are finger nails and toe nails cut and clean? Any signs of infection in the toes?
• Is shaving done regularly (male and female), well and safely?
• Urinary incontinence (bladder control)? Are they up several times a night? Are there loose bowel movements or uncontrollable ones? Constipation, or urinary or yeast infections?
• Any skin redness or problems? Hair care & maintenance: Does the person continue to put on deodorant, perfume, shaving cologne, make-up, etc.?
• Are eyeglasses (or contact lenses) worn as prescribed, kept clean? Are regular eye appointments made and kept? Are eye drops taken as prescribed?
• Is clothing appropriate, clean, fit correctly, neatness, no rips/buttons missing or stains/holes?
• Do shoes fit properly, in good condition, comfortable, easy to put on/off and clean? Are weather appropriate coats/shoes available, do they fit, are they in good condition and clean?
• Is the pocket book or wallet a mess, too heavy, in need of cleaning, or need to be replaced?
• Is the person able to list out the pros and cons or options of the decision they are trying to make? Do they need a little or a lot of help, do they even want help, do they ask for help and if so, in what areas usually? What areas do family members see that there are problems in or with what decisions were made?
• Are appointments made when needed, are they kept, and are recommendations followed? Is the person sleeping through the night, if not, how often are they waking up & why?
• How many hours do they sleep at night? What time do they usually go to bed and get up?
• Are they taking naps during the day? If so, how often and for how long? Where do they take their naps - in bed, in the chair sitting up, in a recliner? Is there any particular task that makes taking a nap necessary?
• Even after a good night's sleep, are they still tired?
• How much energy does the person have - slight decline or more of decline than anticipated?
• How many typical daily tasks can the person do before they are winded or tired and have to sit down or take a nap?
• How is the person's ability to use utensils properly and safely? Are they messy, cutting pieces too large, eating with fingers, is food coming out of their mouth?
You will want to add this list to Parts 2 & 3, in order to have a complete ADL assessment tool to use.
Asking the right questions, listening, observation and trying different ways of doing things, while having meaningful conversations with your elderly parent, is key to really getting an accurate picture how well a person is functioning in their home.
If you have concerns or questions, there are several agencies who provide information - such as Elder Care, Senior Caregiving and The Practical Expert (which is the only certified coach specialist on aging parent issues & trained in home assessment and accommodations). Getting some assistance, can save you time, energy and help with making the assessment process smoother and more thorough and thus getting the information you need easier.
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