HELPING WITH DAILY LIVING Activities of daily living (ADL) and instrumental activities of daily living (IADL)
• Grocery shopping and meal preparation • Laundry • Housekeeping chores • Personal finance management • Safety and emergency response capability
Activities of daily living (ADL) are functions of everyday living learned throughout life and encoded in unconscious thought. Implicit memory, which is acquired in early life and brain development, may not be impaired for some AD patients, leaving them with the ability to perform ADLs. FIf this is the case, the patient will be able to maintain aspects of health and independence for a longer period. Table 5 lists the basic activities of daily living. Table 5. Basic Activities of Daily Living Eating Bathing Dressing Personal hygiene: Grooming and toileting Sit and stand Continence Walking/mobility Note: Adapted from Lourenco et al., 2019 Instrumental activities of daily living (IADL) are activities that are not implicit but require executive function and reasoning skill. While IADL vary, they are intrinsic to everyday life and include:
• Medication management • Transportation and mobility
As AD progresses, additional support for both ADL and IADL may be needed. The person may respond with frustration, anxiety, and anger—all of which create stressful situations. Feelings of loss, an overall sense of fear, confusion, and a lack of control can also impair IADL. Self-Assessment Quiz Question #13 Instrumental activities of daily living (IADL) are different from activities of daily living (ADL) because IADL: a. Require musical instruments. b. Are acquired with dementia. c. Require more executive function and reasoning skills. d. There is no difference between IADL and ADL.
ADL/IADL STRATEGIES FOR ASSISTING IN THE EARLY STAGES OF AD
Support for ADL/IADL will increase as the disease progresses. Progression occurs over an extended period, so it is important to design a meaningful, accommodating life. Table 6 identifies strategies that can assist the AD patient as the disease progresses over time.
Healthcare Consideration: Caring for a patient with AD is expensive, and costs increase as more care is needed. Identify supportive services in the community, such as adult day care programs. These organizations can provide stimulation, socialization, and safety that can be beneficial to the person, as well as the caregiver (Gomez-Galleo & Gomez-Galleo, 2021).
Table 6. Management of ADL/IADL through the Stages of AD Disease Stage Activity of Daily Living
Suggested Supportive Methods
Early
Dressing
• Encourage choice • Give autonomy to actively participate in dressing • Provide comb and brush along with encouragement to groom themselves • Aid with shaving, if needed • Help with toileting when needed; respect modesty • Provide easy-to-remove clothing to assist with bladder control • Provide wet wipes for easy cleaning • Monitor for safety • Engage patient in food selection; encourage choice and participation • Engage in grocery shopping, meal preparation, and clean-up • Provide adaptive utensils, as needed • Encourage patient to serve and feed themselves • Cut food, if necessary • Monitor for safety • Assist with bathing/shower as needed • Establish specific bath time
Personal hygiene
Bathing and toileting
Eating
Book Code: SWUS1525
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