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What Are ADLs and IADLs? A Family Guide to Understanding Daily Care Needs

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A person’s ability to manage everyday tasks such as bathing, dressing, and preparing meals is measured in two categories: activities of daily living (ADLs) and instrumental activities of daily living (IADLs). Together, these activities help families and caregivers understand what kind of support someone actually needs at home.

If you have started noticing your mom skipping showers or your dad’s fridge is emptier than usual, you are probably already asking this question: how much help does he or she actually need right now? In caregiving circles, that question has a name: ADLs and IADLs. Once you understand what they are, figuring out what kind of support makes sense becomes easier.

What Are ADLs?

Activities of daily living, or ADLs, are the basic self-care tasks a person performs every day to care for their own body, and these tasks show up in nearly every conversation about senior care:

    • Bathing — getting in and out of the shower or tub safely, and keeping up with personal hygiene
    • Dressing — choosing and putting on clothing without confusion or physical strain
    • Grooming — brushing teeth, combing hair, shaving, basic skincare
    • Toileting — using the bathroom and maintaining personal cleanliness afterward
    • Transferring — moving safely, like getting out of bed or up from a chair
    • Eating — feeding oneself, including handling utensils and swallowing safely

    When one of these becomes hard, the issue is rarely just about that one task. A parent who is avoiding showers may also be at higher risk of falls. Someone struggling to get up from a chair on their own may also be skipping meals because standing at the stove feels risky. In other words, these things tend to be connected and are rarely isolated issues.

      What Are IADLs?

      Instrumental activities of daily living, or IADLs, are the tasks that enable someone to live independently in their home and community, rather than just caring for their own body.

        • Preparing meals
        • Handling finances
        • Grocery shopping
        • Housekeeping
        • Doing laundry
        • Using transportation, including public transportation
        • Using a telephone
        Woman caregiver helping senior out of bed | what are ADLs and IADLs | Neighborly Home Care

        Here is the difference in plain terms: ADLs are about the body. IADLs are about independent living. A parent might still be perfectly capable of showering and dressing on their own (strong ADLs) while quietly falling behind on bill payments or letting prescriptions run out (declining IADLs). Families often catch struggles with instrumental activities of daily living first, since these are issues that show up in the mail, the pantry, or the medicine cabinet before showing up as a physical limitation.

        Are you unsure whether what you see with your loved ones counts as an ADL or IADL challenge? Schedule a consultation with our care team today so we can walk you through it.

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        How Are ADLs and IADLs Assessed?

        Families do not need to run a formal assessment to notice something is off. Still, it helps to know that professionals often do, using two widely recognized assessment tools.

        • The Katz Index of Independence in ADLs scores a person’s independence across six core ADLs, from full independence down to needing help with every task. It is simple by design: a caregiver or clinician rates each activity as either independent or dependent, and the total gives a quick read on how much daily support someone needs.
        • The Lawton-Brody IADL Scale does the same for eight IADLs, rating how well someone manages tasks such as cooking, finances, and transportation independently.

        You do not have to use either scale to make a good decision about care. Still, if a doctor, discharge planner, or Medicaid Waiver coordinator mentions “ADL scores” or “IADL functioning,” now you know exactly what they are talking about.

        Signs Your Loved One May Need Help

        Most families do not get a single clear moment where everything changes. These signs often manifest in smaller signals, stacked up over weeks or months:

        • Wearing the same clothes several days in a row
        • Skipping showers or grooming altogether
        • Unopened mail, missed bills, or a pantry that does not match what is actually being eaten
        • New bruises with no clear explanation
        • Disorientation during routines that used to be automatic, like making coffee or locking the door
        • A car that has not moved in weeks, or rides quietly being turned down

        None of these alone means it is time for full-time care. But together, they are usually a sign that some level of support, even a few hours a week, would make daily life safer and less exhausting.

        What Kind of Help Makes a Difference

        Most seniors need help with specific tasks that have become difficult, while maintaining control over everything else. That is the model behind our home care services.

        A caregiver might spend a morning helping with a shower and getting dressed (ADL support), then stay to help prep lunch (IADL support). Another family might only need someone to handle the grocery run and a ride to a doctor’s appointment. A spouse who has been providing all of this help alone might just need a few hours of respite care a week to rest. There is no single right combination. It depends entirely on what is actually happening in that specific household.

        At Neighborly Home Care, care plans are built around the specific ADLs and IADLs a person is struggling with, not a generic package. Families in Philadelphia and the Main Line can start with a few hours a week and adjust as needs change. All of our caregivers are directly employed, trained, and insured by Neighborly, with GPS-based clock-in verification for every visit, so families always know who is showing up and when. Contact us today to talk through the right fit for your family.

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        When You Need More Than a Few Hours a Week

        Sometimes the pattern is bigger than occasional help. A recent hospital stay, a fall, or a new diagnosis can shift someone from managing on their own to needing daily support fairly quickly. In those situations, families start asking about assisted living, memory care, or full-time home care as alternatives, and it is worth understanding what each actually involves before deciding.

        For many families, staying at home with the right level of in-home support is both more comfortable and more affordable than moving. If a recent hospitalization is part of what is driving the conversation, our recovery care after a hospital stay page walks through what that kind of support typically looks like. If the person you are caring for has a disability rather than an age-related decline, our disability care services page covers how that support is tailored differently.

        And if cost is the sticking point, we accept both private pay and Medicaid Waiver programs. If a family member is already working with a Medicaid Waiver coordinator, our Medicaid Waiver options page breaks down how that process works.

        Talk to Neighborly Home Care Today

        If you are noticing changes in a loved one’s activities of daily living, you do not have to figure out the right level of care alone. Schedule a consultation with Neighborly Home Care, and we will talk through what you are seeing, answer your questions, and help you understand what kind of support actually fits.

        Call (610) 658-5822 or contact us today to get started.

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        FAQ

        What are the 8 IADLs?

        The eight IADLs are: using the telephone, shopping, food preparation, housekeeping, laundry, transportation, managing medications, and handling finances.

        What are the first signs of IADL difficulty?

        The earliest signs are usually financial or logistical, not physical. Unpaid bills, expired or missed medications, an empty fridge despite having spent grocery money, or turning down rides and errands they used to handle easily are common early indicators.

        Is doing laundry an ADL or IADL?

        Laundry is an IADL. It is one of the eight tasks measured on the Lawton-Brody IADL Scale, alongside housekeeping, meal preparation, and managing finances.

        How do ADLs affect eligibility for home care or assisted living?

        Most home care agencies and assisted living communities use ADL and IADL needs to determine what level of care and staffing a person requires. More ADL dependence generally means a higher level of daily support is recommended, though every agency and community sets its own criteria.

        Do I need a doctor’s referral to start home care for ADL support?

        Not for non-medical home care. Families can typically contact an agency directly to discuss ADL and IADL needs and set up a plan of care. A referral may be involved if care is being coordinated through a hospital discharge or a Medicaid Waiver program.