Those unfamiliar with long term care may ask: what does ADL stand for? ADL stands for Activities of Daily Living, which commonly refers to basic skills required when caring for oneself. As people age, it is common for mobility issues to develop, which impact a senior’s social, psychological, and physical circumstances.
A study from the University of Alabama showed that the negative effects of the loss of mobility can be minimized or prevented if seniors participated in more holistic practices, like being more physically active, maintaining a healthy body weight, improving their strength and balance, and managing chronic illnesses—like diabetes and arthritis—better. Furthermore, when seniors live a healthier lifestyle, they tend to experience fewer depression symptoms and have better memory and thinking skills.
Meanwhile, the loss of mobility for seniors becomes a significant problem if they do not have any supportive family or friends nearby who can assist with general ADLs. If seniors cannot perform some or any of these activities independently, it is advisable to seek additional care assistance. In such cases, seniors can explore home health services or move into a long term care facility, where a range of ADL services and support is given to meet their individual needs.
ADLs are typically categorized into six areas:
- Eating – Having the ability to feed oneself without the need for assistance (not including food preparation)
- Dressing – Putting clothes on and taking them off without help (not including laundry)
- Personal Hygiene – Washing oneself either in a bath or in a shower independently (also includes oral hygiene, grooming, and nail care)
- Toileting – Having the ability to go to the toilet independently (lowering and lifting oneself from the toilet)
- Continence – Maintaining and controlling both bladder and bowel functions without the need for a catheter or colostomy
- Mobility – Being able to independently move from a sitting to a standing position, including getting in and out of bed
Facilities will often use ADL indicators, like the Barthel Index, to assess a senior’s functional status and physical performance abilities. Each senior will have different functional capabilities. Therefore, long term care facilities need to identify what level of care and assistance is required so a personalized care plan can be created for each resident to ensure that their needs are met.
Facilities use long term care software to document resident ADLs more efficiently and quickly with integrated solutions, like point of care, that increase clinical productivity. Nurses, CNAs, and other clinical staff find that long term care EHR software systems improve workflow processes by eliminating paper documentation. While being beside a resident, they can document real-time care, saving hours on inefficient documentation processes every shift.
Furthermore, because residents’ ADL details are documented electronically, clinical staff can also access the information from multiple locations within the facility via portable, handheld devices synced with the nursing home software. This allows for better workflow with fewer disruptions, ultimately improving the level of care given to residents.
What Is the Difference Between iADLs vs ADLs?
While ADLs cover basic daily activities, iADLs (Instrumental Activities of Daily Living) are more complex and are related to a person’s ability to live independently in the community. iADLs are not daily activities. Therefore, when seniors lose these functional activities, they are less noticeable and may take longer to realize.
While states may vary slightly in their iADLs categories, they all primarily include the same categories. Here are the categories in Oregon:
- Housekeeping
- Laundry
- Meal Preparation
- Medication Management
- Shopping
- Transportation
Facilities tend to rely on their point of care software to track ADLs and iADLS accurately. Caregivers need to enter vast quantities of care data—like CNA/ADLs, Restorative Nursing, Therapy, and Mood Observation—simultaneously for each resident. Therefore, a tailored care plan can only be created once the data is entered into the care plan software so the clinical staff can efficiently and adequately track residents’ ADLs.
Finding the Right Assistance
Now that we have made clear the difference between iADLS vs ADLs and answered the question of what does ADL stand for, we can look at how iADLs and ADLs are essential for seniors to maintain an independent lifestyle. By assessing these collaborative activities, facilities can determine the level of assistance needed. When seniors lose the ability to perform these activities, they will experience a significant decline in quality of life. There are several organizations that seniors and their families can contact to find the proper support.
State-funded, non-Medicaid programs—like the Texas Community Care for the Aged/Disabled—assess ADLs and IADLs. Suppose a senior cannot perform two to three of these activities. They can apply for assistance from the program that primarily helps low-income seniors receive home health assistance rather than moving into a more expensive, institutionalized Medicaid-funded nursing home.
Meanwhile, government programs like Medicaid often require seniors to qualify for nursing home care. Seniors must demonstrate an inability to complete ADLs and iADLs. Each state has different requirements to qualify for different care settings, such as in one’s home, adult day care, assisted living, memory care, and adult foster care homes. The inability to complete ADLs and iADLs indicates a senior’s functional eligibility.
Seniors who are deemed eligible will apply for Medicaid funding over Medicare, because Medicare does not include custodial or personal care, categories into which ADLs and iADLs typically fall. However, an alternative option is to apply for Medicare PACE. This all-inclusive care program helps seniors find coordinated care assistance rather than moving into a long term care facility.
PACE typically coordinates the care needed with a small team of caregivers, so seniors tend to develop strong bonds with their caregivers. The all-inclusive services incorporate Medicare and Medicaid services, including drugs, home care, transportation, hospital visits, and nursing home stays when necessary.
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Documenting Daily Living Skills
Documenting daily living skills, both ADLs and iADLs, is a way of determining how much a senior’s functionality has declined or been impaired. When seniors initially struggle with daily activities, they and their families may ask what does ADL stand for and begin looking for help. Losing functionality usually occurs due to the natural aging process causing the gradual decline and subsequent loss of activities of daily living functionality.
Many long term care facilities rely on an efficient long term care software system to collect and store resident ADL data used for personalized care plans. Furthermore, clinical staff needs to track and update details, regardless of the iADLs vs ADLs dichotomy, and note changes via the point of care software so that authorized personnel can access real-time information on each resident, minimizing medical errors while providing optimal care.
Effective long term care EHR software systems also include printable ADL vs iADL list functions, also known as nursing Kardex charts or cheat sheets. These are usually available in color and black and white and are used simultaneously with the electronic Kardex.
A printable ADL checklist is particularly useful when nurses, CNAs, and other medical staff need to see the entire contents of a resident’s data and an electronic device is unavailable. Using state-of-the-art nursing home software, even if there is an excessive amount of resident data, ensures the clinical staff does not miss any relevant information.
Some other benefits of using an electronic Kardex include:
- Increased Accuracy – Nurses, CNAs, and other medical staff can accurately enter and retrieve resident data more efficiently using an electronic Kardex. This reduces mistakes and omissions of crucial medical information.
- Increased Speed – It takes significantly less time for clinical staff to write out resident care summaries when using nursing home software, thus increasing work output.
- Greater Privacy and Security – Only authorized personnel can use and access resident information. This means that “fewer hands” are dealing with records, resulting in greater privacy and security of resident information.
- Centralized Database – A centralized database ensures all resident care summaries are stored in a centralized database via the long term care software. While this information is centrally-stored, it can be accessed throughout the facility. Thus, staff can spend more time caring for residents and less time on documentation.
- Increased Work Productivity – Nurses, CNAs, and other medical staff can better manage their time as workflow processes become more efficient and streamlined, ultimately improving resident care.
- Reduced Cost – Unlike traditional paper Kardex documentation, an electronic Kardex does not require paper and paper machinery. Over time, this will reduce costs while being more eco-friendly.
- Information Backups – Clinical staff can easily save and back up any resident information, thus preventing the loss of resident information in the event of an equipment failure.
What Does ADL Stand For, and Why Is It Important?
Ultimately, if a senior or their family is wondering: what does ADL stand for, then it is likely that the senior is already experiencing problems with ADLs or iADLs. It is time to look into further assistance and support in such cases.
Depending on the senior’s functionality, or lack thereof, either home care assistance or moving into a long term care facility will be needed. However, if seniors or their families delay seeking aid, the symptoms and functionality will worsen, placing more burden on families to support and help their aging relatives.
Studies show that the inability to complete ADLs and iADLs can translate to unsafe living conditions, further putting seniors at risk. This inability also impacts seniors’ quality of life, affecting their psychological state due to losing the ability to perform daily activities. Therefore, families need to seek the appropriate medical assessment, planning, intervention, and evaluation of ADLs and iADLs when they see senior relatives struggling with ADLs or iADLs.
The right support gives seniors the best chance of aging independently while getting the appropriate daily assistance needed. Healthcare providers and caregivers can enhance patient care and management with early diagnosis, thus improving patient outcomes, keeping seniors content, and creating healthier lifestyles for older adults looking to take advantage of their golden years.
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