For most of us, if there is an issue with Activities of Daily Living (ADLs), such as bathing or dressing or eating, the need for support is very obvious. We will return to this topic (ADLs) in a future blog, but today we want to talk about Instrumental ADLs (IADLs) as a basis for determining need for homecare support. We have adapted an IADL discussion from an early gerontology article, because we think it is still one of the most useful. We have provided just three examples, below, of the seven IADLs included in an Excel spreadsheet we have created that is posted on our Web site.
Ability to Use Telephone (4 points – highest – to 1 point)
Operates telephone on own initiative; looks up and dials numbers, etc.
Dials a few well-known numbers
Answers telephone but does not dial
Does not use telephone at all.
Shopping (4 points to 1 point)
Takes care of all shopping needs independently
Shops independently for small purchases
Needs to be accompanied on any shopping trip
Completely unable to shop.
Food Preparation (4 points to 1 point)
Plans, prepares and serves adequate meals independently
Prepares adequate meals if supplied with ingredients
Heats, serves and prepares meals or prepares meals but does not maintain adequate diet
Needs to have meals prepared and served
The idea, for each IADL, is that the more functionality I have, the higher my score will be. In this particular scale, as we have implemented it, there is a maximum of 31 points, total, for all seven IADLs. However, each IADL needs to be looked at by itself, as well as being part of an overall pattern.
In my current baseline (as discussed in a prior blog), I’m doing okay and do not need home care. However, for each IADL, I have set a lowest acceptable status before taking a very serious look at getting home care for myself.
We would be delighted to have your feedback and suggestions. Thanks for listening.