We have talked about the Advance Living Directive Support For Home developed before. It is adapted from The Gerontological Society of America, from an article by M.P. Lawton and E.M. Brody. This tool allows individuals and families to look at all of the Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs) that we perform virtually every day.
We really do encourage families to participate in this exercise together, applying it not just to Mom and Dad, but to themselves, as well. Using the tool together and discussing the results as a family goes through the exercise will generate some excellent discussion and make the outcome more meaningful for all.
By examining our current and projecting our future ability to perform those activities, we can set a baseline for helping us determine whether we need home care or if we need even more support, in a skilled nursing facility, for example.
The goal is to begin using the tool before there is any question about our ability to perform those ADLs and IADLs. That way, there is not stress and no temptation to “fudge” just a bit as we rate our abilities. And, there is less of a tendency for families to get into confrontations about Mom’s or Dad’s functional level or need for support.
In Part II of our series exploring the concept and the tool in greater depth, we will talk about the individual ADLs (Activities of Daily Living). What are they and why are they singled out? In a subsequent article, we will cover the Instrumental Activities of Daily Living (IADLs), that we consider to be as important as the “regular” ADLs. Then we will talk about the “scoring” levels for each of the ADLs and IADLs and what they mean – and what decisions should be made based upon the individual and cumulative scores.
If you want to get started on this topic, there are several good sources, including Wikipedia. There are many daily living assessment tools, but most of them are too technical and cumbersome for a family to make much use of, frankly. That is why we developed a Microsoft Excel tool for our clients and families – and ourselves. You can find that tool, and a PDF version, on our Website.
Part II will be posted soon. In the meantime,
Best wishes, Bert