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What are 'Activities of Daily Living - ADL'

Activities of daily living (ADL) are routine activities that people tend do every day without needing assistance. There are six basic ADLs: eating, bathing, dressing, toileting, transferring (walking) and continence. A person's ability to perform ADLs is important for determining what type of long-term care — for example. nursing-home care or in-home care — and health coverage the person needs such as Medicare, Medicaid or long-term care insurance.

BREAKING DOWN 'Activities of Daily Living - ADL'

Nearly half of all Americans who turn 65 during any given year will eventually enter a care facility as a result of being unable to perform ADLs. While the majority of care facility admissions will be for the short term (less than a year), about a quarter will stay longer than one year. Typically, coverage for nursing costs requires an individual who is unable to perform two or more of the six basic ADLs.

ADLs and Independent Living

As Americans age, their ability to live independently is directly linked to their ability to engage in ADLs. Thus, when physicians or adult care social workers evaluate people to determine suitability for assisted living or nursing home placement, they consider ADLs as they affect the person's ability to do housework, prepare his own meals, go shopping, drive or use public transportation and take any medication as prescribed. Key to determining the person's ability to live independently is his ability to understand his financial situation and handle money.

Levels of Assistance

Those in need of assistance with ADLs can opt for in-home, assisted living or nursing home care. Some sometimes make the decision to receive in-home care or transition to assisted living communities with the help of family members. However, family members usually make the decision to transition the person to a nursing home without the person's input.

Families often hire home health workers to provide ADL assistance when the person resides in the home or in an assisted living community — which provides a private apartment — and needs some, but not total, care. Health insurance covers some or all of the cost of hiring licensed home health workers, depending on the person's policy; most licensed home health workers are state-certified nurse aides (CNAs). Home health workers help the person with ADLs and support independent living by helping with activities such as going shopping, reminding him to take his medication and accompanying him on walks.

Those who transition to nursing homes do so because they can no longer engage in any ADLs on their own. When this is the case, a health team consisting of a physician, nurses and nurse aides supervises their care on an around-the-clock basis.

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