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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. The performance of these ADLs is important for determining what type of long-term care — for example. nursing-home care or in-home care — and health coverage such as Medicare, Medicaid or long-term care insurance a person will need as they grow older. 

BREAKING DOWN 'Activities of Daily Living - ADL'

Nearly half of all Americans who turn 65 (a common retirement age) will eventually enter a care facility as a result of being unable to perform specific 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, long-term care insurance coverage for nursing costs requires an individual who is unable to perform two or more of the six basic activities of daily living. 

ADLs and Independent Living

Being able to perform activities of daily living as Americans age is directly linked to independent living, as physicians and adult care social workers use ADLs to determine the need for assisted living or nursing home placement. Why? Because these skills affect a person's ability to do housework, prepare his or her own meals, go shopping, drive or use public transportation, and take any medication as prescribed. Those in need of assistance with ADLs can opt for in-home, assisted living, or nursing home care. In some cases, families can help those in need make the decision between transitioning to an assisted-living community or opting for in-home care. In extreme cases, families may have to transition a person into a care facility without their consent. 

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

Those who transition to nursing homes do so because they can only engage in few, if any, ADLs on their own. When this is the case, in most situations, a health team consisting of physicians, nurses, and health aides supervises care on an around-the-clock basis at the facility. 

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