Most long-term care involves assisting with basic personal needs rather than providing medical care. The long-term care community measures personal needs by looking at whether an individual requires help with six basic activities that most people do every day without assistance- called activities of daily living (ADLs). ADLs are important to understand because they are used to gauge an individual’s level of functioning- which in turn determines whether the individual qualifies for assistance like Medicaid or has triggered long-term care insurance coverage.
The six ADLs are generally recognized as:
- Bathing. The ability to clean oneself and perform grooming activities like shaving and brushing teeth.
- Dressing. The ability to get dressed by oneself without struggling with buttons and zippers.
- Eating. The ability to feed oneself.
- Transferring. Being able to either walk or move oneself from a bed to a wheelchair and back again.
- Toileting. The ability to get on and off the toilet.
- Continence. The ability to control one’s bladder and bowel functions.
There are other more complicated tasks that are important to living independently- but aren’t necessarily required on a daily basis. These are called instrumental activities of daily living (IADLs) and include the following:
- Using a telephone
- Managing medications
- Preparing meals
- Managing personal finances
- Shopping for groceries or clothes
- Accessing transportation
- Caring for pets
Long-term care providers use ADLs and IADLs as a measure of whether assistance is required and how much assistance is needed. In order to qualify for Medicaid nursing home benefits- the state may do an assessment to verify that an applicant needs assistance with ADLs. Other state assistance programs also may require that an applicant be unable to perform a certain number of ADLs before qualifying. In addition- long-term care insurance usually uses the inability to perform two or more ADLs as a trigger to begin paying on the policy.