Activities of Daily Living: What They Are, How They Relate to Independence and How NeuLife Helps Clients Regain the Ability to Perform Them
Activities of Daily Living (ADLs) are the basic aspects of self-care and independent living that most people take for granted — until the ability to perform them is reduced or disappears. This may be due to a stroke, a catastrophic injury, a traumatic brain injury, a traumatic amputation or some other kind of difficult and challenging diagnosis. No matter the cause, they all require the types of innovative, specialized post-acute rehabilitation that NeuLife provides best.
Healthcare professionals often refer to the ability or inability of an individual to perform ADLs as a measure of his or her functionality. This is particularly true of persons with disabilities caused by traumatic brain injuries (TBI), strokes (CVA), spinal cord injuries (SCI) and other types of trauma. The increase in the ability of the individual to perform ADLs, either with or without adaptive assistance, is a key to the goal of ultimate achievement of successful sustained outcomes and independence to the greatest degree possible, for each NeuLife client.
Following are the ADLs:
• Bathing and showering
• Dressing
• Eating/feeding including the ability to chew and to swallow
• Functional mobility which is the ability to move from one place to another while performing activities at the same time
• Personal hygiene and grooming, including activities such as brushing teeth, combing or brushing hair, shaving and styling hair
• Toilet hygiene including the tasks involved with urinating or having a bowel movement[1].
A somewhat grim, but perhaps useful, mnemonic device for recalling the list of ADLs is “DEATH”: Dressing/bathing, Eating, Ambulating (walking), Toileting and Hygiene[2].
But NeuLife has a far better mnemonic for its clients and for the innovative care that it provides to them: “LIFE”: Living, Independence, Functionality and Excitement. Excitement? Yes, because a NeuLife client who may have once seen himself/herself as a victim, may no longer have that self-image. There are hills to climb and challenges ahead, but they can be temporary and overcoming them can likely be accomplished with the help of NeuLife staff. That’s a great deal to be excited about. This “new normal” may be somewhat of a different life, but life, nevertheless. Certainly it’s a fulfilling life, gained through the help of NeuLife’s innovative post-acute rehabilitation, clinically relevant services, its supported living and through each client’s hard work.
There is another category of Activities of Daily Living, referred to as “Instrumental ADLs” (IADLs). These do not relate to the basic, fundamental functioning as do the basic ADLs. Instead, these abilities, which NeuLife also fosters for its clients, permit them to live as independently as possible in a community. Here, too, while full independence is the goal for each client at NeuLife, if full independence is not possible after specialized rehabilitation, the best possible, sustained, successful outcome is sought consistent with the client’s physical, psychological and psychosocial condition.
IADLs are usually considered to be the following activities. The ability to perform them is consistent with independent living when post-acute care at NeuLife has concluded:
• Housework
• Taking medications as prescribed
• Managing money
• Shopping for groceries or clothing
• Use of the telephone or other forms of communication
• Using some forms of technology
• Transportation within the community
The assessment of a client’s ADLs and IADLs is performed by occupational therapists in conjunction with other professionals. When the assessments have been completed and needs identified, NeuLife incorporates the therapeutic needs into the client’s customized Client Goal Plan.
Proper and timely post-acute rehabilitation may determine the difference between disability and independence is what NeuLife refers to as the “platinum post-acute period” — the crucial window following acute care that is needed to nurture the whole person to health with specialized, clinically relevant services. Early intervention is critical.
NeuLife’s philosophy is that healing, wellness and personal fulfillment are best accomplished in a positive and uplifting therapeutic environment where caring staff encourage, assist and support each client so he or she may achieve specific goals. NeuLife believes personal fulfillment is equally as important as goals to increase function and independence. NeuLife seeks to achieve, for all of its clients, maximized, sustained outcomes that exceed the expectations of all persons served.
NeuLife, in Mount Dora, Florida, is a fully accessible residential post-acute program providing specialized rehabilitation to individuals diagnosed with traumatic brain injury (TBI), spinal cord injury (SCI), traumatic amputations and other catastrophic injuries.
2725 Robie Avenue
Mount Dora, Florida 32757
[1]Roley, SS, et al, “occupational therapy practice framework: domain and practice, 2d edition”
[2] “Activities of Daily Living” (http://www.medicine.uottowa.ca/sim/data/Disability_ADA_e.htm. 2011-08-26.
