Activities of Daily Living (ADLs) are the fundamental, day-to-day tasks that a person needs to carry out to live independently. In the UK, these activities are central to how health and social care professionals assess an individual's care needs, whether due to age, disability, or a health condition. By breaking down a person's abilities, professionals can create a tailored care plan that provides the right level of support, from small adjustments to comprehensive care packages.
Basic Activities of Daily Living (BADLs)
Basic ADLs are the most fundamental self-care tasks, often centred on physical functions. Assistance with these is considered essential for an individual's personal hygiene, health, and dignity. The primary BADLs include:
- Bathing and Showering: The ability to get into and out of a bath or shower, wash one's body, and manage personal hygiene safely. For some, this might involve using assistive devices like grab rails or bath seats.
- Dressing: The ability to choose appropriate clothes and to put them on and take them off, including managing fasteners like buttons, zips, and laces.
- Toileting: The ability to get to and from the toilet, use it independently, and manage personal hygiene afterwards.
- Continence: The capacity to manage bladder and bowel functions. This can involve managing incontinence aids, such as pads.
- Eating: The ability to feed oneself. This includes the physical act of getting food from the plate to the mouth and swallowing safely. Specialised cutlery or adapted cups may be required.
- Transferring and Mobility: The ability to move from one position to another, such as getting in and out of bed or a chair, as well as the ability to walk around safely, with or without mobility aids.
Instrumental Activities of Daily Living (IADLs)
Instrumental ADLs are more complex and require higher-level thinking and organisational skills to live independently within the community. Needing help with IADLs is often an earlier indicator of declining independence than problems with BADLs. Key IADLs include:
- Managing Finances: This covers paying bills, handling money, budgeting, and avoiding scams.
- Shopping: The ability to procure necessary items, including groceries and household goods. This may involve online shopping or assistance with visiting shops.
- Meal Preparation: The ability to plan and cook meals, operate kitchen equipment safely, and clean up afterwards.
- Housekeeping: Maintaining a clean, tidy, and hygienic home environment, which includes tasks like laundry, dusting, and vacuuming.
- Medication Management: The ability to obtain, organise, and correctly take medication at the right time.
- Using Communication Tools: This involves using devices like telephones and computers to stay in contact with others.
- Transportation: Managing one's own travel, whether by driving, using public transport, or arranging other transport.
How Activities are Assessed for Care in the UK
In the UK, ADL assessments are a crucial part of determining an individual's eligibility for social care services and financial support. The process involves several steps:
- Contacting the Local Council: The first step is to contact your local council's Adult Social Care department to request a care needs assessment.
- Assessment by a Professional: An occupational therapist, social worker, or other health professional will conduct an assessment, often in the individual's home. They will observe and discuss the person's ability to perform various ADLs and IADLs.
- Using Assessment Tools: Standardised tools, such as the Katz Index for basic ADLs and the Lawton Scale for instrumental ADLs, may be used. In the UK, the focus is on a holistic, person-centred approach.
- Creating a Care Plan: Based on the assessment, a care plan is developed. This outlines the individual's needs and how they can be met, which may include equipment, adaptations, or care assistance.
Activities of Daily Living and PIP in the UK
The ability to perform ADLs is also central to applications for the Personal Independence Payment (PIP). The benefit is for working-age people with a long-term health problem or disability. It has two components: Daily Living and Mobility. The assessment for the Daily Living component directly relates to a person's ability to perform everyday tasks. Points are awarded based on the level of difficulty experienced across a range of activities, which determines whether the individual is eligible for the standard or enhanced rate.
Comparison of Basic vs. Instrumental ADLs
| Feature | Basic Activities of Daily Living (BADLs) | Instrumental Activities of Daily Living (IADLs) |
|---|---|---|
| Definition | Fundamental self-care tasks for personal maintenance. | More complex tasks for independent living in the community. |
| Examples | Bathing, dressing, eating, toileting, continence, and transferring. | Managing finances, shopping, cooking, housekeeping, medication management, and transportation. |
| Skills Required | Primarily physical functions. | Higher-level cognitive and organisational skills. |
| Dependency | Problems with BADLs often indicate a higher level of dependency. | Issues with IADLs often appear earlier and can be an initial sign of declining independence. |
| UK Benefits Link | Assessed for the Daily Living component of PIP. | Also assessed for the Daily Living component of PIP, particularly budgeting and communication tasks. |
The Role of Occupational Therapy
Occupational therapists (OTs) play a vital role in addressing difficulties with ADLs in the UK. Through thorough assessments, they can recommend a range of solutions to promote independence, including:
- Prescribing Equipment: This can include adapted cutlery for eating, grab rails for the bathroom, or mobility aids for transferring.
- Home Adaptations: Recommending changes to the home environment, such as installing a ramp or adapting the bathroom.
- Alternative Techniques: Teaching new ways to perform tasks, such as using visual prompts for routine management.
Conclusion
What are activities of daily living in the UK? They are the essential everyday tasks used to measure an individual's functional independence, serving as the foundation for social care needs assessments and eligibility for benefits like Personal Independence Payment. By distinguishing between basic and instrumental activities, professionals can identify the specific areas where support is needed. Recognising the importance of ADLs helps to ensure that people can receive person-centred care that promotes safety, independence, and dignity, enabling them to live as fulfilling a life as possible at home.
A list of resources for UK social care
- Social care and support guide (NHS): The official NHS guide provides comprehensive information on social care services, including personal care and how to get help at home.
Please note: This is a guide and should not be considered a substitute for professional medical advice. Always consult with a healthcare professional for a personalised care needs assessment.
