INTRODUCTION TO SELF CARE ACTIVITIES
Activities of Daily Living
[ Lecture No. 08]
Activities of Daily living(ADL)

Introduction
Activities of Daily Living (ADL) is
used in rehabilitation as an umbrella
term
relating
to
self
care,
comprising those activities or tasks
that people undertake routinely in
their every day life.
Categorization of ADL

Basic ADL (BADL): It is typically restricted
to activities involving functional mobility and
personal care.

Instrumental ADL (IADL): instrumental
activities of daily living functions are
concerned with a person's ability to cope
with her/his environment.[domestic and
community activities]
Basic ADL’s (BADL)





Self-Care
Mobility
Communication
Management of Environmental
Hardware and devices [Operating
bolts of doors/windows, electrical
switches etc.]
Sexual expression
Self-Care
Feeding
 Grooming
 Dressing
 Bathing
 Toileting

Mobility:
moving from one place to another e.g.,
inside the house(indoor mobility) and movement in
community(outdoor mobility)
Bed Mobility
 Wheelchair Mobility
 Transfers (movement from one surface to

another like bed to wheel chair or wheel chair to
commode)

Ambulation (passive transfer from one
surface or one place to another)
Communication
Writing
 Using a telephone
 Using communication devices

Instrumental ADL’s (I-ADL)

Home Management [cooking, cleaning up]

Community Living Skills [money management,
shopping, using public transport]

Health Management [ Handling medications,
knowing health risks, making appointments]

Safety Management [Calling at emergency
nos., identifying dangerous situations]
Feeding
Set-up
 Handling utensils and cups
 Chewing and swallowing

Grooming & Hygiene
Oral Care
 Brushing the hair
 Washing the face
 Washing the hands
 (Shaving, makeup)

Dressing
Retrieving Clothing
 Dressing/Undressing
 Donning/Duffing [ Shoes/Socks]
 Prosthesis or Orthosis[ prosthesis is the

mechanical replacement of lost body part and
orthosis is the mechanical device to support
weak body parts or to enhance function]
Bathing
Washing & Drying
 Excludes neck, back
 Managing Clothes
 Transfer not included

Toileting
Perineal hygiene
 Managing Clothing
 Transfer not included

Occupational Therapy and
Activities of Daily Living
Occupational
therapists
work
with
persons, groups and organizations that
are
experiencing
difficulties
in
performing the occupations of life (i.e.
self-care, work voluntary activities, play,
and
leisure).
Therefore
a
large
component of occupational therapy
practice is to provide interventions to
overcome ADL and IADL deficits.
Role of Occupational
Therapy
Assess Performance
 Equipment Needs
 Intervention
 Patient and Family Training
 Recommendations

Assessing Performance
Functional Independence Measure
(FIM)
 Universal Standard
 Multidisciplinary
 Severity of Disability
 Track Changes
 Analyze Outcomes
FIM Scores
7
6
5
4
3
2
1
Independent
Modified Independent
Supervision/Set-up
Minimal Assistance
Moderate Assistance
Maximal Assistance
Total Assistance
No Helper Required
Independent
 Normal method, performance
Modified Independent
 Equipment
 Extended time
 Saftey risk
Helper Required

No physical contact required

Supervision
Set-up
Cuing
Orthosis
Helper Required

Physical Contact Required

Patient does:
75-100% Minimal Assistance
50-74%
Moderate Assistance
25-49%
Maximal Assistance
0-24%
Total Assistance
Items of assessment
FIM consists of 18 items organized under six categories:
 Self Care
 1. Eating
 2. Grooming
 3. Bathing
 4. Dressing upper body
 5. Dressing lower body
 6. Toileting
Sphincter Control
1. Bladder management
2. Bowel management

Mobility
1. Transfers: bed/chair/wheelchair
2. Transfers: toilet
3. Transfers: bathtub/shower

Locomotion
1. Locomotion: walking/wheelchair
2. Locomotion: stairs

Communication
1. Expression
2. Comprehension

Social Cognition
1. Social Interaction
2. Problem Solving
3. Memory

Other Assessment Tools

Barthel Index

Katz Index

Canadian Occupational Performance
Measure & Many more……..
Self- care activities

Skills for restoring
Function
Independence
Dignity