Published: October 30, 2023
Reviewed by: Dr. Brindusa Vanta, MD
If you’re researching senior living or senior care for yourself or an older loved one, you may have heard the term “IADLs.” Instrumental Activities of Daily Living, or IADLs, are tasks or activities that everyone must perform regularly, such as cooking, cleaning, and managing one’s finances. Senior care and other health professionals often evaluate a senior’s need for care based on their capacity to perform their IADLs and basic Activities of Daily Living (ADLs).
Below, we explain IADLs in more detail so you can better understand how much help you or your loved one may need.
What Are IADLs and What is the Difference Between ADLs and IADLs?
Instrumental Activities of Daily Living are the complex tasks required to maintain independent living conditions. They go beyond the six essential ADLs, which are:
These ADLs represent the basic activities that people must be able to accomplish to live independently, which often must be combined to complete one IADL. For example, while eating is an ADL, the ability to plan and prepare meals, shop accordingly, and eat a healthy diet is an IADL. To clean and maintain a home, a senior must be able to walk on their own.
Consider this brief list of some common IADLs as a way to do more research to better evaluate your loved one’s condition:
- Managing a budget
- Shopping for groceries
- Planning meals
- Attending doctor appointments
- Taking medications as prescribed
- Managing transportation
- Using communication devices
- Completing housework
- Taking care of pets
- Maintaining the property
- Engaging in hobbies
How Do I Know If I Need Help With IADLs?
A medical professional can evaluate your ability to complete IADLs using the Lawton-Brody IADL Scale. This scale breaks down the eight most common IADLs and asks you to rate your loved one or yourself on a scale of 0-1 for each one, with a score of 8 being a high-functioning, independent individual.
One interesting note about the scale is that men can pass with a score of 5 or higher since many senior men have simply never had to do laundry or housework before. Additionally, while the test can be used informally, it should be corroborated in a community or hospital setting before action is taken.
If the scale demonstrates that you or your loved one needs help with IADLs, you have options before considering assisted living and other retirement communities. Often, home modifications, informal help, or a paid housekeeper can get a senior’s IADL score up to acceptable levels.
Does Assisted Living Help with IADLs?
Assisted living facilities focus on ADLs and do not offer high-level medical care. However, they can help seniors if a deficiency in IADLs prevents them from living independently. They are especially advantageous since they allow residents to retain as much independence as possible while assisting them in their problem areas.
For instance, assisted living communities often offer transportation for residents, which can help with certain IADLs like shopping and meeting doctor’s appointments. Additionally, staff members take care of housekeeping, maintenance, laundry, and meal prep for residents while the facility schedules social activities to keep residents busy.
Get Help With IADLs
Assisted living communities can be prohibitively expensive. According to the Genworth Cost of Care Survey for 2021, they cost an average of $4,500 per month, though this varies widely between states.
Since assisted living is not always the best option, consider the below measures if you or a senior loved one needs help with specific IADLs but can otherwise continue living independently.
Make Home Modifications
In many cases, the home itself prevents seniors from completing their IADLs. For example, someone may feel pain from going up and down stairs, leading them to skip appointments or forgo grocery shopping. Likewise, if a senior has trouble navigating their home, maintenance, basic housekeeping, and even laundry can become more difficult than they should be.
Simple home modifications that focus on the accessibility challenges of your situation can be enough to improve someone’s IADL score. These could involve paying for maintenance and repairs, hiring a paid housekeeper, or installing home safety equipment. However, the modifications don’t have to be this drastic. Sometimes, helping a loved one clean up around the house can be enough to improve their mobility.
However, in some cases, modifications are insufficient to solve the problem. But rather than moving to an assisted living facility, many seniors would prefer to move to a more accessible home or hire help if it means maintaining their independence.
Hire In-Home Care
In-home care may be expensive, but for most needs, the cost is still lower than residency in an assisted living community. In-home care can help with several IADLs, including housekeeping, meal preparation, laundry, or even transportation.
According to Genworth, homemaker and home aide services cost about $1,000 per month for 10 hours of care week. Therefore, you can hire an in-home aid for yourself or your senior loved one for around 38 hours per week before the cost reaches the average for assisted living facilities. However, these numbers differ by state, so check the rates in your area before hiring someone.
Move To Assisted Living
Finally, if your loved one cannot manage their IADLs even with modifications, assisted living facilities can help. These facilities offer housekeeping, meal preparation, laundry, transportation, and socialization services while helping residents complete daily tasks.
Since the cost of assisted living varies between states, look up communities in your area to get a feel for the options available. While the conversation can be difficult, the best thing for your loved one may be to live where help is available 24/7 to ensure they complete the daily tasks they can no longer tackle on their own.