What skills are needed for independent living?
As we age, tasks that were once manageable can become difficult or impossible to perform without assistance. When the basics of daily life become overwhelming, seeking help from trained professionals, either through home care or a residential assisted living facility, can allow individuals to live higher quality, less stressful lives.
The decision to enter an assisted living facility or to allow a caregiver into the home is often incredibly difficult, however. You may wonder if things are really "bad enough" to justify the choice. To help make an objective decision, read on to find out exactly what abilities are necessary for individuals to live safely on their own.
Activities of Daily Living
Activities of daily living (ADL) are the things we normally do on a daily basis, including any daily activity we perform for self-care.[1] These are tasks that are absolutely necessary for someone to live independently. The following are examples of ADLs.[2]
- Bathing
- Dressing and undressing
- Eating
- Transferring from bed to chair, and back
- Voluntarily control of urinary and fecal discharge
- Using the toilet
- Walking (not bedridden)
For some individuals, performing these activities is simply a matter of making some home modifications such as installing grab bars in the bathing area. However, if someone you know is having difficulties with three or more of the above, he or she may be a good candidate for nursing home care. [3][4] An occupational therapist can help you determine whether modifications alone will provide an individual with adequate resources to perform ADL.
Instrumental Activities of Daily Living
Unlike the tasks listed above, instrumental activities of daily living (IADLs) are not absolutely necessary for fundamental functioning, but they allow an individual to live independently within a community. The following are the six IADLs.[5]
- Light housework
- Preparing meals
- Taking medications
- Shopping for groceries or clothes
- Using the telephone
- Managing money
About one-fourth of nursing-home residents need help with one or two IADLs and three-fourths need assistance with three or more. More than half of residents are incontinent (meaning they have problems using the bathroom), and more than a third have difficulty with hearing or seeing.[3]
As these activities become more difficult, an individual may find that entering residential care that allows an independent lifestyle while providing help with the chores of daily life provides a greater quality of life than living alone. Such individuals may want to investigate independent living communities or assisted living facilities.
Cognitive Capabilities
Cognitive capabilities are abilities that involve thinking and reasoning. Cognitive disorders, such as Alzheimer's disease and other dementias, can affect an individual's ability to perform activities necessary for independent living. People affected by dementia can experience gradual deterioration of intellectual abilities and behavior that eventually interferes with customary daily living activities. They may have problems with tasks such as balancing the checkbook, driving the car, and socializing with others.[3]
About 50 percent to 70 percent of nursing home residents are affected by dementia.[3] Additionally, more than three-fourths of nursing home residents have difficulty making daily decisions, such as what to have for dinner, and two-thirds have problems with memory or knowing where they are occasionally.[3]
In the earliest stages of dementia, independent living is often possible. However, as the disease progresses, it becomes stressful and dangerous for an individual to live alone. An assisted living facility will provide a safe environment that includes easy-to-navigate floor plans to help minimize disorientation. Some specialized facilities also include programs that provide activities and exercises to slow the progress of the disease.
If your loved one is no longer able to perform the necessary skills to live independently, Emeritus can provide him or her with a safe and nurturing environment. With a variety of options including adult day care, assisted living, and Alzheimer's care, we meet each individual's needs while maximizing autonomy.
For More Information
Learn more about independent living services and independent living communities at Emeritus.
References
1. MedicineNet.com. (October 21, 1998). Definition of ADLs (activities of daily living). Retrieved June 17, 2009 from the MedicineNet.com Web Site: http://www.medterms.com/script/main/art.asp?articlekey=2152.
2. McDowell, Ian and Newell, Claire. Measuring Health: A Guide to Rating Scales and Questionnaires, second edition. Oxford University Press, 1996.
3. The American Geriatrics Society Foundation for Health in Aging. (n.d.) Nursing Home Care. Retrieved June 16, 2009 from The American Geriatrics Society Foundation for Health in Aging Web Site: http://www.healthinaging.org/agingintheknow/chapters_print_ch_trial.asp?ch=15#Lives.
4. Gaugler, Joseph E, Duval, Sue, Anderson Keith A and Kane Robert L. (June 19, 2007). Predicting Nursing Home Admission in the U.S.: A Meta-Analysis. Retrieved June 15, 2009 from the PubMed Central Web Site: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1914346.
5. Bookman, Ann, Harrington, Mona, Pass, L, and Reisner, Elizabeth. Family Caregiver Handbook. Massachusetts Institute of Technology, 2007.
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