Table of Contents
What Are Instrumental Activities of Daily Living (IADLs)?
IADLs vs ADLs: What’s the Difference?
Examples of Instrumental Activities of Daily Living
IADL Assessment Tools: How Is Function Evaluated?
Who Is Affected by IADL Impairments?
Why IADLs Are Key in Long-Term Care and Home Care Planning
Recognized Instrumental Activities of Daily Living (IADLs) Checklist
When it comes to maintaining independence, especially for older adults or those recovering from an illness or injury, it’s not just about getting dressed or taking a shower. There’s a whole other layer of tasks that are just as critical, like paying bills, making meals, and remembering to take medications. These are called Instrumental Activities of Daily Living, or IADLs, and they can be the key to whether someone can live on their own or needs help.
At FreedomCare, we support caregivers who help their loved ones with both basic and complex daily tasks. In this post, we’ll break down everything you need to know about IADLs: what they are, how they’re different from other daily activities, how they’re assessed, and why they’re so important in home care.
What Are Instrumental Activities of Daily Living (IADLs)?
Instrumental Activities of Daily Living (IADLs) are the more complex tasks required to live independently, such as managing medications, preparing meals, or handling finances. Unlike basic self-care activities (like bathing or dressing), IADLs demand higher-level thinking, planning, and often physical coordination. These tasks are frequently the first areas where individuals begin to experience difficulty as they age or encounter health challenges. In fact, a 2014 study found that limitations in both Activities of Daily Living (ADLs) and IADLs increased significantly with age, with adults aged 75 and older being the most likely to need assistance: 10.6% for ADLs and 18.8% for IADLs.
IADLs include things like:
- Managing finances (e.g., paying bills, budgeting)
- Handling transportation (driving or arranging rides)
- Shopping for groceries or clothes
- Preparing meals
- Doing housework and laundry
- Taking medications correctly
- Using communication tools (phones, computers)
These activities are essential for a person to manage their life independently. If someone can no longer do these tasks safely or effectively, it might be time to bring in support, like a family caregiver or a program like FreedomCare that allows loved ones to provide care and get paid for it.
IADLs vs ADLs: What’s the Difference?
To truly understand IADLs, it helps to first understand Activities of Daily Living (ADLs). These are the basic, fundamental tasks most people learn in early childhood and perform daily:
- Bathing
- Dressing
- Eating
- Toileting
- Transferring (moving from bed to chair, for example)
- Continence (control of bowel and bladder function)
IADLs, on the other hand, are more advanced tasks that require higher-level cognitive and physical functioning. While ADLs are typically focused on self-care, IADLs relate to managing one’s household and life.
Think of it this way: if ADLs are the foundation, IADLs are the structure built on top. Both are essential, but IADLs often signal how independently someone can truly live.
Examples of Instrumental Activities of Daily Living
Let’s take a closer look at real-world examples of IADLs and why they matter:
- Managing Finances: Can the person balance a checkbook, pay bills on time, and understand financial transactions?
- Handling Transportation: Can they drive safely, use public transportation, or arrange rides through services?
- Meal Preparation: Are they able to plan, cook, and store meals safely?
- Shopping: Can they create a list, get to the store, compare prices, and carry items back home?
- Housekeeping and Laundry: Are they capable of cleaning the house and washing clothes regularly?
- Medication Management: Do they know what medications to take, when, and how?
- Using Communication Devices: Can they use a phone, email, or apps to stay connected with family, friends, or doctors?
Struggling with any of these tasks doesn’t necessarily mean someone is unable to live on their own, but it is a sign that extra help might be needed.
Who Is Affected by IADL Impairments?
IADL impairments are most common in:
- Older adults who may be experiencing cognitive decline, vision or hearing loss, or limited mobility.
- Individuals with chronic illnesses such as Parkinson’s, Alzheimer’s, or stroke survivors.
- People recovering from surgery or injury, who may temporarily be unable to perform these tasks.
Often, the decline in IADLs is gradual. A person may still appear “fine” to others but start to miss medication doses or forget to pay bills. That’s why family members and caregivers play a crucial role in spotting early signs.
Why IADLs Are Key in Long-Term Care and Home Care Planning
Many people can manage ADLs just fine but struggle with IADLs, and this is often where home care services come into play. In fact, eligibility for programs like Medicaid long-term care often depends not just on whether someone can bathe or dress, but also whether they can handle more complex tasks.
Caregivers, whether family members or professionals, often step in to support IADLs. At FreedomCare, we’ve seen firsthand how critical this support is. Family caregivers often shop, cook, clean, manage appointments, and help their loved ones stay on track with medications—all without realizing they’re performing IADLs.
That’s why we believe family caregivers deserve recognition and compensation for the care they’re already providing.
Recognized Instrumental Activities of Daily Living (IADLs) Checklist: Know Where Support Is Needed
While many care assessments traditionally focus on 6 to 8 core IADLs, more comprehensive approaches, especially those used in advanced care planning and geriatric evaluation, iidentify up to 16 distinct instrumental activities of daily living. Recognizing this broader range provides a fuller picture of an individual’s ability to live independently, highlighting both practical and cognitive aspects of daily life that contribute to overall well-being.
Here are 16 IADLs commonly recognized across various care models:
1. Managing Finances
Summary: Involves paying bills on time, budgeting monthly expenses, and keeping track of bank accounts or credit cards.
Support Approach: Care should be guided by the individual’s comfort level and routine—some may only need reminders or oversight, while others might benefit from a trusted family member handling finances with their consent and involvement.
2. Managing Medications
Summary: Taking prescribed medications properly, at the right time, and understanding dosage instructions.
Support Approach: Medication routines should be built around the person’s daily habits, using pill organizers, alarms, or caregiver check-ins to maintain independence while ensuring safety.
3. Meal Preparation
Summary: Planning, cooking, and storing meals that meet personal and dietary needs.
Support Approach: Support should honor food preferences, cultural traditions, and dietary restrictions. Some individuals may just need help shopping or chopping ingredients, while others may benefit from pre-prepped meals or shared mealtimes with a caregiver.
4. Housekeeping
Summary: Keeping the home tidy, including dusting, vacuuming, doing dishes, and other light chores.
Support Approach: Household help should be aligned with the person’s energy levels and sense of pride in their space, offering assistance while allowing them to take part in tasks they enjoy or value.
5. Laundry
Summary: Washing, drying, folding, and putting away clothes and linens.
Support Approach: It helps to involve the individual in parts of the process they’re comfortable with—whether it’s sorting laundry, folding, or simply choosing their clothes, fostering autonomy and routine.
6. Shopping
Summary: Buying food, hygiene products, clothing, or other necessities.
Support Approach: Assistance should reflect the person’s preferences and priorities, support can range from helping write a list and driving them to the store, to doing online orders together from home.
7. Using Transportation
Summary: Getting to appointments, the store, or social events using a car, public transit, or rideshare services.
Support Approach: Transportation support should be designed around the individual’s comfort with mobility and independence, whether that means a familiar driver, help navigating public routes, or tech tools for booking rides.
8. Using Communication Devices
Summary: Using a phone, computer, or tablet to stay in touch with family, friends, and professionals.
Support Approach: Communication tools should match the person’s tech abilities and preferences, some may need help learning apps, while others may simply benefit from having devices set up and ready to use.
9. Home Maintenance
Summary: Performing or coordinating repairs, changing light bulbs, and maintaining a safe home environment.
Support Approach: It’s important to listen to what tasks matter most to the person and ensure they have a say in who performs repairs, what gets prioritized, and how things are handled.
10. Managing Appointments
Summary: Scheduling, remembering, and attending medical or social appointments.
Support Approach: Appointment management should fit naturally into the person’s existing routine, using calendars, phone reminders, or caregiver support without overwhelming or confusing them.
11. Managing Nutrition
Summary: Making healthy food choices, following dietary guidelines, and understanding nutritional needs.
Support Approach: Nutritional support should reflect cultural values, taste preferences, and personal goals, whether it’s healthy aging, managing a health condition, or simply enjoying meals.
12. Community Engagement
Summary: Participating in spiritual, social, or recreational events and staying connected to others.
Support Approach: Social connection should be tailored to the person’s interests, whether that means helping them attend church, join a club, or video chat with loved ones. The goal is to nurture joy and a sense of belonging.
13. Emergency Preparedness
Summary: Recognizing and reacting to emergencies like falls, fires, or health crises.
Support Approach: Plans should be built around what feels safe and familiar for the individual, using easy-to-access alert systems, emergency contacts, and walkthroughs of what to do if something goes wrong.
14. Handling Mail
Summary: Receiving, reading, and responding to mail, including bills, benefits notices, or personal letters.
Support Approach: Assistance should maintain the individual’s privacy and dignity. Support might mean sorting mail together or reading important items aloud, with the person always in control of decisions.
15. Financial Planning
Summary: Managing long-term money matters such as retirement funds, insurance, Social Security, or Medicaid.
Support Approach: Financial decisions should involve the person fully, with explanations and options presented in a way that respects their goals, history, and confidence in managing money.
16. Supervising the Home Environment
Summary: Identifying hazards, organizing the home for safety, and maintaining a peaceful, functional living space.
Support Approach: Home adjustments should be collaborative, allowing the person to help decide furniture placement, lighting, or grab bars—so they feel empowered, not displaced, in their own home.
Together, these 16 IADLs provide a comprehensive view of how well someone can navigate the responsibilities of daily living. Even if a person has difficulty with just a few of these tasks, they may still maintain their independence with the right support. However, when challenges span multiple areas, it might signal the need for more consistent help, whether that’s through trusted family members stepping in or through a program like FreedomCare, which empowers loved ones to become paid caregivers while providing the care and familiarity that truly matters.
FAQs About Instrumental Activities of Daily Living
Q: What’s not considered an IADL?
Basic personal hygiene like brushing your teeth or using the toilet is not an IADL—that’s an ADL.
Q: Can IADLs improve with therapy?
Absolutely. Occupational therapy, cognitive rehabilitation, or in-home care support can often restore or enhance someone’s ability to perform IADLs.
Q: What if someone can do some IADLs but not others?
That’s very common. Some people might manage finances but struggle with transportation. Care plans should be tailored to the individual’s specific needs.
Q: Are IADLs the same in every culture?
Not exactly. While many IADLs are universal, the way tasks are performed may differ across cultures. For example, meal preparation varies widely.
Why IADLs Matter and How FreedomCare Can Help
Understanding and recognizing IADLs is about more than just checking boxes. It’s about preserving independence, dignity, and quality of life. When a loved one starts struggling with these tasks, it’s not a failure—it’s a signal that extra support is needed.
At FreedomCare, we’re here to help. If your loved one qualifies for Medicaid, you may be able to get paid to care for them in the comfort of their own home. That means no strangers in the house, and more time for connection and compassion.
Need help getting started? Contact us today to learn how you can become a paid family caregiver.