ADLs Defined
You may have seen the acronym ADL’s maybe as part of your own web searches on dementia terms, or a medical provider or insurance carrier may cite ADL’s in their documentation.
I wanted to devote a full blog to the term ADL’s because talking the “language” of dementia is an important tool for dementia caregivers for many reasons. And ADL’s is a big one. The acronym stands for activities of daily living. They include: eating, toileting, bathing, grooming, transferring/walking.
First, knowing the ADL’s gives you a framework to evaluate your loved one in a more objective way. It can act as a checklist for when you worry in your gut something is wrong, but it may be difficult to find concrete evidence.
People living with early dementia will often cover up change in memory. This happens not because they’re intentionally lying, but because they honestly may feel embarrassed at not knowing how to answer your question about things like what they ate for lunch, or loss of bladder control. Your loved one may just provide vague responses like, “oh I ate the same thing I always eat,” or “I already ate eggs and toast” but there is no toast smell wafting through the house, and there is no egg carton in the fridge.
My aunt for weeks told me she was drinking her protein shakes that my brother and I shipped to her. But when I visited, and I found them stacked in unopened boxes in the kitchen, a few things suddenly became very clear: she didn’t know what to do with them, or she didn’t like them, and did not know how to communicate this to us. Another example is you start to notice that the towels in their bathroom remain in mint condition, and are never wet or wrinkled. Or their shower gel bottle has been empty for your last two visits. Suddenly, you realize that they may be forgetting to shower or bathe.
Second, the other reason you’ll want to familiarize yourself with ADLs is that it you have language to use when you see medical providers to clearly communicate your concerns. Noticing changes in your loved one can be hard. We can even often deny that they are happening in the first place. Rather than vaguely saying “my dad just seems different and not himself,” you can speak to these specific ADLs which will be very helpful for medical providers. ADL deficits often mean your loved one is on their way down a dementia pathway, and it can tell providers quite a bit about how to craft a plan for further evaluation.
And be sure to keep a list of your observations to rely on during the appointment with their doctor: write down the ADL skill, your observation that your loved one needs help managing it, and any potential consequence. For example, “showering: the bath towels are always dry, explains unwashed hair.” Another example is “eating: the fridge is empty; may explain weight loss.” Another is “dressing: buttons are misaligned with button holes.”
Third, if your loved one has long term care benefits, then these ADL deficits fulfill criteria to start accessing those benefits and receive reimbursement for care. I encourage you to check the clause in the long term care benefits plan that explain qualifying criteria. Some of them can be vague, but usually ADL deficits factor into qualifying criteria somehow. You will need to explain or show some proof of this if you would like to bring an aid into the home and get reimbursed from that long term care insurance policy.
Stay tuned for further information on how to clearly communicate to your loved one’s medical providers and long term care insurance.
