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Updated April 02, 2015.
Written or reviewed by a board-certified physician. See About.com's Medical Review Board.
What Are Activities of Daily Living?
Activities of Daily Living (ADLs) are tasks that need to be accomplished on a regular basis to function. Examples of ADLs include bathing, dressing, grooming, eating, mouth care and toileting.
What Impact Does Dementia Have on ADLs?
Alzheimer's disease and other kinds of dementia often make performing ADLs difficult. Tasks may be done halfway, poorly or not at all.
For example, while some people with dementia appear as if there's nothing wrong with them, others look disheveled and may wear dirty, mismatching clothes.
A person's ability to perform ADLs is often evaluated when assessing their cognitive functioning. Since dementia is typically a progressive condition, the ability to perform ADLs declines over time.
Why Does Dementia Make ADLs Difficult?
Several of the brain functions required to perform ADLs are impacted by dementia.
It can be difficult to correctly order the multiple steps required to wash hair, for example, or to get dressed. It's not uncommon to see people put clothing on in the wrong order, such as trying to put a bra on over their shirt. Sequencing, planning and organizing a multiple-step activity can be very difficult.
Sometimes, the person with dementia just forgets to do the task or how to perform it. They might not remember to put clean clothes on in the morning or comb their hair.
Poor decision-making skills can also impact ADLs.
In the middle of winter, someone with dementia might decide he doesn't need long pants or a jacket.
The ability to focus on completing an activity such as a bath might be challenging if the environment is noisy or if the person is feeling tired or experiencing pain.
Sometimes, dementia can affect personality and behavior so that a loved one resists assistance with ADLs, further complicating things. She might become fearful or angry at your "meddling" because she doesn't understand that she needs assistance with a bath or brushing her teeth.
The visual perception of where the toothbrush is on the bathroom counter or an uncertainty as to which container is the toilet can make completing ADLs difficult.
How Can You Help Someone Who Has Dementia with Their ADLs?
- Remain calm
- Provide one direction at a time
- Model the behavior along side the person
- Decide what's really important and let the rest go
- Allow extra time to decrease stress
- Use humor (Here's how to use it appropriately)
- Choose the caregiver or family member who has a good rapport
- Take a break if it's not going well and try again later
- Hire home health care to assist
- Practice the activity in the same routine every day
If other conditions such as arthritis or a significant decline in function exist, ask your physician if Medicare will pay for Occupational Therapy for a period of ADL assistance or training.
Practical Help for Coping with ADL Challenges in Dementia
Tips for Bathing Someone with Dementia
How to Respond to Problems with Dressing in Dementia
Personal Hygiene and Grooming Issues in Alzheimer's
Living with Dementia: How to Get Those Teeth Brushed without a Battle
16 Tips for Eating, Appetite Changes and Weight Loss in Dementia
How to Prevent and Reduce Incontinence for People with Memory Loss
Sources:
Alzheimer's Association. Dressing and Grooming. Accessed March 29, 2015. https://www.alz.org/care/alzheimers-dementia-dressing.asp
Alzheimer's Association. Glossary. Accessed March 29, 2015. http://www.alz.org/care/alzheimers-dementia-glossary.asp
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