ADLs in aged care are the everyday activities someone needs or wants to manage. The abbreviation stands for activities of daily living. Looking at these activities helps an occupational therapist understand where a person is comfortable, where tasks have become difficult and what support might be useful.
A practical assessment starts with the person's normal routine. It asks what matters to them and how they would prefer to receive help. Being independent does not always mean doing everything without assistance. The right equipment, an adapted task or reliable support can help someone retain choice and participation.
Basic everyday activities
Personal activities can include washing, dressing, using the toilet, eating and moving between the places used during the day. Difficulty may involve starting an activity, completing the steps, physical effort or feeling safe enough to attempt it.
For example, someone might be able to wash while seated but find entering the shower difficult. Another person may manage the physical task yet need a reminder to begin. Those situations need different responses, which is why a general description such as 'needs help showering' is often insufficient.
Tasks that support life at home
People also manage shopping, preparing meals, household tasks, appointments and other responsibilities. These are often called instrumental activities of daily living. The demands can be substantial even when personal care remains manageable.
Consider cooking an evening meal. The person needs to choose food, obtain ingredients, organise the kitchen, follow a sequence and use appliances safely. An OT can explore which part has become harder and whether fatigue, access, memory or another factor contributes.
How an OT assesses ADLs
An assessment may involve talking through the routine, observing relevant activities and reviewing the environment. The therapist asks about current assistance and what happens when the usual support person is unavailable.
Useful details include:
- Which steps the person manages comfortably.
- Which parts need prompting, supervision or hands-on help.
- How long tasks take and whether they cause fatigue or discomfort.
- Equipment already used and any difficulties with it.
- Activities the person has stopped doing or avoids.
The therapist should explain the assessment and seek consent before observing personal activities. Family or carers can contribute useful information with the person's agreement. Their concerns are important, but they should not replace the person's preferences.
What might change after an assessment?
Recommendations may involve rearranging commonly used items, practising an agreed task, changing its timing or considering suitable equipment. Some situations call for changes to the home or a different level of personal assistance.
The recommendation should relate to a specific difficulty. A shower chair, for example, needs to suit the person and bathroom; buying one without checking fit and access can leave the original problem unresolved. A support plan should also explain who will help put the recommendation into practice.
Talking about changes respectfully
It can be uncomfortable to discuss tasks that used to feel easy. Start with a concrete concern rather than a broad statement that someone is 'not coping'. Ask what has become frustrating or what they would like to keep doing.
An adult child might say, 'Would you like some help finding a safer way to use the shower?' This creates room for the person's response. Avoid reorganising their home or purchasing equipment without discussing it, unless there is an immediate situation requiring appropriate urgent assistance.
Common questions about ADLs
Does needing help mean someone must leave home?
Not necessarily. An assessment helps identify support options, but the appropriate living arrangement depends on the person's needs, preferences and circumstances. No single ADL score settles that question.
Can an OT assess someone who already has a carer?
Yes. The assessment can consider the tasks the carer assists with, how the assistance is provided and whether the current arrangement is sustainable. The person's goals remain part of the discussion.
Is an ADL assessment the same as an aged care assessment?
They have different purposes. An OT assessment focuses on function and practical recommendations. A formal aged care assessment considers access to government-funded aged care services.
How do we get started?
Write down the activities that have changed and what the person wants help with. You can enquire directly with Ergo and discuss how an OT assessment would fit alongside existing services or a Support at Home provider.
Make a referral to discuss activities of daily living support at home across Melbourne and Western Sydney.