Caregiver Need to Know Program
Chapter 1: What's Their Now?

Lesson 2 Activities of Daily Living (ADLs)

Complete & Continue Next Lesson Learn More

IN THIS LESSON

Assessing Your Loved One's Daily Independence

What You'll Learn in This Lesson

The key question we're answering: How well is your loved one managing their daily activities, and where might they need support?

Activities of Daily Living (ADLs) are the fundamental self-care tasks we all do every day. Understanding how your loved one is managing these activities helps you identify where support is needed and plan for their safety and independence.

The Essential ADLs to Assess

  • Toileting

    Key questions to observe:
    Can they safely get to and from the bathroom?

    If they use a walker, does it fit through the bathroom door?

    Can they maintain proper hygiene independently?

    Are they experiencing accidents or confusion about bathroom use?

    Helpful option: Bedside urinals can provide dignity and safety for men with mobility challenges.

  • Dressing

    Watch for these abilities:
    Can they put on shirts, pants, and undergarments without help?

    Do they choose weather-appropriate clothing?

    Can they manage buttons, zippers, and shoelaces?

    Adaptive solutions: For women, simple dresses can be easier than separates. Choose slip-on shoes with non-slip soles over lace-up footwear.

  • Bathing

    Safety considerations:
    Should someone always be present during bathing?

    Can they safely step into and out of a tub or shower?

    Do they need grab bars, shower chairs, or non-slip surfaces?

    Remember: Falls in the bathroom are serious; when in doubt, prioritize safety over independence.

  • Meal Preparation

    Cognitive and physical considerations:
    Do they remember when something is cooking on the stove?

    Can they safely use kitchen appliances?

    Is their hand coordination adequate for cutting and cooking tasks?

    Are they maintaining proper nutrition?

When Additional Support May Help

Durable Medical Equipment (DME)

DME includes medical supplies and devices that can dramatically improve safety and independence. Examples include:

  • Grab bars and shower seats

  • Toilet seat risers

  • Mobility aids (walkers, wheelchairs)

  • Hospital beds or lift chairs

Good to know: Many DME items are covered by Medicare when prescribed by a healthcare provider. If you're receiving home health services, therapists can often recommend and help order appropriate equipment.

Click below for what falls into the DME category and for an idea of what is covered by Medicare..

DME & Medicare

Could a Home Health Agency help?

Home Health Agency Support

Two types of home care services:

Skilled Home Health (Medicare may cover):

  • Includes nursing or therapy services

  • May also provide ADL assistance when skilled care is involved

  • Requires physician orders

Non-Skilled/Custodial Care (for ADL assistance only):

  • Focuses purely on helping with daily activities

  • Payment options include Medicaid, Long-Term Care insurance, VA benefits, or private pay

  • More details on these payment sources in upcoming lessons

Facing the reality: Many families discover they don't qualify for Medicaid, lack LTC insurance, and can't afford private-duty care. If this sounds familiar, don't despair, you have options.

Your Action Plan

Step 1: Observe and Document

Your approach: Watch more than you advise. Let your loved one go through their normal routine while you quietly assess their abilities and safety.

Focus especially on:

  • Transfers (getting in/out of bed, chairs, car)

  • Toileting (most critical for safety)

  • Any task where they could get hurt

Step 2: Use Your Checklist

Complete the assessment checklist from Lesson 1 based on your observations. Take notes about specific challenges you notice.

Step 3: Understand Service Types

Learn the difference between skilled and non-skilled care services. Read my blog post about this distinction to help you navigate options effectively.

If you are considering the home health route,
here is that Home Health Questions Checklist that was in the previous lesson.

Home health Questions

✦ Important Safety Alert

If your loved one requires hands-on assistance with transfers and toileting AND has cognitive impairment, they likely need 24/7 supervision immediately. This combination creates serious safety risks.

Need guidance? Reach out for personalized direction.

To Do

  • Ability and safety?

    Reminder: closely observe (more watching and assessing than advising) and allow them to proceed as usual. Make notes on the checklist.

    Especially watch for the transfers and, if you can, their toileting.

  • Make notes on your checklist of your observations and experience with your loved one

  • Know the difference between Skill vs Non-skill. Here's that blog

Resources

  • Glossaryof relevant terms and definitions. A useful tool to equip you along your caregiver journeycare insurance

  • Download this PDF to interview potential home health agencies

  • Take a read to understand the difference.

Know their now worksheet

Now You Know

✓ You now understand how your loved one is managing their daily activities
✓ You can identify which activities require supervision or assistance
✓ You know about potential solutions through home health services and medical equipment
✓ You're building a personalized knowledge base for care planning

The beauty of this approach: Instead of following generic advice, you're creating a tailored plan based on your loved one's specific needs and abilities.

You're doing great! Each lesson builds your expertise and confidence as an advocate for your loved one.

Up next: Lesson 3 covers cognitive changes; one of the trickiest aspects of dementia care.

You're ready for it!