Let's say you get a letter from your health plan with a lot of acronyms in it. It says you may qualify for help at home, but the paperwork is full of terms you didn't recognize, like "ADLs" and "IADLs."
You may not be familiar with these initialisms, but you're already well-acquainted with what they represent: the essential functions that drive our everyday lives. Let's go over what ADLs and IADLs are — and why understanding them could help you get support faster than you think.
ADLs, or Activities of Daily Living, are the basic physical tasks a person needs to perform every day to take care of themselves. The term was coined in the 1950s by a physician named Sidney Katz as a way to measure a person's functional independence. Today, doctors, insurance companies, care managers, and benefit programs across the country still consider ADLs to be the same six activities defined by Dr. Katz.
Here they are described in plain language, along with the kinds of support that exist for each one.
Bathing is the ability to wash yourself — cleaning your body and getting in and out of the tub or shower. It also includes basic hygiene like brushing your teeth and shaving.
Trouble with bathing is one of the most common reasons people begin receiving in-home care. It's also one of the most underreported, because it's such a private and personal task. If you're avoiding the shower because it feels unsafe, or if you've needed someone nearby to make sure you don't fall while you're washing, those count as struggling with this ADL.
How to get help: Personal care aides can assist you with bathing while protecting your privacy and dignity. Home safety modifications like grab bars, shower seats, and handheld showerheads can also reduce your risk and extend your independence.
Dressing means being able to select appropriate clothing and put it on yourself, including managing buttons, zippers, and fasteners.
Arthritis, weakness, or balance issues can make getting dressed take much longer than it used to, or force you to sit down to get dressed safely. These are real functional changes worth noting.
How to get help: Personal care aides can assist with dressing. There is also adaptive clothing that's designed to be easier to put on and take off.
Eating, in the ADL context, means getting food from a plate or cup into your mouth. It does not include cooking or preparing a meal — that's a different category.
If swallowing has become difficult, or if you need someone to help guide food to your mouth, you may qualify for eating support.
How to get help: Home health aides can assist you with feeding. Meal delivery services — where prepared meals come to your door — can cover the nutrition side even if you can still feed yourself.
Transferring means moving from one position to another — for example, getting in and out of bed, rising from a chair, or moving to and from a wheelchair. It's sometimes referred to as mobility or ambulating.
Falls often happen during transfers. If you've had near misses, or if you need someone to steady you when you stand, these are real needs your health plan may cover.
How to get help: Personal care aides can provide hands-on transfer assistance. Occupational therapists can assess your home for safety risks. Equipment like bed rails, transfer boards, and hospital-style beds can also reduce risk.
Toileting means getting to and from the toilet, using it appropriately, and cleaning yourself afterward.
This is another area where people prefer to manage challenges in silence because it feels embarrassing, but needing help with toileting is a legitimate medical and functional need — not something to push through alone.
How to get help: Personal care aides are trained to assist with toileting discreetly and respectfully. Home modifications like raised toilet seats and grab bars near the toilet can also make a significant difference.
Continence means being able to control bladder and bowel function — or, if you can't control it fully, being able to manage it yourself with products like adult briefs or a catheter.
If managing incontinence requires another person's help, that qualifies as an ADL limitation.
How to get help: Home health aides and personal care aides can assist with continence care. Your health plan may also cover supplies.
IADLs stands for "Instrumental Activities of Daily Living." They're the more complex tasks that allow you to manage your life and household — things that require planning, judgment, and organization, not just physical ability.
Here's something important that most people don't realize: IADLs typically decline before ADLs do. Someone might still be able to bathe and dress independently while quietly struggling to manage their medications, keep up with bills, or get to medical appointments. Those IADL challenges are often the first signs that more support is needed, and they're exactly the kind of tasks that in-home services can address.
IADLs do not always qualify someone for benefits the way ADLs do, but once your ADL benefits are activated, the services you receive often directly address IADL needs as well. Your plan may also cover IADL-related support even before the formal ADL threshold is met, depending on your specific coverage.
Here's an intro to the main IADLs and the kinds of help that exist for each one.
Meal prep refers to everything you have to do before your food reaches your plate: planning meals, gathering ingredients, cooking, and getting food to the table. This is different from the eating ADL.
Struggling to cook safely — for example, forgetting things on the stove, having difficulty standing for long periods, or getting confused about steps in a recipe — is a real functional change.
How to get help: Meal delivery services can bring prepared meals directly to your home. Home care aides can assist with cooking. Grocery delivery services can handle the shopping.
Housekeeping or homemaking describe keeping your home clean, doing laundry, and maintaining a safe living environment.
A home that was always clean and organized but now looks cluttered, dirty, or unsafe is often one of the first visible signs that someone needs support.
How to get help: Homemaker services and home care aides can assist with cleaning, laundry, and general household upkeep.
Taking the right medications at the right times, refilling prescriptions, and monitoring for side effects all fall under the umbrella of medication management.
Missed doses, extra doses, and expired medications are serious health risks. If keeping track of medications has become confusing or burdensome, that shouldn't go unaddressed.
How to get help: Care management services can coordinate medication schedules. Pill organizers, medication reminder apps, and pharmacy delivery services are also widely available.
Transportation-related activities that may be considered IADLs include getting to medical appointments, running errands, grocery shopping, and staying connected to your community.
Being unable to drive safely doesn't just make your day-to-day routine more difficult but can also cut you off from socialization. Isolation poses serious health risks.
How to get help: Nonemergency medical transportation, ride services for seniors, and errand assistance are available through many plans and community programs.
Good financial management requires paying bills on time, keeping tabs on your bank accounts, and handling insurance paperwork and claims.
Unpaid bills, missed insurance payments, or confusion about financial accounts can be early signs of cognitive decline. Financial management is one area where family members often step in quietly for months before a formal assessment happens.
How to get help: Care managers can assist you with navigating insurance paperwork and benefits. Financial Power of Attorney (PoA) arrangements can bring a trusted family member or advisor into the process.
IADL shopping refers to buying groceries, household supplies, clothing, and other necessities.
Shopping becomes difficult when driving is no longer safe, when carrying bags is physically challenging, or when cognitive changes make shopping trips overwhelming.
How to get help: Grocery and essential delivery services. Home care aides who can accompany or shop on someone's behalf.
Comfortably using the phone, a computer, and other devices is typically necessary for staying in touch with family, scheduling appointments, communicating with medical providers, and managing daily logistics.
How to get help: Technology support services, digital literacy guidance, simplified devices designed for older adults, and caregiver assistance with scheduling and communication can help you navigate the modern tech landscape.
Here's the clearest way to understand how ADLs and IADLs interact with your coverage.
ADLs are the keys that unlock the lock. Most long-term care insurance policies require that you need help with at least two of the six ADLs — or that you have a documented cognitive impairment — before benefits begin to pay out.
IADLs are what those benefits often pay for. Once your policy activates, the services you receive — like meal delivery, housekeeping, transportation assistance, or medication management support — are largely IADL-related. They're the practical kinds of help that keep someone living at home with dignity day by day.
The gap between these two categories is where a lot of people get stuck. They're struggling with IADLs but don't realize their ADLs may also qualify them for coverage, or they've already qualified but don't know what services are available to them. That's the gap that a good care manager can close.
ADL limitations aren't the only way to activate care benefits. Many plans also include cognitive impairment as a separate qualifying condition.
If a doctor has documented Alzheimer's disease, dementia, or another condition that affects someone's memory, judgment, or the ability to recognize safety hazards, that diagnosis alone can trigger benefits coverage, even if the person can still bathe and dress themselves.
This matters because cognitive decline often shows up in IADLs first — missed medications, unpaid bills, getting lost on familiar routes, and so on. If those things are happening, a formal assessment is worth requesting sooner rather than later.
One thing the research is clear on: People who seek support earlier tend to do better. They stay home longer, they avoid hospitalizations, and their care is often both less intensive and less expensive.
Waiting for a crisis like a fall, a hospitalization, or a sudden inability to manage basic tasks could mean starting from a much harder place.
If you or someone you love is struggling with any of the tasks described in this article, that's worth paying attention to. It doesn't mean your independence is over — it means support is available, and you should find out what your coverage includes.
Contact your insurance carrier or government health plan to ask about the benefits that are accessible to you. If your plan includes support services through companies like The Helper Bees, a care specialist can walk you through what you qualify for, what services are available in your area, and how to get started.
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