What Are Activities of Daily Living (ADLs)?
Activities of Daily Living (ADLs) are the six basic self-care tasks that a person performs every day. When someone can't do one or more of these on their own, it's a signal that they need help, and it's often the trigger for qualifying for Medicaid, VA benefits, or long-term care insurance coverage.
The six ADLs are: bathing, dressing, eating, transferring (getting in and out of a bed or chair), toileting, and continence (managing bladder and bowel control).
Why ADLs Matter
ADLs aren't just a medical checklist. They're the yardstick that insurance companies, Medicaid programs, and the VA use to decide who qualifies for care benefits.
- Texas Medicaid uses ADL assessments to determine if someone needs a "nursing facility level of care," which is the threshold for both nursing home Medicaid and STAR+PLUS HCBS waiver services.
- VA Aid and Attendance requires the veteran to need help with ADLs to qualify for up to $2,424/month.
- Long-term care insurance policies typically begin paying benefits when the policyholder needs help with 2 or more ADLs, or has a cognitive impairment.
In practical terms: the number of ADLs your loved one struggles with determines what kind of care they qualify for and who pays for it.
The 6 ADLs
| ADL | What It Means |
|---|---|
| Bathing | Washing the body, including getting in/out of the shower or tub |
| Dressing | Putting on and taking off clothing, including fasteners |
| Eating | Feeding oneself (not meal preparation) |
| Transferring | Moving between surfaces: bed to chair, chair to standing |
| Toileting | Getting to and from the toilet, managing clothing, cleaning oneself |
| Continence | Controlling bladder and bowel function, managing incontinence supplies |
ADLs vs IADLs
There's a related set of tasks called Instrumental Activities of Daily Living (IADLs). These are more complex activities that a person needs to live independently:
- Managing finances (paying bills, handling a bank account)
- Managing medications (taking the right pills at the right time)
- Food preparation (cooking meals)
- Housekeeping (cleaning, tidying)
- Laundry
- Transportation (driving or arranging rides)
- Using the telephone or other communication
- Shopping (groceries, household needs)
IADL limitations often show up before ADL limitations. If your parent is forgetting to pay bills, can't manage their medications safely, or has stopped cooking meals, those are early warning signs that more support is needed, even if they can still bathe and dress independently.
How ADLs Are Measured
Assessments typically rate each ADL on a scale:
- Independent: Can perform the task without any help
- Needs supervision: Can do it but needs someone watching for safety
- Needs assistance: Requires hands-on help from another person
- Dependent: Can't perform the task at all without someone doing it for them
For most benefit programs, "needing assistance" or "dependent" in 2 or more ADLs is the threshold that triggers eligibility.
Not sure if your parent's care needs qualify them for benefits? Chat with Brevy for a quick assessment.
Common Misconceptions
"My parent can still do some things, so they won't qualify." Qualifying doesn't mean your parent can't do anything. Needing help with just two ADLs (say, bathing and transferring) is often enough to trigger Medicaid or insurance benefits.
"ADLs only matter for nursing homes." ADL assessments also determine eligibility for home care, assisted living, VA benefits, and adult day programs. They're used across the entire spectrum of senior care.
Related Terms
- Medicaid spend-down: The process of qualifying for Medicaid by spending excess income on medical expenses
- Nursing Facility Level of Care (NFLOC): The clinical determination that someone needs the level of care a nursing home provides, based largely on ADL limitations
- VA Aid and Attendance: VA pension benefit requiring ADL limitations for eligibility
Learn More
- Texas Medicaid Programs for Seniors
- Home Care vs Home Health in Texas
- VA Aid and Attendance in Texas
- Assisted Living in Texas
- How to Pay for Senior Care in Texas
The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Medicaid rules vary by state and change frequently. Always verify eligibility and benefits with your state Medicaid agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.