A Complete Guide to Activities of Daily Living (ADLs) in Singapore

As a caregiver, you’ve probably heard the term Activities of Daily Living (or ADLs). Before diving any deeper, it’s important to know what this all means in the first place.

by Hannah Grey

Medically Reviewed by Belinda Ngui, R.N. and Homage Care Specialist.

You may have come across the term “ADL”, but what does it mean? According to the National Cancer Institute, ADL refers to “Activities of Daily Living” or a set of six basic self-care tasks and is a concept of how independent a person is. These are routine activities that people have learned from a young age and usually do daily without any assistance, such as eating, dressing, grooming, and using the toilet. 

Many of these ADLs may seem like simple and mundane tasks for most able-bodied people. However, given the increasingly ageing population in societies all around the world, there may be more and more elderly people who are unable to function like they used to and need support with basic ADLs.

What are the six Activities of Daily Living?

The 6 Activities of Daily Living are washing, toileting, dressing, feeding, mobility, and transferring (in and out of a bed or a chair).

1. Washing

This refers to one’s ability to wash their face or body in the bath or shower independently, as well as physically getting in and out of the shower. While this seems simple, it can be quite tiresome and even dangerous for the elderly.

Generally, seniors get cold more easily and can experience a loss of balance or range of motion as they age. Combined with slippery floors, this can cause falls. 

As such, having someone to support with washing and showering can help to prevent falls and minimise the chances of injury. 

2. Toileting

Toileting is the ability to get to and from the toilet, use it properly, and being able to clean oneself afterwards. This can also mean putting on protective undergarments such as diapers or surgical appliances unaccompanied if required.

Since functional disability is associated with falling and seniors are generally more susceptible to falls, unaccompanied toileting may result in minor or major injuries for the elderly. 

3. Dressing

This refers to the ability to choose which clothes to wear, put them on, and manage one’s self-appearance. Part of what constitutes dressing also includes securing and unfastening any artificial limbs, braces, and other medical and surgical appliances, if needed.

As they age, some elderly adults may lose the ability to dress due to health conditions like arthritis, a stroke, broken bones, or even cognitive impairments like dementia. Because of this, they may need extra help when getting dressed.

4. Feeding

Feeding refers to being able to feed oneself after the food has been prepared. Over time, elderly adults with cognitive or physical decline may lose their ability to feed themselves completely. This could be due to a decline in motor or swallowing functions. Furthermore, they can also experience dietary and nutritional challenges, such as losing their appetite and simply forgetting to eat meals.

5. Mobility

Functional mobility touches on the ability to sit, stand, walk and move from one place to another on level surfaces all by yourself. Other mobility-related activities include getting onto and off of the toilet, sitting and rising from the couch or other furniture, as well as going up and down the stairs.

6. Transferring

While it is similar to functional mobility and sometimes used interchangeably, transferring focuses on all aspects of being able to move from a bed to an upright chair or wheelchair and vice versa.

Can technology and equipment help with ADLs?

Yes, various types of assistive equipment can help you complete ADL tasks with far more ease. Not only does this make the process of completing ADLs easier and safer, but also reduces the amount of time needed to complete them as well.

For activities that require your elderly loved one to get up from a seated position, whether that’s on a toilet seat or chair, grab bars and bed rails can prop them up by giving them the added support that they need. For those with mobility-related problems, walkers and wheelchairs can allow seniors to get from one place to another more quickly, conveniently, and safely. 

Other examples of assistive equipment include: 

  • Ramps 
  • Hearing aids 
  • Buttoning aid hook 
  • Medical alert devices 
  • Chair lifts 
  • Toilet seat risers 
  • Shower chairs 
  • Handheld shower heads 
  • Washcloth mitts 
  • Kitchen utensils with larger handles for more grip 
  • Shoes with velcro straps

While these devices may be simple, they can make a huge impact on an elderly person’s life and allow them to live more independently as they age.

Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs): How are they different?

There are Activities of Daily Living (ADLs), which we are already familiar with, and Instrumental Activities of Daily Living (IADLs). So, how do these two classifications differ from one another? 

ADLs are tasks that are necessary for basic functional living. On the other hand, IADLs involve slightly more complex tasks that require more thinking and organisational skills than regular ADLs. While IADLs are not critical to functional living, they are “important for independent living in the community,” shares Belinda, a Care Specialist at Homage.

The list is rather long, but some examples of IADLs include:

  • preparing meals and cooking,
  • cleaning and doing chores,
  • shopping,
  • travelling and managing one’s transport,
  • handling finances and money, and
  • managing medications.

If a person is not able to carry out ADLs or IADLs independently, they will likely need support. However, how do we determine if one needs help with these activities? 

How are ADL assessments in Singapore like?

An ADL assessment is a tool used to evaluate one’s level of cognitive and physical functioning in personal care and social activities.

“ADL assessments can be conducted by healthcare professionals, such as physiotherapists, occupational therapists, doctors, and registered nurses,” says Belinda. In addition, assessments can be done either in the elderly person’s home environment or at an elderly care facility

The common areas covered in an ADL assessment include: 

  • Personal care (washing, hygiene, and grooming) 
  • Physical functions (feeding, dressing, and toileting) 
  • Functional mobility (transferring) 

During the assessment, you may also be asked to provide more information about your loved one’s current health conditions and status, their living environment, and how they are at social and communal activities.

In Singapore, individuals will complete a Functional Assessment Report to determine whether they or their loved one requires ADL assistance. 

What is the purpose of an ADL assessment? 

Not only is an ADL assessment useful in determining the cognitive and physical functions and limitations of the elderly, but it also helps ensure that they can receive the right kind of care support. Evaluating one’s independent living skills allows healthcare professionals and elderly care service agencies to decide which areas your elderly loved one needs more assistance with. 

Moreover, these assessments can also determine whether or not an elderly person may need further rehabilitation or assistance in their own homes or at a long-term care facility. It may also be used as a tool to detect early signs of illness or physical injury among patients.

After all, the inability to ambulate such risks may lead to potential falls and injuries that could have been prevented.

Where can I find ADL support for a loved one? 

If an elderly person in your family requires further assistance after taking an ADL assessment, the next step is to figure out where and how they can receive the necessary care support. 

Nursing homes and assisted living facilities can provide practical care to seniors who are unable to perform certain ADLs or IADLs. From personal and emergency care to food preparation and recreational activities, skilled caregivers and nurses will assist seniors with ADLs and IADLs to the best of their abilities. 

On the other hand, in-home care providers for the elderly are suitable for seniors who have mobility-related issues and are designed to aid independent living all at the same time. Receiving care and assistance right from your home also eliminates the need to travel to an eldercare facility and allows for more convenience and comfort as well.

Finding the right care option is incredibly crucial not just in helping your elderly family members complete basic ADLs, but also making them feel empowered and independent in their daily lives. Assisted care isn’t meant to remove the aspect of independence from an elderly person’s life but rather, to give them a sense of dignity and normalcy despite physical limitations.

Homage’s Care Pros can help

Trained professionals, like Homage’s Care Pros, can visit your home and assist your loved one according to their needs. Our caregivers, nurses and therapists can also spot potential health hazards in your home and will advise you on the different measures you can take to prevent any accidents. 

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  1. Agency for Integrated Care. (n.d.). Agency for Integrated Care. Retrieved February 20, 2024, from https://www.aic.sg/caregiving/fall-prevention/.
  2. Chen, T. (n.d.). Predictors of Falls Among Older Singaporeans. Retrieved from https://www.duke-nus.edu.sg/docs/librariesprovider3/research-policy-brief-docs/predictors-of-falls-among-older-singaporeans.pdf?sfvrsn=e8b838ae_0
  3. Dr Ng, Y., & Dr Jung, H. (n.d.). ASSESSMENT OF THE SIX ACTIVITIES OF DAILY LIVING IN ADULTS. Retrieved from https://www.cfps.org.sg/publications/the-singapore-family-physician/article/221_pdf
  4. Guo, H. (2020, March 18). Instrumental Activity of Daily Living (IADL). Retrieved September 28, 2020, from https://www.ncbi.nlm.nih.gov/books/NBK553126/
  5. Hui, T. (2020, August 03). Top Nursing Home and Old Folks Home in Singapore. Retrieved September 28, 2020, from https://www.homage.sg/resources/nursing-home-singapore/
  6. NCI Dictionary of Cancer Terms. (n.d.). Retrieved September 28, 2020, from https://www.cancer.gov/publications/dictionaries/cancer-terms/def/adl
About the Writer
Hannah Grey
Hannah is an all-around creative with a flair for travel and photography, and has written extensively on topics surrounding health and eldercare in Singapore. She also only has her coffee black, which should be the only way to drink it.
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