Instrumental Activities of Daily Living (IADL): Definition & Scale

Instructor: Sharon Linde

Sharon has an Masters of Science in Mathematics and a Masters in Education

Do you know an elderly person that might not be able to live independently any more? The IADL scale can help determine how much assistance they need - opening the door to talk about appropriate levels of care.

What are IADLs?

Sally and her siblings have decided the time has come to have 'the talk' with their parents, William and Edna. It has become increasingly apparent to all the siblings that the older couple no longer have the skills to take care of themselves in an independent living situation. The decision to start this talk came after Sally had seen a list of instrumental activities of daily living (IADLs), and was concerned her parents were having trouble with many of them. The IADL skill list is:

  • Use of the telephone
  • Shop for necessities
  • Prepare meals
  • Keep house
  • Launder clothes & linens
  • Utilize transportation
  • Medicate correctly
  • Manage finances

These skills are usually learned during the teenage years and can be lost as people age. Let's take a closer look at these.

IADL Scale

The list Sally had seen also included a scoring guide, or scale. Each of the eight topics were given a score on a pass/fail system - one point if the ability was judged adequate to live independently, zero points otherwise. Scoring in this way gives a possible scale of 0-8. Lower scales indicate a higher level of assistance is needed for the person or persons involved.

The details of the IADL are often open to interpretation, but involve the following:

  • Telephone

How well does the person use the telephone? One point is clearly awarded if the person can look up numbers and use the phone on their own. A point can also be earned if the person only dials a few known numbers, or even if they don't call at all but can answer the phone. Inability to do any of these on a consistent basis earns no points.

  • Shopping

One point is awarded if the person plans for and completes shopping for all necessities on their own.

  • Cooking

One point for planning, preparing, and serving adequate meals on their own.

  • Housekeeping

One point is earned if all tasks are taken care of independently, of course. The point can also be earned if the person can only do light housework and needs help to keep the home in acceptable condition.

  • Laundry

Similar to housekeeping, a person can earn the point here by either being completely independent in this area or if they need some assistance. The point is only unearned if they don't contribute at all to this task.

  • Transportation

The ability to drive safely earns a point, as does using public transportation independently; even using a taxi or car service is acceptable, if the person arranges this transportation themselves. Using public transportation with some assistance from another person also qualifies for a point.

  • Medication

One point if all necessary medication is taken independently at the correct time and in the correct dosages.

  • Finances

A point is earned if all financial matters are adequately met, or even if the day-to-day finances are met, with the larger financial decisions requiring assistance.

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