Long-Term Care: A Glossary to Guide Choices

By Dr. Gerard Muraida

The phrase “long-term care” is somewhat vague. This form of care can be provided in a variety of places by different caregivers, depending upon a person’s needs. “Activities of daily living,” known as ADLs in the health care industry, may determine where these services are provided and by whom. Knowing one’s ability to perform certain functions can help determine a “right fit” for desired services and the appropriate provider for such services.

ADLs refer to the most basic of personal functions. They include:

  • Mobility (also called ambulating or transferring) – The ability to move about both inside and outside of one’s home. This includes walking, going up and down stairs, getting out of bed and into a chair/wheelchair, and standing from a seated position.
  • Dressing – Choosing appropriate clothing and putting it on. This includes fastening buttons and zipping zippers.
  • Eating – Utilizing a fork and other utensils to bring food up to the mouth and the physical act of chewing and swallowing.
  • Personal hygiene – Safely getting in and out of the bathtub or shower and cleaning oneself. This also includes other grooming activities, such as shaving, nail care, and brushing teeth.
  • Toileting (also called continence) – Getting to the toilet in time by controlling one’s bladder and/or bowel, getting on and off the toilet, and cleaning oneself after use.

To further define one’s ability to live independently, instrumental activities of daily living, or IADLs, have been established. These include more advanced daily functioning skills than the ADLs. This also means they do not have to be done every single day. These include:

  • Shopping – Buying essentials, such as groceries, prescription medications, and clothes.
  • Meal preparation – Planning meals, getting the necessary ingredients, and cooking.
  • Housework – Maintaining the home, keeping it clean and free of trash, doing laundry, etc.
  • Money management – Paying bills, managing bank accounts, etc.
  • Transportation – Driving oneself or obtaining and accessing other modes of transportation, such as public transportation, taxis, and arranging rides with loved ones.
  • Medication management – Ensuring prescriptions are filled and taken as prescribed.
  • Communication – Looking up phone numbers and using the telephone, or communicating via a computer.

As we age, our ability to perform the ADLs and IADLs declines due to natural aging and or disease processes such as dementia, Parkinson’s disease or vision problems. When these declining functions are identified by health care experts, they can help to determine which living environment – home, assisted living, nursing home – and type of care assistance, if applicable, is best suited for a particular senior and his or her needs.

Most long-term care is provided at home by unpaid family members and friends. Assisted living facilities are another option. They range in size, housing anywhere from three to five occupants to large facilities that care for 50 or more residents. Nursing facilities are even larger and are usually corporate run.

If the need arises, discuss your options with your health care provider. The location you select for yourself or a loved one should be based on ADLs.

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