Activities of Daily Living (ADLs) Checklist: Basic and Instrumental ADLs Explained
What activities of daily living are, basic ADLs vs instrumental ADLs with examples, how OTs assess them (Katz, Lawton, FIM), and a free printable ADL checklist.
Getting up, washing, dressing, eating and moving around the home: most of us do these without thinking. When illness, injury, disability or ageing makes them harder, they become central to care planning. These everyday tasks are called activities of daily living (ADLs), and they’re at the heart of occupational therapy.
Basic ADLs vs instrumental ADLs
| Basic ADLs (BADLs) | Instrumental ADLs (IADLs) | |
|---|---|---|
| What they are | Self-care tasks to look after your body | More complex tasks to live independently in the community |
| Examples | Bathing, dressing, toileting, transfers, continence, feeding | Cooking, shopping, money, medication, housework, laundry, transport, phone |
| Skills needed | Mainly physical abilities | Physical plus thinking skills: planning, memory, problem solving |
| Common assessment | Katz Index of Independence in ADL; Barthel Index | Lawton IADL Scale |
| Often lost first | Later | Earlier, e.g. in early dementia |
The 6 basic ADLs (Katz Index)
- Bathing: washing the body in a bath, shower or at the sink
- Dressing: choosing clothes and putting them on and off, including fastenings
- Toileting: getting to and using the toilet, cleaning oneself and adjusting clothes
- Transferring: moving in and out of a bed or chair
- Continence: controlling bladder and bowel
- Feeding: getting food from the plate to the mouth
The 8 instrumental ADLs (Lawton Scale)
- Using the telephone
- Shopping
- Preparing food
- Housekeeping
- Doing laundry
- Using transport
- Managing medication
- Handling finances
Many modern frameworks, including AOTA’s Practice Framework, also include health management, rest and sleep, childcare, pet care, community mobility and religious or spiritual activities.
Levels of independence
When OTs assess ADLs, they record how much help the person needs.
Most independent ↑
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Independent
Does the task safely with no help or equipment.
-
Modified independent
Uses equipment or takes extra time.
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Supervision or prompts
Needs someone nearby, or reminders.
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Some physical help
Does most of the task with hands-on help.
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A lot of help
Does only part of the task.
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Dependent
Someone else does the task.
Most help
Read more about assistance levels in the rehabilitative frame of reference.
How occupational therapists assess ADLs
| Tool | What it measures |
|---|---|
| Katz Index of Independence in ADL | 6 basic ADLs; scores 0–6 (6 = fully independent) |
| Barthel Index | 10 ADL and mobility items; widely used in rehabilitation |
| Lawton IADL Scale | 8 instrumental activities; scores 0–8 |
| Functional Independence Measure (FIM) | 18 items of motor and cognitive function, each scored 1–7 |
| Assessment of Motor and Process Skills (AMPS) | The quality of task performance, observed during real tasks |
| Observation at home | How the person manages in their own environment |
How OT helps when ADLs become hard
- Practising tasks in new ways, such as one-handed dressing after a stroke
- Equipment: shower chairs, grab bars, raised toilet seats, reachers, sock aids, adapted cutlery
- Home modifications: rails, ramps, better lighting, rearranging the kitchen
- Memory and planning supports: checklists, pill organisers, reminders. See OT for dementia.
- Energy conservation for people with heart, lung or chronic conditions
- Carer training in safe, supportive ways to help
ADLs in children
Children’s daily living skills develop with age: feeding, dressing, toileting and hygiene. Pediatric OTs help children with developmental delays, autism or physical disabilities build these skills. See pediatric OT goals and OT goals for autism.
Summary
Activities of daily living are the everyday tasks that keep us independent. Basic ADLs cover self-care; instrumental ADLs cover running a home and life in the community. Occupational therapists assess both, then use practice, equipment, home changes and support to help people stay as independent as possible.
References
- Katz S, Ford AB, Moskowitz RW, Jackson BA, Jaffe MW. Studies of illness in the aged. The index of ADL: a standardized measure of biological and psychosocial function. JAMA. 1963;185:914–919.
- Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. The Gerontologist. 1969;9(3):179–186.
- Mahoney FI, Barthel DW. Functional evaluation: the Barthel Index. Maryland State Medical Journal. 1965;14:61–65.
- American Occupational Therapy Association. Occupational Therapy Practice Framework: Domain and Process—Fourth Edition. 2020.
Frequently asked questions
What are the 6 activities of daily living?
What is the difference between ADLs and IADLs?
What are examples of instrumental activities of daily living?
Who assesses activities of daily living?
Why are ADLs important?
Written by
Deepam Pawar, OT
Deepam Pawar is an occupational therapist and co-founder of Occupational Therapy OT. He focuses on clinical frameworks, assessment, and evidence-based practice.
All articles by Deepam →This article is for general education and is not a substitute for individualized assessment or treatment by a licensed occupational therapist. Always seek the guidance of a qualified professional for specific concerns.
