As the disease progresses you will need to help more and more with the seamingly simple activities of daily living (ADLs). Eating, dressing, basic hygiene, shaving, and eventually toileting will likely be neglected as routines are forgotten and abilities deteriorate.

Activities of daily living (ADLs) are those things we all need to do on a regular basis to ensure our health and well-being. ADLs are those need-to-do things that take up so much of our day and that we all take for granted – until we can't do them anymore. Activities involving health and hygiene are called basic activities of daily living. By contrast instrumental activities of daily living are those abilities that allow a person to live independently.

Basic Activities of Daily Living
  • Eating
  • Bathing
  • Dressing
  • Toileting
  • Continence
  • Ability to get out of bed or a chair
  • Walking (can be with the aid of a cane or walker)
Instrumental Activities of Daily Living
  • Food Preparation
  • Housekeeping and Laundry
  • Managing Financial Matters
  • Shopping
  • Use Telephone
  • Take Medication
  • Responsible for Transportation (public transit, auto, etc.)

Doctors and nurses, psychologists, social workers, and other healthcare professionals measure ones ability to perform these activities to ascertain his or her functional ability. Tools such as the Katz ADL Scale and the Lawton IADL scale, are often used to determine the level of care an injured or disabled person needs. Ultimately this may include the recommendation for long-term institutional care.

ADLs and Alzheimer's Disease

As Alzheimer's disease and other non-curable dementias progress there is a steady deterioration of abilities including the capacity to perform those activities necessary to live independently. There is a physical aspect to Alzheimer's disease. As the plaques and tangles that affect memory and cognition take hold, motor control also deteriorates. It is very frustrating and depressing to realize that this is happening.

Anxiety, irritability, anger, aggression, and apathy and withdrawal, are often listed as symptoms of Alzheimer's disease. These behaviors are more likely the result of the cognitive recognition that one's basic abilities are deteriorating, and along with those abilities, one's independence.

Unfortunately, this trend cannot be reversed; that is the nature of the disease. We can, however, provide therapies that delay the motor and cognitive effects of dementia. We can also help to make these daily activities easier, or at least more do-able. We improve a person's quality of life by prolonging that person's independence, and by making her feel that she is being productive.

Create a Safe Environment

Safety is the first concern of anyone caring for a person with a disability, but stay aware of independence issues while creating a safe place. Many of the things we take for granted can be dangerous for someone who has trouble maintaining focus, remembering that a knife, for example, can cut fingers as well as vegetables. Alzheimer's-proofing a house is very similar to child-proofing it.

Establish and Maintain a Routine

This is probably the most significant step you can take to extend the independence of the person with Alzheimer's. The basic activities of daily living should be part of a routine, done at the same time and in the same order each day.

Put Her to Work

Losing the feeling of being a productive member of the family or of society is as big a blow to someone as her loss of independence. Give her chores around the house. Let her help with the dishes, even if you have to re-wash them later. Allow her to vacuum, even if you have to finish up later. Let her chop vegetables (keeping in mind the safety imperative), even if.... Well, you get the idea. She could sort and fold laundry, clip coupons, dry silverware, dust tables; most any of the pesky household chores can provide some meaning for the person with dementia.

Provide Physical and Mental Exercise

Stretching, dancing, and walking, anything that is physically stimulating, will extend the time that the person with Alzheimer's can remain physically independent. Game, puzzles, reading, anything that is cognitively and sensorially stimulating will increase the time he will remain mentally independent. Tailor or select each activity according to the abilities and interests of the individual. The more enjoyable it is, the more beneficial it will be.

Don't forget to exercise the hands. Keeping them strong and limber will make it easier to do many of the activities listed above.

Specialized Clothing

This doesn't necessarily mean "funny looking" or "odd." For someone in the earlier stages of Alzheimer's, shoes with Velcro fasteners, tube socks, pull-over or zipper front shirts and sweaters, all make it easier for him to dress and undress himself. In later stages you may need clothing that is designed for someone who needs help dressing. Eventually clothing that he can't remove may be necessary, as inappropriate undressing can be a problem in the middle and later stages of dementia.

Other Aids

Something as simple as a cane can make it possible for him to get around. Specially designed forks and spoons make it easier to eat by himself. Sturdy grab bars make getting in and out of the tub easier and safer. Raised toilet seats extend his independence by making toileting easier. Begin by defining the problem. It is very likely that someone has found a solution that fits. If you would like help, contact us, describe the issue, and we will do our best to help or point you in the right direction.

Photo Phone

Clarity Photo Phone

When dementia begins to effect memory, just dialing the phone can become an insurmountable task. With this Photo Phone all one needs to do is press the picture of the person he needs to call, and the programmable phone dials the right number. We offer 3 models of programmable picture phones, each with different features.


Merry Gilbert McArthur summarizes some recent research on the effects of exercise on the Alzheimer's patient as well as on the Alzheimer's caregiver, and their relationship. She prescribes regular exercise to improve the quality of life for patient and caregiver, and to delay the physical effects of the disease.