My Dad’s Dementia: More Tools for Clarity

It’s always a challenge to know what items to use when evaluating your loved one with dementia. In addition to ADL’s (last article here), there are more fine tuned “Instrumental Activities for Daily Living” or IADL’s.

Clarity is a beautiful thing — particularly when so much of caregiving is foggy.

Tired of the toileting questions? Yeah, I get it. The ADL’s are very helpful, but they’re basic. In the early stages of cognitive decline there are some areas that you really want to pay attention to. These are more complex and nuanced than continence, feeding and dressing.

Per the NIH website, the Instrumental Activities for Daily Living are:

• Transportation and shopping: Ability to procure groceries, attend events, and manage transportation, either via driving or by organizing other means of transport.
• Managing finances: This includes the ability to pay bills and manage financial assets.
• Shopping and meal preparation, ie, everything required to get a meal on the table. It also covers shopping for clothing and other items required for daily life.
• Housecleaning and home maintenance. Cleaning kitchens after eating, maintaining living areas reasonably clean and tidy, and keeping up with home maintenance.
• Managing communication with others: The ability to manage telephone and mail.
• Managing medications: Ability to obtain medications and take them as directed.

When I evaluated my dad’s condition with ADL’s I felt like I was taking a black and white snapshot of the most basic activities. When I evaluated the IADL’s it was a much more complex and detailed photo of a moment in time.

It is impossible in one article to review each of these IADL’s, so I’m going to write about each of them and my experiences with my dad in subsequent articles. Safe to say, however, that each of the topics is incredibly important.

Each of these areas (transportation, finances, shopping, meal prep, housecleaning, communication and medication management) is radically affected by cognitive decline.

Exploring each topic also provides concerned family members and caregivers insight into just how much risk and vulnerability aging family members have under normal conditions. How much more when cognitive decline and dementia start to take over?