Why ADLs Can Be So Hard To Complete ADLs are those routine aspects of daily life that we all just have to do: dressing, bathing, fixing our hair, brushing our teeth, moving from place to place…and the list goes on. Healthy adults probably don’t think about them too hard, but for folks with physical or cognitive challenges, ADLs become a big deal. In fact, losing the ability to do some of those activities is what calls for extra help in the first place, whether help comes from family and friends, from home care and hospice professionals, or from a move to some place with professional help in-house. There are many reasons why ADLs can be such a challenge for seniors and for caregivers. They are different for everyone, of course, but some of these might be contributing factors: Physical pain. Seniors and people with physical challenges often deal with pain, and even when their pain is well-controlled with medication, the work of completing ADLs can still hurt. In particular, because older adults usually have decreased range of motion in their extremities, tasks like dressing can be rather uncomfortable. It’s hard to be sweet when you hurt. Our job is to make it hurt less. Feelings of shame. Especially for folks who are aware of their circumstances, the mere fact that they need someone to help with basic activities can feel really bad. Add on to that the fact that they may need help dressing or bathing – sometimes by someone of the opposite sex – and those daily activities can bring up powerful feelings of shame. It may or may not get easier to accept care. Our job is to give the highest priority to preserving dignity. Agitation or aggression. For folks who are confused because of dementia or delirium, those feelings of pain or shame can turn into aggression – fighting back against the person who seems to be hurting them. You can imagine how difficult it must be to be going about your regular activities – reading the paper, drinking coffee – and then being wheeled into the shower room and made to undress. As difficult as it is, we cannot react to the senior’s aggression or agitation with our own irritation or anger. Our job is to understand what the senior must be feeling and to take steps to solve the underlying problem. Difficulty following directions. People who are confused enough that they can’t complete their own self-care chores may also have difficulty following the caregiver’s simple directions to help. It gets more difficult to process verbal information in the later stages of dementia, and it becomes increasingly difficult to get your mind and your body to work together to get something done. This requires a LOT of patience on the part of the caregiver. Our job is to give clear directions and cues while staying calm and patient. Add these together, and completing ADLs can be quite tough, for the senior and for the caregiver.