What Are ADL Activities? A Clear Definition
The Cleveland Clinic defines Activities of Daily Living (ADLs) as essential tasks we perform each day that support our basic physical health and survival. These tasks are sometimes called physical ADLs because they relate directly to the body’s everyday needs—like bathing, eating, or using the toilet. Understanding ADLs is key to providing appropriate care for individuals with changing health or mobility needs.
Understanding ADL Activities: What Do They Include?
From the moment we are born, we all perform ADLs either independently or with some form of assistance. As a baby, we depend on our parents/guardians to ensure that our self-care ADLs are met – bathing, feeding, dressing. As we get older, we learn more mobility ADLs tasks, such as walking, toileting and eventually we become independent in completing our own ADLs. As we continue to age, or maybe suffer from an illness/accident, we may need some degree of assistance completing or relearning our ADL tasks. Whether due to age, illness, or injury, many people may need help with ADLs at some point, and understanding this natural progression helps inform compassionate care.
ADL Activities Examples: Real-Life Daily Living Tasks
Basic ADLs provide a framework for evaluating an individual’s functional ability. Here is a chart adapted from the Cleveland Clinic that outlines common ADL tasks:
| ADL |
What It Involves |
| Bathing |
Using soap, water, towels and other supplies to wash, rinse and dry your skin. Standing, sitting or moving in ways that allow you to bathe every part of your body. |
| Personal hygiene and grooming |
Oral care, hair care, and grooming activities using items like deodorant or nail clippers. |
| Toileting and continence |
Getting to the toilet, managing hygiene, and controlling bladder and bowel function. |
| Eating and feeding |
Chewing, swallowing, and using utensils to bring food to the mouth. |
| Dressing |
Selecting clothes and putting them on in the correct order, including handling fasteners. |
| Moving/transferring |
Shifting from one position or place to another, such as bed to chair or room to room. |
ADL Activities in Nursing Homes: How the RAI Defines Them
In nursing homes, documenting ADL support is critical for care planning, staffing, and regulatory compliance. Typically, nursing assistants record the level of assistance each resident receives, which feeds into the Minimum Data Set (MDS). The MDS is a standardized tool used in Medicare- and Medicaid-certified facilities to assess residents' health and function.
According to the RAI (Resident Assessment Instrument) Manual, “Activities of daily living are those needed for self-care and mobility” and include tasks such as bathing, grooming, oral care, ambulation, dressing, toileting, eating, transferring, and communicating. Data from Section GG helps classify residents into therapy and nursing components under the Patient-Driven Payment Model (PDPM).
Section GG and ADL Activities: Functional Abilities in the MDS
Section GG of the MDS evaluates a resident’s ability to perform self-care and mobility tasks over time. It includes observations on admission, throughout the stay, and at discharge. This section also records the use of assistive devices and any limitations in range of motion.
A resident’s ability can change over the course of their time at the nursing home. Residents in short-term rehab may improve their ADLs with therapy, while long-term residents may need ongoing support to maintain their current level of function. In some cases, therapy can help a resident return home or to their previous level of functioning. Whether recovering or adapting, Section GG ensures each resident’s functional potential is accurately captured and addressed.
Why Promoting Independence in ADL Activities Matters
Recognizing and adapting to small changes in daily function can make a big difference in quality of life. At home, healthcare providers may recommend simple modifications—like removing rugs or installing grab bars—or suggest physical or occupational therapy to regain strength and balance.
In nursing homes, allowing residents to participate in their own ADLs—rather than having staff complete the tasks for them—promotes autonomy and better health outcomes. Even if it takes more time or adaptive tools, encouraging independence supports dignity, reduces health risks, and leads to longer, healthier lives.
The Role of Therapy in Supporting ADL Activities
Therapists play a vital role in maintaining and improving residents’ ADL performance. According to the RAI, functional decline can lead to serious consequences including depression, social isolation, respiratory issues, and pressure injuries.
Qualified therapists assess the need for services and tailor interventions to help residents reach or maintain their highest level of functioning. Therapy supports independence, improves quality of life, and can sometimes enable a safe return home.
Restorative Nursing Programs (RNPs) and ADL Support
Restorative Nursing Programs (RNPs) bridge the gap between therapy and daily care. As defined in the RAI, these programs focus on helping residents adapt and function as independently and safely as possible.
RNPs are particularly beneficial after formal therapy ends, allowing residents to maintain their gains through structured interventions. These programs must include measurable goals, be documented in the care plan, and evaluated regularly by a licensed nurse. While daily tasks may be completed by trained staff, oversight by licensed nursing professionals ensures consistency and quality.
How the ADL Functional Score Impacts Quality Measures (QMs)
ADL scoring in Section GG of the MDS plays a significant role in shaping a facility’s Quality Measures (QMs) and overall care quality rating. Like many other areas of the MDS, how you code ADL tasks directly affects your quality scores. Two function scores are calculated: the total nursing function score and the total OT/PT function score.
The nursing function score includes:
- Eating
- Toileting hygiene
- The average of: sit to lying and lying to sitting on the side of the bed
- The average of: sit to stand, chair/bed-to-chair transfer, and toilet transfer
The OT/PT function score includes all of the above, plus:
- Oral hygiene
- The average of: walk 50 feet with two turns and walk 150 feet
Each ADL activity in Section GG is assigned a score:
- 06 = Independent
- 05 = Setup or clean-up assistance
- 04 = Supervision or touching assistance
- 03 = Partial or moderate assistance
- 02 = Substantial or maximal assistance
- 01 = Dependent or requiring two or more helpers
These GG scores are then converted into function scores:
- Scores of 06 or 05 = Function score of 4
- Score of 04 = Function score of 3
- Score of 03 = Function score of 2
- Score of 02 = Function score of 1
- Score of 01 or a non-completed task (Score of 07, 09, 10, 88 due to refusal, inapplicability, environmental, or safety concerns) = Function score of 0
These scores contribute to key Quality Measures. For short-stay residents, the Discharge Function Score is directly impacted. For long-stay residents, the relevant QMs include Residents Whose Ability to Walk Independently Worsened and Residents Whose Need for Help with Activities of Daily Living Increased.
