Ask The Expert. I recently filed a claim for benefits with our long-term care provider. The policy repeatedly mentions ADL care and a plan of care. Can you explain what they are talking about?

The plan of care (POC) for an individual is used to determine what type of problems, needs or challenges an individual may have, tasks or action steps to address those and goals to meet. It will also identify who will be involved in addressing needs and reaching goals. A POC is typically created and maintained by the health care provider or practitioner involved. It may be very specific to a certain type of therapy or more general to overall functionality. I like to think of them as a road map to care.

When evaluating a person’s care needs, you will often see the term ADL or IADL. Here is how to break them down:

ADL (Activities of Daily Living) Basic daily functions:

· Bathing – how does the individual complete the bathing process. What type of assistance do they need to do it correctly and safely?

· Grooming – this might include brushing teeth, nail and hair care, as well as shaving or other daily grooming tasks.

· Dressing – how does the individual dress and undress themselves daily. What challenges might they face, like buttons, balance or weather appropriate choices?

· Toileting – is the person able to use the toilet independently? To include wiping correctly, getting on and off the seat.

· Continence – is the person continent of bowel and bladder? Do they have accidents?

· Eating – is the person able to manage the mechanics of eating a meal? Do they use the utensils correctly, cut and chew food appropriately?

· Mobility – how does the individual move from one place to another? Can they walk? Get up out of a chair on their own? Fall risk? Do they need help to transfer from one place to another?

IADL (Instrumental Activities of Daily Living) Supportive daily functions.

· Transportation – does the individual still drive? Do they have access to transportation?

· Meal Prep – who cooks and prepares the meals?

· Shopping/Errands – how does the person access groceries? Are they able to shop and run errands?

·Managing Medication – how are daily medications managed? Does the person take them correctly or need reminders?

· Money Management – who manages household finances, bill paying, banking and taxes? Does the person need assistance to do these correctly?

· Telephone Use – Can the person pick up the phone and call for help? Would they know to call 911?

· Housekeeping – is the person able to clean the home, do laundry, change bedding?

· Social Companionship – does the individual still engage in social outings, have access to activities, do things with friends or family? Is there a risk for isolation?

· Safety Supervision – is the person oriented to time, place, location? Is it safe to leave the person alone or are there cognitive issues that create a risk?

Addressing each of these areas is a great way to identifying how well a person is able to function independently and where they need additional support. Each area of challenge can be broken down into specific details identifying specific problems and opportunities to support the person to ensure needs are being met. Tasks or action steps can be put in place, and goals established to help the person function and participate in each task to the best of their ability. 

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