This activities of daily living checklist gives families a plain way to see what help a parent or spouse needs at home. It covers six self-care tasks and seven everyday-living tasks, rates each one at three levels, and shows what the pattern usually points to.
What This Checklist Covers and How to Use It
Something feels different, but it is hard to name what changed or how much it matters. A checklist turns that feeling into specifics you can act on.
Care teams sort daily tasks into two groups. Activities of daily living are the basic self-care tasks: bathing, dressing, grooming, toileting, eating and moving around. Instrumental activities of daily living are the tasks that keep a household running, such as cooking, paying bills and driving. This ADL checklist for seniors draws on both groups.
Each task gets one of three ratings: independent, needs prompting or some help, or needs hands-on help. Choose the rating that fits what you have seen over the past few weeks. The checklist is a way to organize your observations. A doctor or care manager makes any diagnosis or assessment.
Fill it out with your family member when you can. Beside each task, write a specific example, such as "left the stove on twice in October." A doctor, care manager or care coordinator will want those details more than the ticked boxes. Print the page and work through it at the kitchen table.
The Six Basic Activities of Daily Living
These six activities of daily living follow the Katz Index of Independence in Activities of Daily Living, a framework geriatric nurses use. The Katz Index also lists continence, which sits under toileting here. Tick one box for each task.
Bathing
Washing the body in the tub or shower and getting in and out safely.
- ☐ Independent: Showers or bathes alone on a regular schedule, with no reminders.
- ☐ Needs prompting or some help: Bathes when reminded or when someone lays out towels and supplies. Bathing has become less frequent.
- ☐ Needs hands-on help: Needs another person present for safety or physical help getting in and out of the tub or shower.
Dressing
Choosing clothes and putting them on, including buttons, zippers and shoes.
- ☐ Independent: Picks clothes that suit the weather and dresses alone.
- ☐ Needs prompting or some help: Needs reminders to change, or wears the same outfit for days. Needs help choosing clothes.
- ☐ Needs hands-on help: Needs someone to help with buttons, zippers, shoes or getting clothes on and off.
Grooming and Hygiene
Brushing teeth, caring for hair and nails, shaving and keeping dentures clean.
- ☐ Independent: Keeps up daily grooming without being asked.
- ☐ Needs prompting or some help: Does these tasks when reminded. Hair, nails or teeth show signs of being overlooked.
- ☐ Needs hands-on help: Needs someone to brush teeth, trim nails, shave or care for dentures.
Toileting
Getting to the toilet in time, using it, cleaning up and managing any continence products.
- ☐ Independent: Reaches the bathroom and manages everything alone, including any pads or briefs.
- ☐ Needs prompting or some help: Needs reminders to go, has occasional accidents, or hides soiled laundry.
- ☐ Needs hands-on help: Needs help with clothing, cleaning up, changing briefs or getting on and off the toilet.
Eating
Feeding oneself once a meal is ready, including using utensils, chewing and swallowing. Cooking is covered in the next section.
- ☐ Independent: Eats a full meal alone and keeps a regular eating routine.
- ☐ Needs prompting or some help: Skips meals unless reminded, or needs food cut up or containers opened.
- ☐ Needs hands-on help: Needs someone to feed them or stay close to watch for choking.
Moving and Transferring
Getting in and out of bed and chairs, and walking around the home. Falls are the leading cause of injury for adults 65 and older, and about one in four older adults report falling each year, so help at this level is a safety need.
- ☐ Independent: Stands, sits and walks through the home steadily, with or without a cane or walker.
- ☐ Needs prompting or some help: Uses furniture or walls for balance, or needs reminders to use a walker.
- ☐ Needs hands-on help: Needs another person to stand up, get out of bed or walk safely.
The Instrumental Activities of Daily Living
Instrumental activities of daily living tend to slip first. A person can still bathe and dress alone while bills go unpaid or groceries run out, so this section often carries the earliest signal. The seven items below follow the Lawton-Brody Instrumental Activities of Daily Living Scale, which also lists laundry. Laundry joins housework here.
Meals and Meal Preparation
Planning, cooking and cleaning up a meal.
- ☐ Independent: Cooks regular meals safely. The fridge holds fresh food.
- ☐ Needs prompting or some help: Relies on snacks or frozen meals, or leaves expired food in the fridge.
- ☐ Needs hands-on help: Needs someone to prepare meals or stay in the kitchen for safety.
Medications
Taking the right medicines at the right times.
- ☐ Independent: Keeps track of every medicine without help.
- ☐ Needs prompting or some help: Needs reminders, or the pill organizer shows missed or doubled doses.
- ☐ Needs hands-on help: Needs someone to hand over each dose.
Money and Bills
Paying bills, balancing the checkbook and spotting scams.
- ☐ Independent: Pays bills on time and tracks spending.
- ☐ Needs prompting or some help: Lets mail pile up unopened, or misses a payment now and then.
- ☐ Needs hands-on help: Needs someone to handle bills and watch for unusual charges.
Housework and Laundry
Keeping the home clean, tidy and stocked with clean clothes and linens.
- ☐ Independent: Keeps up with cleaning and laundry at a steady pace.
- ☐ Needs prompting or some help: Dishes, clutter or laundry build up between visits.
- ☐ Needs hands-on help: Needs someone to do most cleaning, laundry and bed changes.
Shopping
Getting groceries and household items.
- ☐ Independent: Plans trips and buys what is needed.
- ☐ Needs prompting or some help: Needs a list or a ride, or buys the same items repeatedly.
- ☐ Needs hands-on help: Needs someone to do the shopping.
Transportation
Driving or arranging rides to appointments and outings.
- ☐ Independent: Drives safely or arranges rides without trouble.
- ☐ Needs prompting or some help: Avoids night driving, gets lost on familiar routes, or misses appointments.
- ☐ Needs hands-on help: Needs a person to drive and go along.
Communication
Using the phone and keeping in touch with family, doctors and friends.
- ☐ Independent: Makes and answers calls and messages with ease.
- ☐ Needs prompting or some help: Misses calls, forgets to return them, or needs help with a smartphone.
- ☐ Needs hands-on help: Needs someone to place calls or relay messages.
Reading the Pattern: What the Checklist Points To
How to assess if a parent needs help comes down to the pattern across the whole checklist. Look at where the ticks cluster, then match them to the three profiles below, which run from lighter to heavier support.
A person who is mostly independent, with a few gaps in shopping, transportation or housework, fits the profile for companion care that covers errands, light housekeeping and rides. A caregiver handles the grocery trip, the laundry and the drive to an appointment, and brings steady company along. Your family member keeps running the rest of the day.
A mix of those gaps plus prompting or hands-on help with one or two basic activities, most often bathing, dressing or toileting, points to personal care at home. A caregiver gives hands-on help with the physical self-care tasks and keeps up the household support alongside.
Hands-on help across most basic activities points to 24-hour home care. So do safety concerns at every hour, such as wandering, fall risk or being unable to stay alone. Caregivers work in shifts, so someone is always there.
Memory loss or confusion changes the picture. When it shows up beside the pattern you have recorded, dementia care at home deserves its own look at any level, because supervision needs in dementia can run ahead of physical ability.
Bring the completed checklist to the conversation with a doctor, care manager or home care agency. Your written examples describe the pattern better than memory can.
Why These Answers Also Matter for Medicaid Waiver Eligibility
Nebraska's Aged and Disabled Waiver looks at the same kind of findings. The program uses the interRAI Home Care tool to judge whether someone meets a Nursing Facility Level of Care, and one path is documented limited functioning in at least three basic activities combined with a risk factor, a medical condition or a cognitive limitation. The state's own assessment makes the determination. Families who think a waiver might apply should keep the completed checklist, since its dated examples are the kind of documentation that conversation runs on. You can read how the Nebraska Medicaid Waiver Program works for home care on the Caretech site.
Next Step: Talking Through What You Found
A completed checklist is useful on its own for a visit with a doctor or care manager. It is also where a home care conversation starts. Caretech is a non-medical home care agency that has provided home care in Nebraska since 1999, and your answers give us a clear starting point for talking about what level of support fits.
When you are ready, contact Caretech to set up a free in-home consultation. A Care Coordinator will talk through what you found with you. You can also see the full range of Caretech home care services at any time.
Frequently Asked Questions
What are the six basic activities of daily living?
They are bathing, dressing, grooming and hygiene, toileting, eating, and moving or transferring. Toileting includes managing continence. Together they describe the basic self-care a person does each day.
What is the difference between ADLs and IADLs?
ADLs are the basic self-care tasks. IADLs are the tasks that keep a household running: meals, medications, money, housework and laundry, shopping, transportation and communication. IADLs often become harder first, so they can give the earliest sign that a parent needs support.
Who should see the completed checklist?
Your family member's doctor, a care manager, and any home care agency you speak with can all use it. Bring the written examples along, since they show how each task goes in daily life.
What kind of help does Caretech provide at home?
Caretech provides non-medical home care, including companion care, personal care, 24-hour care and dementia care. The right fit depends on the pattern your checklist shows, and a Care Coordinator can talk it through with you.
- Activities of Daily Living Checklist for Families - November 9, 2026
- 5 Reasons Pets Can Help Seniors in Their Day-to-Day Life - November 6, 2026
- 10 Ways Dementia Affects a Caregiver Mentally - October 29, 2026
