Measuring extended Activities of Daily Living (eADLs) in 2025: what do older people and multidisciplinary professionals think?

Introduction 

Measuring extended Activities of Daily Living (eADLs) is an important part of functional assessment. Several eADL scales are currently used, resulting in heterogeneity and lack of standardisation. Existing scales are potentially outdated, containing activities which are no longer considered relevant by older people. We aimed to explore the perspectives of older adults and healthcare professionals on eADL assessment to inform new approaches to eADL measurement.

Method 

Semi-structured qualitative interviews were undertaken with older adults and healthcare professionals. Perspectives were gathered on preferences around eADL assessment, scale administration and activities that could be included in a new scale. We also explored the contribution of education and digital literacy. Thematic analysis was used to develop themes from verbatim interview transcripts. 

Results 

A total of 41 interviews (online and in-person) were conducted with 21 older adults (>60yrs) and 20 professionals representing different members of the multidisciplinary team. Five themes were developed from interview data. Older adults identified that both physical and social activities should be included in eADL scales, and that technology has changed how eADLs are carried out. They also highlighted that views on the acceptability of receiving help must be considered to ensure accurate scoring. Professionals acknowledged that while eADL assessments could be conducted by a machine, face to face communication has key benefits. Inclusivity was consistently prioritised, with gender roles and financial factors identified as key influencing factors in eADL assessment. 

Conclusions 

Participants identified priorities for future approaches to eADL assessment that will offer a holistic assessment of eADLs and be inclusive to all, whilst reflecting the contemporary activities of life in the 21st century. This requires attention to sources of bias which can arise around inequities in education, access and finance. Further research is needed involving older people who are not digitally confident.