Activities of Daily Living: Doing It Safely and Keeping the Resident Independent
What this domain tests
ADLs are the hands-on tasks you perform every shift: bathing, mouth care, grooming, dressing, eating, toileting, and bed making. The exam asks you to know the safe sequence of each procedure, how to protect privacy and dignity, and what you must observe and report.
Core concepts
- Independence first. Let the resident do whatever they can, even when it is slower. Assist only the part they cannot manage.
- Privacy and dignity. Knock, identify yourself, close the door and curtain, and drape with a bath blanket so only the area being washed is exposed.
- Perineal care always moves from front to back (clean to dirty) to prevent urinary tract infection.
- Dressing order matters: put clothing on the weak or affected side first, then the strong side.
- Feeding. Seat the resident as upright as tolerated, offer small bites, allow time to chew and swallow, watch for food pocketed in the cheek, and stop at any sign of choking.
- Skin inspection happens during bathing. Report redness, bruising, tears, or rashes to the nurse.
- Personal items are never shared between residents; label and store them separately.
Traps
Reverse-order questions are the classic pitfall. If a resident has left-sided weakness, dressing begins on the left, and undressing removes the strong side first. Also watch for answers that "do for" the resident to save time, that leave a resident undraped "just for a second," or that have you make a nursing judgment instead of reporting.
Rule of thumb
"Weak side first when dressing, weak side last when undressing." Say it in that order and you will answer order-of-care questions correctly.