As occupational therapists, we walk a fine line between simplifying ADL (Activities of Daily Living) and IADL (Instrumental Activities of Daily Living) interventions and overcomplicating them. Striking the right balance isn’t just about efficiency—it shapes how our role is perceived by clients and other healthcare professionals.

Why Simplification Matters

We’ve all been there—trying to keep things simple, but in doing so, we sometimes strip away the depth of what we do. The result? Our ADL/IADL interventions start to resemble the work of care aides or nursing assistants. Let’s be clear—those are essential, respectable roles, but they aren’t our role. When we oversimplify tasks like dressing, grooming, or meal prep, we risk three things:

1. Clients disengage because the intervention lacks relevance.
2. Colleagues undervalue the expertise we bring to the table.
3. The intervention misses the mark, preventing full rehabilitation potential.

On the flip side, overcomplicating ADL training is just as common—and just as problematic. This tends to show up in two ways:

Overcomplicating the Treatment Itself

Sometimes, in our excitement to make therapy engaging, we forget the simple truth—clients are adults. They don’t want to put on their pants 50 times in front of us, and no one wants to clean their hospital room windows just because we needed to make an activity “salient.” Yes, repetition is valuable, but if the task feels unrealistic or excessive, we risk losing buy-in.

Over-Instructing

Here’s the one that took me years to unlearn. Somewhere along the way, I picked up the idea that there was a “right way” to put on pants or make a sandwich. As a new grad, I’d walk clients through step-by-step instructions of how things “should” look—and if their method didn’t match, I’d assume they hadn’t met the goal.
But here’s the reality—everyone moves differently. There isn’t one “correct” way to complete an ADL, and trying to force one leads to frustration. Now, I ask:

• Is it safe?
• Is it efficient?
• Does it happen within a reasonable timeframe?
• Does it avoid poor movement patterns that could lead to injury?

That’s the real goal—not forcing someone into my idea of how something “should” look.

Streamlining ADL Training: A Step-by-Step Framework

Simplifying ADL intervention doesn’t mean watering it down. It means structuring your approach through activity analysis—breaking down tasks in a way that makes sense for each client. Here’s how to do it:

Break Down the Task—Step by Step

• Start with the end goal (e.g., preparing a light meal).
• List out the essential steps in the correct order.
• Pay attention to the moments of struggle and adjust your focus there.

Example:
Task – Lower Body Dressing

• Step 1: Gather clothing.
• Step 2: Sit with feet flat.
• Step 3: Guide leg into pant leg.
• Step 4: Stand (if safe) and pull pants to waist.

No fluff. Just the steps they need to achieve the task—their way.

Analyze Body Functions

• Which physical components are required for success? (Strength, endurance, balance)
• Where do they fatigue or struggle?
• What can you modify or adapt to increase independence?

Checklist:
☐ Balance/Postural Control
☐ Grip Strength/Coordination
☐ Fine/Gross Motor Skills
☐ Range of Motion

Cognitive Components

• Can they sequence the steps correctly?
• Do they need visual or verbal cues?
• How’s their attention and problem-solving?

What to Look For:
☐ Memory (Can they recall the next step?)
☐ Safety Awareness
☐ Ability to Adjust (If the shirt is inside-out, can they problem-solve?)

Adapt—But Keep It Realistic

• Reorganize the environment if needed, but don’t overdo it.
• Use adaptive equipment only when necessary—not just for the sake of it.
• Focus on small wins. One step at a time builds confidence.

Real-Life Example: Simplifying Meal Prep

Instead of expecting a full meal to be prepared from start to finish, break it down:

• Day 1: Work on cutting and chopping safely.
• Day 2: Focus on timing (can they juggle more than one task at once?).
• Day 3: Combine steps.

Gradually, they reach the goal—without the overwhelm.

Simplifying doesn’t mean doing less—it means doing what matters most. By stripping away unnecessary complexity, we engage clients, demonstrate our expertise, and ensure functional, meaningful progress.