Participation in activities of daily living can reduce loneliness in older adults.

Sir,

We agreed with Tiwari that loneliness among older adults become significant public health issue.[1] In his guest editorial, Tiwari mention three types of loneliness situational, developmental and internal loneliness.[1] We believe the ability to perform activities of daily living (ADL) can help to reduce the chances of loneliness. For healthy ageing and to maintain older adults mobile ADL activities plays an essential role.[2] They focus more on ADL activities compare to any other work because it is a common activity people used to do throughout their lives to fulfill their time and give meaning of their life.[3]

Activities that a person value encourage to participate and give help to look forward in daily life.[3] Valued life activities categorized as obligatory, committed and discretionary activities[3] among these obligatory and committed activity are purely ADL activities. Obligatory activities include activities necessary for survival basically known as personal ADL[34] or basic ADL[4] such as bathing, showering, bowel and bladder management, dressing, eating, feeding functional mobility, personal device care, personal hygiene and grooming, sexual activity, toilet hygiene.[34] Committed activities includes social role, family care and family responsibility known[4] as instrumental ADL such as care of others, care of pets, child rearing, communication management, community mobility, functional management, health management and maintenance, home establishment and management, meal preparation and clean-up, religious observance, safety and emergency maintenance, shopping.[4] When older persons able to perform all these ADL task independently with or without the help of assistive devices, surely it gives them satisfaction and felling of independence.[2] Which surely help them to reduced loneliness by providing the confidence and self-esteem. It also helps them to occupy their time by doing those activities in regular basis and help to integrate with social life. However, older adults showed age related decline with tasks even when those task are familiar, practiced and environmentally valid.[5] It is also applicable to their ADL activities also. Older adults should perform ADL as many as possible to maintain their activeness when they are not able to increase their activity level according to require guidelines within their abilities and depend upon health condition.[2] Ability to perform any ADL activity depends on client factors, performance skills, pattern of performance, and demand of that activity, context, and the environment.[4] Without detail evaluation of all aspect, it is a difficult task to address ADL related issues in elderly. Evaluation and implementation of the intervention is individualistic in nature, which makes this job a specialized one. We occupational therapist do ADL evaluation and intervention in our everyday practice because occupational therapy profession uses the term occupation to capture the breadth and meaning of everyday activity of an individual.[4] Though a multidisciplinary team approach is require to prevent loneliness where occupational therapist can play an important role to make older adults independent in their ADL activities by modifying the demand, context, environment and pattern of the activity.

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Conflicts of interest

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