Modifying International Classification of Functioning, Disability, and Health (ICF) to Guide Development of Environmental Interventions for Transfer Performance by Individuals with Disabilities and Their Caregivers

To improve ICF’s utility in guiding design decisions about physical environmental interventions forindividuals with activity limitations and their caregivers, a more robust approach is needed to classify, describe, and measure the task-relevant environmental characteristics that create demands on activity performance. The purpose of this paper is to demonstrate one possible approach, through examination of physical environmental influences that impact caregiver-assisted toilet transfer performance by older adults and their caregivers. By applying the Modified Dyadic ICF in our analysis of caregiver-assisted transfers, we make suggestions for conceptualization of physical environmental factors in the ICF. This work suggests that physical environmental influences in dyadic activity performance are highly dynamic, oftentimes reciprocal, and task-specific. The proposed approach appears to be a feasible method to reveal areas of suboptimal environmental interaction during activity performance, which can be remedied by future environmental design interventions. Future research is needed on additional activities to validate the generalizability of this approach.