International Classification of Functioning: A Framework for Understanding Elderly Problem in the Bathroom - A Pilot Study

Alakananda Banerjee, Deepak Rohilla, and Deepak Kumar


ICF geriatric core set, Depression


The International Classification of Functioning, Disability and Health (ICF) Geriatric core set provides the potential framework for standardized reporting and measurement and setting the framework along the continuum of care. The ICF’S conceptual framework illustrates how facilitators and barriers in the environment interact with and influence health and functioning. Osteoarthritis (OA) remains one of the most common forms of musculoskeletal disease in the world. Approximately 40 % of adults older than the age of 70 suffer from OA of the knees, 80% of people with OA have limitation of movement and 25 % cannot perform their activities of daily living. The goals of assessment in rehabilitation and health are to describe the health status–related qualities within domains of functioning. The primary goal of this paper is to consider the assessment implications of the ICF. Aim of the study • ICF was used as a framework to identify the elderly problems in the bathroom due to pain in the lower leg and help to understand appropriate modifications for helping elderly in toileting and bathing. • ICF was used to acknowledge the dynamic interaction between different components of health so as to have a holistic approach for patient’s management. • Aim of the study is to recognize the role of environmental factors (grab rails) in improving disability and importance of participation as desired outcome. • To review existing grab rails in bathrooms. Methodology-Using the ICF geriatric core set as a framework, the problems of 65 community dwelling elderly (with MMSE more than 23) residing in New Delhi were identified. The pain in the lower limb (b28015), knee structure (e75011), problem in squatting (d4101), and the grab rails in the bathroom were studied. Result and discussion-Subjects had difficulty in lower limb functioning with moderate pain (33.84 %) to severe pain (27.69 %%) in the lower limb. There was impairment of the knee structure (moderate impairment: 33.84 %, severe impairment: 16.92%) which was causing activities and participation restriction with difficulty in squatting (severe difficulty: 26.15 %, complete difficulty 29.23 % of the elderly). Inspite of all these factors contributing it was found that only 15 % had grab rails in their bathroom (environment). The presence of grab rails in the bathroom can improve the functional status of the elderly and his/her quality of life. Conclusion-Elderly problems can be identified using ICF as a framework to understand the dynamic interaction between different components of health so as to have a holistic approach to elderly problem. There is the need to framework policies to ensure safe homes for elderly and create awareness about the home modifications and assistive devices in the community in India.

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