Conceptualizing communication enhancement in dementia for family caregivers using the WHO-ICFframework

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Abstract
Despite the importance of educating and training family caregivers about the language and communication changes associated with Alzheimer's Disease (AD), a comprehensive framework for interventions has not been put forward to date. There are three objectives of this paper. The first is to review the World Health Organization's (WHO) International Classification of Functioning, Disability and Health (ICF) conceptual framework. The second objective is to provide a detailed description of the ICF as it relates to the language and communication changes experienced by individuals with AD that family caregivers find stressful. The third is to discuss the use of the ICF in the development and implementation of language and communication enhancement education and training programs for family caregivers of individuals with AD. The ICF provides a comprehensive framework, offers a universal language, includes the family caregiver as a potential support or barrier, and necessitates a consideration of the everyday communication activities and participation of individuals with AD. The ICF will require more explicit considerations of the subjective experience of disability and further exploration of the concept of third-party disability. Empirical testing of communication enhancement interventions based on the ICF framework will be needed as well as an increased acceptance and incorporation into clinical practice by speech language pathologists and other health care professionals.