Bathing the Alzheimer's patient in long term care: Results and recommendations from three studies

Abstract

In the management of persons with Alzheimer's disease and related dementias, bathing constitutes a major source of agitation and discomfort for care recipients, and represents a significant job stress for caregivers. This paper reports three studies that were conducted in nursing facilities to help guide staff and administrators in efforts to improve resident bathing. The first study, a mail survey of nursing directors or charge nurses in 71 skilled care facilities, documented a high level of problematic behaviors (43.2 percent) during bathing of residents with dementia, a concomitant low level of satisfaction (50.7 percent) with bathing, and a wide range of recommended environmental modifications to improve bathing areas. The second study, a review of 515 incident reports from bathing areas in 25 nursing homes, found that agitation was rarely reported, and that the majority of injuries occurred when a caregiver was absent. The third study, a critical review of 14 specialized tubs in terms of suitability for the Alzheimer patient, found wide differences in accessibility for caregivers, disinfection times, reported safety and repair records, and suitabilityfor persons at various stages of dementia. The results of these studies provide practical recommendations for nursing facilities, domiciliary care settings, and home caregivers interested in improving the bathing process for persons with Alzheimer's disease.