Bathing without a battle: Providing more person-centered experiences for long-term care residents with dementia

Bathing of persons with Alzheimer's disease in long-term care facilities is often accompanied by behavioral symptoms such as resistance, agitation, and aggression. Caregiver behaviors (e.g., verbal confrontation, invalidation, and failure to verbally inform the resident before initiating a task) and certain bathing situations (e.g., washing the hair, axilla, perineum, or feet) are particularly likely to precipitate behavioral symptoms. In response, person-centered approaches to bathing have been developed; they focus on resident preferences, individualization of care, and resident comfort. In a randomized controlled clinical trial, two interventions (person-centered showering and the towel bath) were compared with standard bathing in 69 subjects from fifteen nursing homes. Results indicated that the frequency or percent of time in which study subjects exhibited behavioral symptoms, and scores on the discomfort scale, were reduced in both intervention groups; differences between the interventions were nonsignificant, except for discomfort, which was significantly lower during the towel bath. Individualized bathing, person-centered approaches, and techniques such as the towel bath can markedly reduce behavioral symptoms and improve the bathing experience for both the care provider and the patient with dementia.