title: Bathing: a framework for intervention focusing on psychosocial, architectural and human factors considerations.
abstract: The process of bathing is usually pleasurable and relaxing for most persons and, although it serves hygienic needs, it is often individualized to a person's preferences in order to enhance the pleasurable experience. In contrast, the bathing process for elderly people suffering from dementia is often a traumatic experience for both the persons with dementia and their caregivers. Agitated behaviors are manifested more often during bathing than at other times. Factors influencing the experience of the bathing process and resulting in agitated behaviors can be categorized into four broad groups: the needs of the person with dementia, the needs of the caregiver, the physical environment in which bathing takes place and institutional factors. A number of approaches have been employed to treat agitated behaviors during bathing; however, a comprehensive approach addressing all of the above factors has not been developed. This paper presents preliminary findings on the effectiveness of the Treatment Routes for Exploring Agitation (TREA) approach for non-pharmacological interventions within a larger framework of human factors, addressing the needs of residents and staff members, environmental factors as well as human factors analysis to improve the process of bathing. A case study demonstrates the efficacy of this approach in reducing agitated behaviors during bathing.
authors.affiliation: Research Institute on Aging of the CES Life Communities, 6121 Montrose Road, Rockville, MD 20852, USA. cohen-mansfield@hebrew-home.org
authors.forename: Jiska
authors.initials: J
authors.lastname: Cohen-Mansfield
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Parpura-Gill
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000374:Aggression; D001494:Baths / Q000379:methods* / Q000451:nursing / Q000523:psychology; D003704:Dementia / Q000451:nursing / Q000523:psychology*; D005260:Female; D005851:Geriatric Nursing / Q000193:education / Q000379:methods*; D006707:Homes for the Aged; D006801:Humans; D008297:Male; D009735:Nursing Homes