Bathing in residential care: understanding the experiences of residents and their care providers

Abstract

Purpose – The purpose of this paper is to understand how changes in an older adult’s physical capacity alter their bathing preferences, how the care environment incorporates residents’ values and beliefs around bathing to fulfil these changing care needs, and how institutional factors, such as staff scheduling and communication processes, influence Resident Care Aides’ (RCAs) bathing practices. Design/methodology/approach – A multiple methods approach involving surveys and interviews with residents and RCAs in a Canadian residential care facility. This paper draws mostly from the semi-structured, qualitative interviews with older adult residents (n=9; Mini Mental Status Exam (MMSE) scores > 15) and RCAs (n=10) on two nursing units offering different bathing options. Findings – Decreasing energy levels and physical decline were commonly cited reasons for residents’ changing bathing preferences. Residents were overall very appreciative of the bathing care they received in residential care, and identified the weekly tub bath as an anticipated encounter where they experienced a valued social interaction with their assigned RCA. While identifying bathing as an occasionally stressful aspect of their work, RCAs also described the bathing experience as an intimate bonding activity. The study identified bathing as an important activity in residential care. Originality/value – Previous studies have focused on moderate to severely cognitively impaired older adults’ and their demonstration of agitated behaviours during bathing. Most participants in this study had only minor cognitive impairment, as measured by MMSE scores (average score=20.6); therefore, this study provides insight into the experiences and needs of older adults whose perspective is not generally reflected in the literature.

Body care of older people in different institutionalized settings: A systematic mapping review of international nursing research from a Scandinavian perspective

“…The papers cover a wide range of participants (Supporting Information: Table 15 ). Two papers have included both care workers and older people (Holmberg et al, 2020 ; Holroyd & Holroyd, 2015 ). Out of the eight papers exploring the experiences of care workers, three focus solely on nurses (Borglin et al, 2020 ; Coker et al, 2017a , b ; Råholm, 2012 ).…”

“…Other discourses within this underlying assumption are the notions of person‐centered care approaches, with a focus on respecting self‐determination, control, autonomy, dignity, and identity, where the relationship between the older people and the care workers is the prerequisite for the provision of body care. McCormack's framework (person‐centered care), or the Fundamentals of Care Framework discussed by Kitson are cited in some of these papers (Achterberg et al, 2016 ; Borglin et al, 2020 ; Coker et al, 2017b ; Hälleberg Nyman et al, 2017 ; Holroyd & Holroyd, 2015 ; Ostaszkiewicz et al, 2018 ).…”

A Healthcare Paradigm for Deriving Knowledge Using Online Consumers’ Feedback

“…The percentage of home health quality episodes in which the patient improved his/her ability to bathe himself/herself on his/her own is reported by the “Improvement in Bathing [ 45 ]” feature. In [ 48 ], the effect of this feature was investigated to understand how alterations in the physical capacity of an older adult affect his/her preferences in bathing, as well as how the care environment incorporates these alterations.…”

Experiences of people with progressive memory disorders participating in non-pharmacological interventions: a qualitative systematic review

“…45,52,55 had a score of nine; nine studies 20,28,30,32,36,39,40,43,47 had a score of eight; 19 studies [17][18][19]25,26,31,37,38,44,46,[48][49][50]54,[57][58][59][60][61] had a score of seven; three studies 33,35,42 had a score of six; six studies 27,29,41,51,53,56 had a score of five; two studies 21,22 had a score of four; and one study 34 had a score of three. The criteria for assessing methodological quality for Q1 was achieved in eight studies, 16,20,21,30,36,49,52,55 for Q6 was achieved i...…”

“…53 One study combined music and spiritual care. 30 Many interventions could be categorized as multi-component interventions, either outdoors 45 or combining physical and social activities 49,52 and support groups. 35 One study used a logopedic intervention, 42 and two studies used a psychosocial intervention.…”