Bathing persons with Alzheimer's disease and related dementias

摘要

Bathing is a complex activity requiring cognitive and physical abilities including balance, strength, coordination, and executive function (Naik, Concato, & Gill, 2004; Rader et al, 2006). In people with Alzheimer's-type dementia, bathing represents one of the earliest activities of daily living (ADLs) to require supervision, then assistance. In a national survey of nursing homes, at least 90% of residents required bathing assistance (Rader et al., 2006). When people with dementia residing in an institution require assistance with bathing, the process is complicated by the culture, values, and expectations of people who assist with the bath. Seemingly simple concepts such as what is clean versus what is dirty and how one responds to what he or she perceives can trigger conflicts. Moreover, in an institutional setting there are policies, rules, and traditions of care that might trump individual needs and beliefs.