Effect of the Bathing Without a Battle Training Intervention on Bathing‐Associated Physical and Verbal Outcomes in Nursing Home Residents with Dementia: A Randomized Crossover Diffusion Study

Abstract

The Bathing Without a Battle educational program, delivered through a train-the-trainer format, is an effective means of improving the bathing experience of residents with dementia in nursing homes. This research supports broadly adopting this intervention, especially for nursing homes serving many residents with dementia.

Non-pharmacological interventions for aggression in persons with dementia: A 10-year follow-up review of the literature

“…[29] Since that time, just four additional studies that met the inclusion criteria have been devoted specifically to addressing aggression during ADLs. [40,43,46,48] Overall, there appears to be continued need for empirical research addressing aggressive behavior that occurs during intimate caregiving situations.…”

“…Most notably, only four were randomized control trials that utilized "gold standard" experimental methods such as random assignment and inclusion of a control group. [31,36,39,40] Two of these studies utilized designs where facilities were randomly assigned to experimental conditions and included adequate sample sizes of over 200, [39,40] whereas two studies [31,36] included random assignment of participants to conditions, but with smaller sample sizes (N = 67 and N = 33, respectively).…”

“…Gozalo et al [40] investigated the effectiveness of the Bathing Without a Battle (BWAB) educational program in reducing physically and verbally aggressive behaviors in residents with dementia. The intervention teaches staff techniques for bathing residents with dementia in a manner that is safer and more comfortable for both the resident and staff member.…”

“…[14,[49][50][51] More recently, three staff intervention studies found significant reductions in aggression. [39][40][41] These programs tend to involve multiple sessions and teach specific skills such as identifying and modifying environmental precipitants of aggression, communication techniques, learning to view problem behaviors as an expression of an unmet need, learning to examine antecedents to aggressive behaviors and their consequences, and distraction. One important feature of some training programs evaluated is that there was an emphasis placed on individualizing intervention strategies based on a "menu" of more general strategies.…”

Psychotic Disorders and Violence

“…Education should increase knowledge, skills, and attitudes related to unmet needs, environmental regulation, and respect for individual preferences. One example of such an educational approach is the "Bathing without a Battle" training program (Gozalo et al 2014). Clear communication of intended tasks, modification of caregiving strategies (e.g., bed baths vs. tub baths), or use of distraction to minimize the focus on caregiving can reduce combativeness and rejection of care (Galindo-Garre et al 2015;Ishii et al 2010).…”