Cohen-Mansfield Jiska, Parpura-Gill Aleksandra
Research Institute on Aging of the CES Life Communities, 6121 Montrose Road, Rockville, MD 20852, USA.
Arch Gerontol Geriatr. 2007 Sep-Oct;45(2):121-35. doi: 10.1016/j.archger.2006.09.001. Epub 2006 Nov 9.
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.
对于大多数人来说，洗澡过程通常是愉悦且放松的，尽管它满足了卫生需求，但通常会根据个人喜好进行个性化调整，以增强愉悦体验。相比之下，患有痴呆症的老年人的洗澡过程，对痴呆症患者及其护理人员来说往往是一次痛苦的经历。洗澡时比其他时候更常出现激动行为。影响洗澡过程体验并导致激动行为的因素可大致分为四大类：痴呆症患者的需求、护理人员的需求、洗澡的物理环境以及机构因素。已经采用了多种方法来治疗洗澡时的激动行为；然而，尚未形成一种综合解决上述所有因素的方法。本文介绍了探索激动行为治疗途径（TREA）方法在更大的人为因素框架内进行非药物干预的有效性的初步研究结果，该框架涉及居民和工作人员的需求、环境因素以及人为因素分析，以改善洗澡过程。一个案例研究证明了这种方法在减少洗澡时激动行为方面的有效性。
