Bathing residents with dementia in long-term care: critical incidents described by personal support workers

Aim and objective. The aim of this study was to describe and gain insight into the critical incidents depicted by personal support workers (PSWs) in long- term care (LTC) related to bathing residents who have dementia. Background. Residents with dementia in LTC often display responsive/protective behaviours during bathing. Consequently, bathing is a source of stress for PSWs who provide most of the personal care for LTC residents in Ontario, Canada. Design. A qualitative descriptive study employing the critical incident technique (CIT) was used. Method. Eight PSWs were interviewed and 24 incidents were collected and analyzed using thematic content analysis. Results. Findings revealed that PSWs experience the following during bathing: managing responsive/protective behaviours, working with limited resources, and dealing with communication difficulties. Participants used various strategies to respond to these challenges; however, they reported limited strategies to manage the most challenging behaviours. Conclusions. Many of the bathing strategies described by the PSWs in this study are found in the literature about best bathing practices in dementia care. However, it is evident that further work is needed to support PSWs to manage the most difficult physical responsive/protective behaviours that occur during bathing. Implications for practice. This study has clear implications for knowledge translation.