Little is known about whether interventions developed in nursing homes will work for family caregivers of cognitively impaired (CI)elders. Nurses are in the position to consult and collaborate with family caregivers and CI elders to improve the outcomes of bathing. The purpose of this study is to conduct a pilot test of an in-home intervention designed to reduce discomfort, disruptive behaviors, and promote self-care in community dwelling CI elders during bathing and to examine the intervention's effect on the family caregivers' perceptions, feelings and actions. The intervention is similar to a bathing intervention developed for use with nursing home residents. The overall goal of the pilot study is to determine the usefulness of the modified intervention, in which a nurse consultant teaches family caregivers about strategies they can use to change the psychosocial environment in which bathing occurs.
Specific aims are to: 1)estimate the effect of the intervention on elders' comfort level, disruptive behaviors, and self-care behaviors during bathing; 2) estimate the effect of the intervention on caregivers' distress, satisfaction and preparedness for bathing, and caregiving behaviors during bathing; 3)assess the feasibility of the data collection methods (e.g., measures, videotaping, caregiver journals, interviews, questionnaires) for use in the home setting with family caregivers and CI elders; and 4) to summarize caregivers' perception about how the bathing plan worked. A pilot study is proposed to estimate the feasibility and efficacy of an intervention designed for the nursing home setting and modified for the home setting. A quasi-experimental, one group, pretest and posttest design will be used to pilot an bathing intervention used previously with nursing home staff and CI residents and modified to use with family caregivers and CI elders in the home. The intervention will involve a nurse consultant collaborating with the family caregiver and CI elder to develop a bathing plan designed to help caregivers use strategies that reduce discomfort, disruptive behaviors, promote self-care (e.g., washing body arts) during bathing. Data will be collected with videotapes of baths, caregiver
