Hoeffer et al., 1997

Hoeffer, B., Rader, J., McKenzie, D., Lavelle, M., & Stewart, B. (1997). Reducing aggressive behavior during bathing cognitively impaired nursing home residents. Journal of Gerontological Nursing, 23(5), 16-23. 

Research Design:  pre- post- test design (single subjects design)

Sample Information: 76 bed proprietary intermediate care facility, urban, 10 subjects (80% female)

Outcomes: Ryden Aggression Scale (RAS), Form II (counts the number of aggressive behaviors, physically, verbally, and sexually aggressive behaviors)

Innovative Features: 2 major components: bedside consultation and individualized bathing care plan; shifting nursing assistant perspective from task-focused to person-focused. (focus on function, frequency, and form – ID function bath is to serve and then frequency required to serve that function, develop individualized bathing care plan)

Major Results/Findings: Significant difference between pre- and post- intervention mean scores for the number of physically and verbally aggressive behaviors observed and how upset subjects appeared. Significant differences between pre- and post- intervention scores on perceptions of subject’s behavior; nursing assistants rated subjects as less upset and aggressive and more calm and relaxed during bathing after the intervention. Significant differences also found between pre- and post- intervention scores on the experience of caring for aggressive residents during bathing. (post intervention, nursing assistants rated their experience as less frustrating and frightening and more quickly done). Use of towel bath as strategy for reducing aggression particularly promising given effectiveness with single subject as intervention to reduce aggressive behavior.