Empowerment Improves Older Adults’ Rehabilitation in Homecare Settings

Background: A study carried out in a public homecare setting aimed at determining older adults’ satisfaction with, evaluation of and attitudes toward personal hygiene by comparing a traditional bath with soap and water to a bath in which prepacked disposable washcloths were used. Based on the results, the purpose of this subsequent study was to refine our methodology in order to compare and identify older adults’ needs and choice of bathing procedure. Methodology: Twenty older adults completed two questionnaires and were interviewed before and after the bathing procedure just like the nurses. Baseline data regarding age, gender, type of housing, bath facilities, activities of daily living and self-rated health were obtained from one questionnaire and questions regarding the older adults' satisfaction with, evaluation of and attitudes toward personal hygiene from another. Nurses completed a questionnaire regarding their satisfaction with the two types of personal hygiene. Data regarding nurses' preferences and recommendations on traditional bath and prepacked disposable washcloths were obtained from another two questionnaires. On the original questionnaires satisfaction were rated using three possible answers. Questions regarding the number of minutes spent for the individual personal hygiene, description of the conditions under which the bath took place, and an evaluation of the ethical dimension were asked. Two questions clarified the bath recommended by nurses and patients, two questions were used to evaluate skin reactions to soap and water and prepacked disposable washcloths. In the refining process the rating of satisfaction was expanded as well as the evaluation of skin condition, the recommendation of either types of bathing procedure was specified. Ideas from the Most Significant Change model were incorporated into the nurses' questionnaire, and self-determination was incorporated in the revised questionnaire. Outcome: Overall, the older adults preferred to have their own individual choice of daily bathing procedure. The nurses’ choice and recommendation of prepacked washcloths was significant and motivated by concern for the older adults’ efforts, time spent and personal wellbeing. The questionnaires containing baseline data, nurses' preferences and recommendations on traditional bath, and prepacked disposable washcloths were considered sufficient for future studies. Specification of questions, expansions, more balanced scales and incorporation of older adults' self-determination increased the quality of the two questionnaires for future