Fighting a New Battle: A Bathing Care Standard for Caregivers of Elderly Male Military Veterans with Delayed Onset Post Traumatic Stress Disorder

Monday, 9 November 2015

Michelle Rose, MSN, RN
Department of Nursing, Governors State University, University Park, IL, USA

Despite many veterans’ hopes that the invisible wounds of war can be healed; they leave scars. Most survivors of military combat who have experienced or witnessed life-threatening events such as, terrorist incidents, and serious accidents can adjust to incidents without lingering effects.  Many years after a war, other aging veterans find themselves fighting a new battle as they strive to cope with delayed-onset posttraumatic stress disorder (DOPTSD). For many aging military veterans with Post Traumatic Stress Disorder (PTSD) activities of daily living, particularly bathing can be an improbable, exasperating, and stressful task. An evidence-based bathing care standard was created for direct care staff at a local Mid Western Hospice organization who have been experiencing the challenges during bathing of their patients. The body of research evidence guiding this project is the Bathing Without a Battle (BWOB) learning tool for long-term care nursing personnel and families who have been affected by Alzheimer's disease and related dementias. This care standard seeks to translate the body of research associated with the BWOB movement applied in the care of veterans with dementias to those with evidence of the agitated and aggressive behaviors associated with DOPTSD triggered by bathing. This project hypothesized that bathing can be accomplished “without a battle” and modeled into a more humane, gentle experience for elderly male Veterans with DOPTSD and their caregivers.  Maladaptive behaviors such as kicking, biting, hitting, scratching, throwing objects, spitting, and cursing were measured using a Log for Maladaptive Behavior.  Results reflected an effective means of improving the bathing experience of veterans with delayed onset PTSD in long term care and residential settings and caregivers. By changing the bathing routine and environment, and implementing patient centered care (PCC) interventions these men may be better able to adapt to bathing, which will no longer be a battle.This topic is very essential in geriatric and veteran care. The bathing process for elderly male military veterans suffering from DOPTSD is often a challenging experience for both veterans and their caregivers. Similar to dementia, persons with DOPTSD can become confused and may misinterpret actions and verbiage by caretakers.