Best Practices for the Design and Evaluation of Bathing Spaces for Older Adults With Cognitive Impairment in Residential Care Settings: A Scoping Review

This is the authors' abstract. We don't add key points for this paper.

OBJECTIVES: Bathing and hygiene routines can be stressful for individuals living with dementia or other cognitive disabilities in residential care. Cold or unfamiliar bathrooms and limited staff resources often contribute to distress. DESIGN: Scoping review. SETTING AND PARTICIPANTS: This scoping review aimed to (1) synthesize existing evidence on communal bathroom design for adults older than 50 who live with cognitive impairment in residential care settings and identify gaps, and (2) explore methods for evaluating the design of these spaces. METHODS: Following Joanna Briggs Institute guidelines, we searched databases (APA PsycINFO, CINAHL, Bloomsbury Architecture/Design libraries, Embase/Embase Classic, JSTOR, Web of Science Core) and gray literature from inception to July 2023. Eligible sources included English peer-reviewed studies, reviews, opinion pieces, theses, and policy or conference abstracts/papers using qualitative, quantitative, or mixed methods. Key findings and gaps were analyzed using qualitative content analysis and synthesized narratively. A best practices framework was developed through collaborative, iterative discussion. RESULTS: Sixty-four sources (44 empirical; 20 gray literature) met inclusion criteria. The review identified 34 best practices, across 7 categories: planning, aesthetics, safety and accessibility, fixtures and assistive technology, environmental characteristics, sensory simulation, and bathing process and environment. Few validated tools or approaches for evaluating bathing environments or pre-postbathing processes were identified, and the residents' perspectives were largely absent. CONCLUSIONS AND IMPLICATIONS: Our findings emphasize the importance of concealing institutional elements and considering individual bathing habits and preferences. Designs prioritizing functionality, person-centeredness, privacy, and dignity may reduce distress and enhance the bathing experience. Future research addressing gaps in empirical evidence to support novel bathroom designs and validated evaluation tools is needed.