Best Practices for the Design and Evaluation of Bathing Spaces for Older Adults With Cognitive Impairment in Residential Care Settings: A Scoping Review
Bibliographic record
Abstract
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.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.098 | 0.225 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.008 | 0.011 |
| Bibliometrics | 0.016 | 0.010 |
| Science and technology studies | 0.002 | 0.004 |
| Scholarly communication | 0.012 | 0.007 |
| Open science | 0.006 | 0.005 |
| Research integrity | 0.006 | 0.005 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".