Medical Hydrology and Balneology: Environmental Aspects

Association of behaviral and psychological
symptoms of dementia with nighttime spa
bathing
Deguchi A (1) , Hamuguchi H (1) , Kawamura Y (1)
(1) Oyamada Memorial Spa Hospital. Yokkaichi. Japan
deguchi@ztv.ne.jp
Introduction and Objectives
Dementia symptoms include a core symptom (cognitive impairment) and behavioral
and psychological symptoms. The behavioral and psychological symptoms of
dementia (BPSD) are sometimes called peripheral symptoms or accompanying
symptoms. The behavioral symptoms include restlessness, agitation, wandering,
socially inappropriate behavior, sexual disinhibition, collectionism, swearing, and
hanging around, and the psychological symptoms include anxiety, depression,
hallucination, and delusion. Many patients with dementia cannot take baths by
themselves and need bathing care. Bathing for institutionalized persons is typically
conducted during the day. However, many patients fall asleep after daytime bathing,
and subsequently, they experience BPSD during the night. From these viewpoints,
we examined the association between nighttime bathing and BPSD.
Materials and Methods
This study involved 10 patients with Alzheimer’s disease in a special nursing
home for the elderly. Assisted spa bathing conducted between 2:00 PM and 3:00
PM twice a week was changed to nighttime bathing between 6:00 PM and 7:00 PM
twice a week. Nighttime bathing was performed 18 times over a period of 9 weeks.
The extent of sleep, restlessness, wandering, and aggression was observed for 13
weeks in total: during the 2 weeks before the onset of daytime bathing, during the 9
weeks of nighttime bathing, and during the 2 weeks after the onset of daytime
bathing.
Results
Nighttime bathing improved not only sleep but also restlessness, wandering, and
aggression. These improvements became statistically significant after 6 weeks of
nighttime bathing.
Conclusions
A study of spa bathing in a facility (referred to as a local interaction home) adjacent
to our hospital, and a further study of day service and day care users, showed
good sleep and increased appetite. Spa therapy may cause the phenomenon of
thermal crisis. Systemic symptoms of thermal crisis include sleep symptoms (par-
Balnea
2012, núm. 6, 344-345
344
ISBN: 978-84-669-1887-0
978-84-669-3482-4