Updating Bathing without a Battle, Developing a Spanish Version, and Providing Free Internet-Based Training for Three Years.

Project: Research project


In 2001-2003 a $286,000 grant from the Retirement Research Foundation funded the development and distribution of the training program Bathing without a Battle to all nursing homes in the United States, including provision of free continuing education credits for nurses and nursing assistants. Since that time, Bathing
without a Battle has become a cornerstone of the person-centered care and culture change movements in nursing homes and an ongoing source of important staff education around person-centered dementia care.
? The Artifacts of Culture Change Tool, developed under a contract from the US Center for Medicare and Medicaid Services, specifies “Bathing without a Battle techniques are used with residents” as one of 79 quality indicators around culture change.
? A 2008 a federal grant to New York State reviewed available training programs for nursing homes and concluded that Bathing without a Battle was the best program currently available.
? A federally-funded evidence-based review published in 2013 identified the research underlying Bathing without a Battle as one of only nine scientifically high-quality nursing home care studies that documented improvement in outcomes for persons with dementia.

The Bathing without a Battle training remains valuable. Ongoing staff education needs persist, due to the high staff turnover rates in long-term care and the large number of caregivers who need education. In the last five years (2010-14) without any marketing effort 3,876 copies of the training have been sold, 3,112 nursing
home staff have applied for continuing education credit, and many more have likely received the training. Furthermore, the training remains timely -- A recent publication in the Journal of the American Geriatrics Society observed that, using Bathing without a Battle in a train-the-trainer program, "a significant change was
observed in how residents were bathed that translated into a significant reduction in the rate of aggressive and agitated behaviors, particularly verbal, during residents’ baths."7 Help is needed, however, to allow this training to continue to be made available. As of December 31, 2014, the School of Nursing at the Oregon Health and Sciences University, which had provided the free credits, stopped doing so. Meanwhile, the computer program used to develop the in-depth interactive training has become so outdated that it is impossible to either update it or place it on web platforms, which are increasingly favored for nursing and nursing assistant education. In fact, the computer program that was used to develop the CD-ROM has been unavailable for nearly 10 years, and the materials will need to be rebuilt in order to update the training and make it available in contemporary formats. Additionally, an increasing minority of longterm care paraprofessionals have Spanish as their native tongue and therefore learn better in that language,
yet a dearth of training exists in Spanish around person-centered care.
Effective start/end date10/1/159/30/18


  • Retirement Research Foundation


nursing home
human being
data processing program
training program
language behavior
home care