A study of sleep habits in care homes has found that staffing levels, shift patterns and safety checks can significantly affect residents' ability to get a good night's sleep.
Researchers suggest a number of ways to improve care in these situations, including use of telecare sensors to minimise disturbances.
The research in three nursing homes and one residential care home formed part of a larger multidisciplinary study of sleep and ageing.
Among the findings were that:
- The time at which some residents went to bed was affected by staffing levels. For example, where a hoist had to be used because of a person's physical disability, the person had to be assisted to bed by the day shift, because more staff were available.
- Many care homes use practices that involve staff entering rooms to check on residents, sometimes hourly, which can contribute to significantly poorer sleep.
- Some residents were not confident approaching staff if they were having sleeping problems because they did not want to be prescribed sleeping medication.
- Physical disabilities could make going to bed a lengthy and painful process and residents highlighted difficulties they faced in positioning their bodies so they were comfortable enough to sleep.
- Due to the risk of falling, residents were usually discouraged from getting up independently at night if, for example, they wanted a walk or a hot drink.
Writing in the journal Nursing Older People, the authors say many staff are already offering emotional support during the night to residents who, in quiet times, talk about their concerns.
'It can be useful if these anxieties are shared with day staff, and where possible, residents are supported to act on their problems and make changes to situations that are worrying them.'
They also say that the number of sleep disturbances caused by night-time checking could be reduced for some residents with the support of telecare.
'Telecare is often used for older people in their own homes, but is less often used by care and nursing homes. Bed occupancy sensors, floor pressure sensors or enuresis sensors could alert a pager held by night staff. Night care planning with individual residents could identify whether they would prefer visits by staff for checking, if this is necessary, or to discuss other options.'
They also suggest that residents have access to resources that could occupy them during wakeful periods at night, such as mp3 players, radio podcasts or audiobooks.
More information: Ellmers T, et al. (2013). Factors affecting residents' sleep in care homes, Nursing Older People, 25, 8, 29-32. dx.doi.org/10.7748/nop2013.10.25.8.29.e466