Why is sleep so important?
There’s a reason why regular periods of uninterrupted sleep are a sacred thing to most of us. Sleep helps us recover and revitalize, and repairs muscle tissue after an active and stimulating day. While you are resting, your immune system identifies intruding elements, and "charges" the recognition of those elements into its memory, to better resist infection. Sleep also consolidates your memories, making you sharper during your waking hours.
What happens when residents lose sleep?
For older residents in need of special care, broken sleep patterns can lead to a whole range of negative consequences, including mood swings, impaired judgment and memory, increased sensitivity to pain, heightened risk of infection, greater risk of falling, and difficulty coping with daily activities and rehabilitation programmes.
At the same time, our bodies change as we get older, and some of these changes can make it harder for the elderly to get a good night's sleep. In general, our sleep becomes shallower, with frequent awakenings. Our kidney function also declines, and our bladder grows less elastic, which results in needing to empty more frequently at night.
Old age also increases the risks involved in nighttime trips to the bathroom. Research1 of over 400 falls that occurred among hospitalised patients over the age of 60 showed that more than 1/3 of all falls were related to toileting, and almost half of these occurred at night. The study also showed that the majority of falls happened due to lack of sufficient assistance.
Tips for an efficient nighttime caregiving routine
Taking good care of residents who are incontinent requires an individualised care plan, with appropriate continence management, good staff cooperation, and knowledge about how various factors affect sleep. Education courses on this subject are available, and gaining deeper knowledge can prove worthwhile. In the meantime, here are a few steps you can take to minimize sleep interruptions and make your nighttime caregiving routine more efficient.
Start with the basics
Seemingly obvious measures like not drinking coffee or too much liquid before going to bed, and voiding the bowel and bladder, are a good place to start. Coordinating the resident's daytime sleep schedule to cut down on the frequency and length of their naps may help too. Make sure they are on a consistent sleep cycle, with regular bed times, and think about their medication regiment. Some medications like diuretics increase thirst and fluid intake, and should be administered earlier in the day to allow time for new fluids to pass through the system.
Good habits for better sleep
Consider behavioural factors that may be contributing to loss of sleep. Is the resident getting enough fresh air and exercise in their daily routine? Perhaps they are experiencing new sources of sleep-depriving pain or irritation, which changes to their analgesic regime could alleviate. Watching TV in the evening may be too stimulating for some residents, and although alcohol does induce drowsiness, it actually interferes with the body's sleep-regulating mechanism. Instead, encourage activities like gentle stretching, reading, or listening to calm music, to promote a restful frame of mind.
Hurried trips to the bathroom alone at night carry a risk for older people. One way to enhance safety and streamline the whole process is to install a chair-style commode next to the bed. If this is not feasible or desirable, at least make sure the resident can see where they are going at night, and has a clear path. Install motion sensor lights, if possible, and be sure to clear the path of loose rugs and other hazards. If advanced dementia is present and night wandering is a concern, a bed alarm can be useful to alert you if the resident should get up and wander off.
Take care of fragile skin
The discomfort of a nagging skin condition can have a serious impact on a resident's sleep, and may in some cases contribute to an increased need to urinate at night. To help maintain natural skin health, TENA has developed a three-step skin health solution for those living with incontinence.