6 Tips To Help Your Residents Sleep Better

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We all know what we feel like after spending a sleepless night tossing and turning in our beds. The next day we feel grumpy, groggy, unproductive, and maybe even a bit confused. So imagine what it’s like for a nursing home resident who sleeps poorly night after night. Today let’s look at some of the causes of insomnia and how we can help our residents enjoy healthy sleep.

Noises in the night

One of my roles as a volunteer is to sit with residents who are nearing death. Occasionally this involves spending time at the nursing home during the night shift. This experience makes me very aware of how noisy a nursing home can be at night.

Even when caregivers are trying to be quiet, sounds are magnified. You hear doors closing, carts going up and down the halls, voices of caregivers and other residents, alarms going off, medical equipment beeping, toilets flushing, and the rustle of people coming and going during the change of shift. Even something as simple as a soda can dropping in a soda machine becomes a disruption during the night.

My suggestion is for nighttime caregivers to take turns monitoring noise levels in the nursing home. Sit in a room for a few minutes at different times during the night and listen to all the sounds residents might hear. Then talk about it as a group and look for creative ways to cut down on the noise.

It’s a good idea to check with residents, too, for feedback on environmental issues that might disturb their sleep such as lights, noises, or odors. Residents often accept these disturbances as simply part of being in a nursing home, so they don’t bring them up to caregivers.

Medications that affect sleep

At one time, sleeping pill usage was very common in nursing homes. Fortunately, today we know of the many potential side effects that are particularly serious in older adults. These include dizziness, impaired balance, constipation, dry mouth, next-day drowsiness, and confusion. Sleeping pills are rarely used in nursing homes anymore, and then only for specific reasons and under careful monitoring.

On the flip side, one type of medication that is often underutilized in nursing homes is pain medication. Pain has a significant effect on a person’s quality of sleep. This is especially true for residents living with dementia who might not be able to verbalize pain. You can learn more about this issue in my previous article where I shared interventions to help control pain.

You would probably be surprised to learn how many commonly prescribed medications can affect sleep. Some cause difficulty falling asleep or staying asleep, while others cause daytime drowsiness.

Here’s an article written by a pharmacist that helps explain some of these medication effects. When a resident has trouble with insomnia, it’s important to ask the consultant pharmacist to review their meds. They will often recommend a change in time of administration or a switch to a different type of medication to solve the problem.

Daytime routine

Exposure to natural sunlight in the morning helps us set a healthy circadian rhythm so we’ll sleep better at night. I’m a strong advocate for helping residents get outdoors whenever possible. Even when that’s not feasible, providing brighter lighting in the morning and softer lighting in the evening will help. Some facilities also use special light bulbs that promote alertness or sleepiness, depending on the time of day.

A daily exercise routine promotes restful sleep at night. too. Plan for more energetic activities earlier in the day, with mellow activities before bedtime.

Daytime naps also affect the quality of a resident’s sleep at night. While a brief nap is often refreshing, depending on the needs of an individual resident, long naps usually aren’t helpful. Unfortunately, residents sometimes take long naps due to boredom, so that’s one reason why a dynamic activities program is so important.

Individualized care

I cringe when I think about my years of working as a CNA in a nursing home back in the ’70s. We woke residents at ridiculous times of the morning simply so we could get their showers finished before breakfast. Sadly, it didn’t matter what they wanted. Residents were expected to fit into our rigid schedules.

Thankfully, today a resident’s normal routines and preferences are assessed and included in their plan of care. What time do they like to go to bed and get up? Do they enjoy special bedtime routines such as reading, listening to music, or eating a snack? Is there a favorite blanket or nightlight they wish to bring from home? (I can’t sleep without my memory foam pillow; that’s going onto my care plan when I enter a nursing home!)

For residents who need assistance with repositioning or using the toilet during the night, individualized care planning is also crucial. I remember the days when we made rounds every 2 hours at night and pestered people whether they needed care or not. Today our goal is to help residents remain as continent as possible at night and protect their skin, while also allowing them to enjoy a good night’s sleep.

Screen time

A decade ago, I never would have thought to put this topic in an article about promoting sleep in the nursing home. However, more and more residents are coming in with laptops, smartphones, and other electronic devices. When exposed to the type of light emitted by these devices within two hours of bedtime, people report having more difficulty falling asleep, in addition to waking up more often during the night.

While residents have the right to use these devices before bedtime if they wish, many are not aware of the potential consequences. This is where education is important, especially if a resident complains of difficulty sleeping.

Medical issues

There are many other approaches to try if a resident has difficulty sleeping. These include relaxing music, white noise, aromatherapy, reducing caffeine intake, or a warm bath before bed.

However, if nothing seems to help, it’s time to seek out a medical evaluation. Numerous health conditions such as sleep apnea, depression, esophageal reflux, and urinary frequency can all impact sleep.

 

Here’s a free printable to help you quickly assess the reason why someone might not be sleeping well.