We recently wrote about the importance of sleep for health and aged care workers, sharing tips for prioritising and managing adequate rest.
But for the people living with dementia in your care, sleep – and indeed, the night in general – can bring a number of complications and special adjustments.
Whether you’re at home, in a hospital or in a residential facility, night-time is a place beyond the usual anchors and cues of daytime. There are no meal-time routines, no visitors. The world is shut away and fears and worries can take hold. This can be an unsettling time for anyone, but for people living with dementia, this stillness and emptiness can be particularly frightening and disorientating.
Services still continue to provide night-time care and support as if the night was a time when people are continually asleep, rather than distressed, or needing reassurance or physical support.
But there are helpful ways you can approach the night when caring for someone living with dementia. Below are three excellent suggestions:
Take an individual approach
Never forget - older people are you in years to come! They have a mixed bag of feelings, behaviours and expectations, just like you. It’s important that night-time care is geared towards providing individualised, holistic and person-centred care. It’s crucial you take the time to know the past of a person in your care – only then can you understand their present.
Understand delirium
Delirium can masquerade as worsening dementia, but it is in fact a sign that something is physically wrong and requires appropriate treatment. Delirium is a sudden change over a short period (days, or even hours), and leads to confusion that is often worse at night. The person may be disorientated, or experience hallucinations. Causes can vary from urinary tract infections and infected pressure sores to dehydration and constipation.
Create a calm environment
Getting a good night’s rest in a noisy, confusing space is hard for any of us. Factoring in the disorientation frequently seen in cognitive decline, it’s no surprise people living with dementia struggle to maintain healthy sleep practices. Cognitive impairment can make it harder to decide which noises are relevant and struggle to know which noises to dismiss – this can be extremely distressing. Buildings should be modified to reduce noise levels (for example, carpet rather than hard flooring), and staff need to reduce noisy activity at night (such as not running washing machines or vacuum cleaners near where people are sleeping).
- Material for this article was sourced from Night-time Care: A Practice Guide (Diana Kerr and Colm Cunningham) and Providing Good Care at Night for Older People (Diana Kerr and Heather Wilkinson). Visit the HammondCare shop to find out more.
