We all know how hard it is to lie awake at night but most of us don’t know how important quality sleep is for our residents. When we don’t have to get up for school or work and our hours and days begin to run together, every day is Saturday! Sadly, everyday isn’t Saturday and breaking a normal wake/sleep cycle can and often does lead to negative outcomes, including falls. Think about it, even if we have dreams, most nights we are relaxed, restoring our energy and recharging our batteries.
That said, did you know that research has shown that almost two thirds of residents have some form of a sleep disturbance? Residents may lay awake during what is referred to as “sleep latency time” before falling asleep. During this time, we walk the halls, talk with other staff, push noisy carts, and enter rooms with bright hallway lights on. No wonder our residents aren’t sleeping well and may be cranky in the morning!
What do we do? Look at your fall log. Target a few of your residents who have experienced more than one fall and start the process of root cause analysis. Sure, you likely did an investigation at the time of the fall, but this is deeper than that. Are these residents sleeping or awake during the night? Engage your night shift staff, initiate a sleep log, educate staff to be alert to some common causes of insomnia including:
- pain (assess)
- respiratory issues such as COPD
- sleep apnea (do they have a bipap/cpap)
- skin issues such as dry, itchy skin (humidifiers, lotions)
- GERD (provide an extra pillow)
- restless leg syndrome
- incontinence
Remember, communication is key. If staff are observing residents lying awake, be sure they are addressing it, it isn’t okay for residents to live with insomnia when you consider the increased risk of falls. How about keeping residents engaged during the day, reducing polypharmacy, avoiding caffeine, staying on a sleep schedule, providing a protein snack at night and provide private rooms when possible. Sleep, ah yes, we all love it! Stay well and stay informed!
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