21 December 2018

Dementia night care: What you need to know

Have you ever woken up in the middle of the night and felt confused from tiredness? That exact feeling is common among those who have dementia.

Waking in the night can leave those living with dementia feeling disorientated. For example, if they want to go to the toilet, they might not be able to find their way. For others, being awake during the night could be linked to their previous life experiences.

Kerr and Wilkinson (2011) describe situations whereby night-time wandering could be linked to residents having been night shift workers and were more used to sleeping by day and being active at night. In line with their recommendations, care home managers and night care staff should always: 

* have a well-rounded understanding of dementia 

* recognise that a person’s past might be influencing their present behaviour 

* be aware of the communication difficulties of people with dementia so that they understand, when a person is trying to communicate that they are in pain or discomfort

* be discouraged from recommending or using “quick fix” solutions such as sedative medication to get people to sleep, instead, exploring alternative methods based on their understanding of why people might be awake (see below)

* adapt the night care time environment to reduce confusion and disorientation, for example, by having suitable lighting and signage in place

* use assistive technology such as sensor mats to enable a prompt response so that any difficulties and the accompanying distress can be prevented or kept to a minimum.

Dementia Care offers the following advice on how to help someone living with dementia to get a good night's sleep... 

  • Make sure the person with dementia is genuinely tired by the evening so they will naturally sleep. Avoid too many daytime naps (often these are out of boredom rather than a genuine need for sleep). Exercise also helps make someone tired.
  • Mid to late afternoon a person with dementia may show signs or irritability and restlessness. This is thought to be associated with light changes and tiredness. This is commonly referred to as Sundowning. A person with dementia may benefit from a short nap in the afternoon.
  • Make sure they have been to the toilet just before getting into bed.
  • Keep to their regular bedtime routine or start one if they don’t have one. Perhaps a milky drink, warm bath, putting on the radio for quiet music.
  • Put away all distracting ‘daytime’ things - clothes, newspapers, books etc.
  • Make sure the room is dark but perhaps with a night-light for reassurance or to help them find the way to the toilet.
  • An alarm pressure pad under the mattress can alert you if the person gets up. If the person moves around a lot whilst in bed, try a pressure pad on the floor next to the bed or an infra-red movement detector to alert you if the person gets up. This can be connected to a buzzer in your pocket or under your pillow.

Read When should you check on a resident at night time? 

Sources:

Dementia Care 

Croner-i Ltd