Page 19 - From Good Sleep to Wellness

Assess each resident at move in to households, and when there is a change in sleep patterns. The care plan should focus on how to assist each resident to have adequate sleep and still receive good skin care. As the team care plans for each resident, consider the ideas listed below. If the resident is unable to communicate, team members who know the resident will be able to provide team with resident specific information.

Bedtime snack
Shower, spa bath or towel bath before bedtime
Toileting before bedtime
Is there a need for a pad or nighttime brief
Listen to soothing music, soothing sounds
Read?
Light level in bedroom
Night light on or off
Bathroom light on with door slightly ajar
Temperature of bedroom
Does the resident like to sleep with a pet or a stuffed animal or a doll?

sheet only flannel sheets knit sheets light blanket comforter bed
warmed with aqua pad
Pillow, size, number and position

At move in, each resident will be assessed for self- change of position. As team members move down the hall at night, check to see if resident has changed position since the most recent observation. Changes in position are not limited from moving side to side. If resident is lying on their side, have they shifted the position of their shoulder and arm? When resident needs assistance with toileting or wears a nighttime brief, offer to toilet when noted to be awake. Many elders sleep in 2-3 hour segments. It is better to toilet them when they are awake than to wake them up. Residents who position themselves on a pressure ulcer may need to be repositioned every two hours. Many residents can be moved off the pressure ulcer by using weight shifting that moves them off the ulcer without having to wake them up to turn to the other side.
Note changes in position with an hour period of time to identify residents who are able to reposition themselves. Note times that the resident is found awake. Use this information to develop a sleep promotion care plan.

The Household Matters Toolkit form Tell Us About... will collect some of this information. The life of a resident is greatly improved when they are able to get adequate sleep.