For most of us we spend our lives seeing our bedrooms as a safe sanctuary – a place to relax, unwind and sleep. But, getting older or living with dementia can make the mundane much more challenging and turn those things we take for granted quite dangerous.
If your loved one is living with dementia, is very elderly and frail or living with a life limiting condition then even something as simple as getting a good night’s sleep can present a genuine problem. But, there are more risks and issues in the bedroom than just dropping of at night.
Life can feel very stressful so getting a good night’s sleep is vital. It’s also really important that you can get up during the night if you have to, without tripping, falling or becoming disorientated.
There are a number of challenges that someone can face in their bedroom, we will deal with six of the most significant.
- Getting into or out of bed
- Night time wandering
- Incontinence at night
- Getting to the toilet
- Getting lost at night
- Orientating between day and night
Here is some useful advice on how to solve these challenges however it is important that you speak to a healthcare professional (such as occupational therapist or physiotherapist) before implementing the suggestions.
Getting into or out of bed
Older people inevitably become less mobile and frailer as they progress along their personal journeys. When this happens the most simple of tasks create a risk, even getting into and out of bed. This is a result of decreased strength, reduction in mobility and a decreasing sense of balance. There is also an ever greater risk of injury which can limit people’s capacity to look after themselves.
How you solve this problem will depend on where people are on their individual journey and what has caused their personal challenges. You may want to consider the following:
- Profiling beds which can go up and down to whatever height the individual needs, so for somebody that is quite short the bed can be lowered to get in and out and then raised to the right height for sleeping. Some also have the facility to raise at the head and foot to make eating meals, drinking or watching TV easier and more comfortable.
- Safety bed rail helps to prevent older people from falling out of bed but is also an excellent support bar for getting in and out of bed. It can give that peace of mind that is sometimes needed but also that little bit of balance and support.
- Carer support when an individual needs that bit of extra support that a bar or beam cannot provide they may have to rely on a carer, either professional or family member to help them. This can vary between a supportive hand to full time care and everything in-between.
Night time wandering
This is only really a concern for people living with dementia and does not impact on those on a different journey. When people do wander it often appears to others that they do so randomly and without reason, but this is not normally the case. When people living with dementia are wandering they are normally looking for something or somebody, even if they can’t articulate this clearly to us.
At different times of the day the likelihood that people will wander varies often at night this becomes more likely and therefore a greater risk. But, this is because they are likely to be looking for their spouse, their children or trying to find the bathroom. They may have become disorientated between time and space and be trying to get ready for work.
Resolving this starts by trying to help them feel comfortable and at ease. You should join them on their journey and help them find what they are looking for. This might mean saying to them work doesn’t start for a few hours so you can get a few more hours work before they need to get up. We should not try and force people into our reality but we should join them in theirs.
We can also set up bed sensors, which can be placed on the floor or under a pillow or mattress. This can then alert a carer when they get out of bed allowing them to support the older person and keep them safe. You could also use a motion sensor or use remote audio monitoring.
Nigh time incontinence
Incontinence is one of the most common and one of the most upsetting symptoms of dementia as well as a number of other conditions. It’s traumatic for both the person affected and for the carer, but despite this there are still ways to make it easier for the person to deal with. There are a number of products that can assist with the impact of incontinence including the following:
Waterproof mattress and duvet protector this makes it easier to get the bed ready for your loved one to get back to sleep but also protects the bed and bedding.
Absorbent underwear for those people that are experiencing less significant incontinence absorbent underwear may be more appropriate than incontinence pads.
Incontinence pads – these should not be the first resort and should not be used until the time is right it can improve quality of life and the dignity of older people experiencing incontinence.
Getting to and from the toilet
Getting to and from the toilet at night can be a challenge for even younger people when they wake up in the middle of the night. It can be disorientating and confusing and often we are not as coordinated as we are during the rest of the day. This can lead to trips and falls which can cause serious injury.
There are a number of options to help with this concern.
Urinal bottles and bed pans are the easiest and least disruptive option because the older person can complete their business without having to get up and get back to sleep quicker.
Commode – if getting out of bed is not a problem but walking to the toilet is then a commode may be the ideal solution.
Assistance to get to bathroom – if you don’t want to use any aids to use the toilet then your only option might be to get assistance to get to the toilet and back into bed again.
Getting lost at night
Primarily an issue with dementia, but also a challenge for anybody experiencing delirium of any sort, symptoms of any number of other conditions that cause disorientation and confusion. In these cases it is important that when people do get up in the middle of the night their path to the toilet is as easy as possible.
Considering suitable lights is also important. You don’t want them searching for the light or stumbling around in the dark at the top of the stairs! Consider automatic lights that come on when people walk past or ones where the switch is illuminated so is easy to find in the dark. Even consider a night-light that provides enough background light to keep them safe if they start moving around without putting the lights on.
Leave the bathroom door open so it can be seen from the bed or bedroom door, think about leaving the bathroom light on.
Knowing if it is daytime or night-time
Struggling with orientation with time can be a real challenge; luckily there are a number of options that can help.
There are clocks that can read out the time, so if your eyesight won’t allow you to read a traditional clock. There are simplified clocks that will tell you it is Friday Night; Early Wednesday Morning or Saturday Afternoon.
During the summer consider blackout blinds to help orientate your body and even a “Light Alarm Clock” that will better simulate dawn breaking even in the middle of winter. These are specifically designed to help the body wake up “naturally”.
If you have any questions relating to care for your relative/friend, please find your nearest Greensleeves Care home and speak to the Home Manager.