For most people, a good night's sleep is essential for good mental and physical health. Sleep interruption or deprivation can affect people of all ages and give rise to other problems. Lack of sleep may be the result of a stressful work schedule, personal problems, having a new baby in the house, a painful physical condition or illness, excess caffeine intake or many other factors.
Finding the cause can be complicated.
As baby boomers become senior citizens and move into assisted-living or nursing care centers, sleep deprivation may contribute to falls, confusion, depression, poor appetite, irritability and other behaviors. The Journal of the American Geriatrics Society reports that "65 percent of residents living in a senior living facility experience clinically significant sleep disturbances." In addition, many seniors cannot or will not communicate such problems.
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PHOTO BY MARYANN KROMER
Activity assistants Matthew Cameron and Wahneta Mockensturm tidy up the kitchen area near the main dining room at Autumnwood.
To address this issue, Autumnwood Care Center in Tiffin, a Volunteers of America facility, has installed a sensor system to monitor the quality of sleep its residents are experiencing. WellAware uses advanced technology to gather data about each person's daily activity or lack of it. Sally St. Clair, executive director at Autumnwood, said WellAware can help residents achieve restful sleep and assist the staff in identifying potential disturbances and interventions for them.
"The general goal is for residents to receive at least four hours of uninterrupted, restorative sleep. We use the WellAware system as just one tool in our effort to reach that goal," St. Clair said.
Starting last fall, WellAware representatives installed a terminal in each hallway, entered the patients' data to get the system operating and trained the staff. The company takes care of everything else. Gina Porter, director of nursing at Autumnwood, and Mary Lee Creeger, director of therapeutic recreation, marketing and volunteers, spoke about the features of the system.
"When they installed it, of course, they were here. Otherwise we just contact them by email and they're able to take care of it," Porter said. "Only the nurse managers had to have training, and it was just a two-hour training to teach them how to read the reports."
"I didn't realize so many people here didn't sleep at night. We probably have 8 percent of people who don't sleep," Creeger said.
Porter explained pain or discomfort is the biggest reason for lack of sleep. Consulting a person's doctor may be needed to find solutions. The system's main sensor is a wireless strip placed under the bed linens. It tracks the amount of time a resident spends in bed each 24-hour period and relays the information to wall-mounted sensors that send it on to a data manager.
The data is incorporated into a graph that nurse managers can access. If a person becomes restless at a certain time of the night, that shows up in the report. Once a pattern is detected, caregivers can try to pinpoint the cause, such as medication wearing off or an environmental factor that disturbs the person. Printouts of the reports also can be sent to the residents' physicians.
"It's recommend that you utilize a two-week pattern," Porter said.
Funding for the sleep sensors came from the Volunteers of America home office. Porter said the organization gradually is adding the system to all of its geriatric centers. The sensors cover all the rooms, with a few exceptions.
"We have a couple that have declined it," Porter said.
"I've noticed just in the activity realm, people start being less involved in things they used to do. They just want to stay in their room and sleep," Creeger said. "People who used to be out and about are either a lot more grumpy or they're not enjoying their life as much any more."
Autumnwood also has made an effort to reduce unnecessary medications that may affect sleep and to provide a homelike setting in which residents feel safe and comfortable during the night. For her part, Creeger is trying to keep residents more active during the day with a variety of activities.
Wednesdays, residents can participate in the "Chefs and Diners" program. Residents can sign up to cook a meal of their choice. Family members can come and eat with their loved one, and residents can sign up to fill the extra spaces. A smaller kitchen is being constructed just off the main dining room where these meals can be prepared and served family-style to 8-14 people. Families have commented how much they enjoy having a loved one fix a family favorite for them again. A few weeks ago, participants made cherry pies from scratch.
Creeger said the Autumnwood Auxiliary contributes money to purchase supplies, which are brought in. Some residents do not take part in other activities, but they don't miss the cooking sessions.
"They love sharing their own recipes. A lot of the recipes are things they cooked when they were at home. Now they can let other people enjoy it," Creeger said.
Activities also has been extended into the evenings three times a week so people have a reason to stay awake longer. The nursing staff can attend to physical needs, but residents also need stimulation for a better quality of life.
"We're doing more intellectual things, like book club and travelogues and speakers coming in for folks who crave those kinds of things," Creeger said. "Our transition people are here for therapy, and they're in therapy during normal activity hours."
These changes, in conjunction with the sleep sensors, are intended to help residents avoid falls, stay healthy and feel more at home.
To learn more about Autumnwood, call (419) 447-7151 or visit the care center at 670 E. SR 18, Tiffin.
