It is amazing how quickly we turned from winter to spring this year! The sun is out in the Midwest which is a rare sight in the month of February but we aren’t complaining! With spring upon us we are looking at day light savings time and “springing forward” in a few weeks. For many of us this means a loss of an hour of sleep, for others it means gaining an hour of golf at the end of the day. Whatever it means to you, have you considered what it means to your residents with cognitive loss?
Residents with a diagnosis of dementia are naturally a higher risk for negative outcomes related to falls, burns, elopements, resident-to-resident altercations, etc. but what does the change in time mean to them? Well, it varies from resident to resident and studies have shown that interrupted sleep/sleep deprivation can increase a resident’s risk for falls/injuries.
So what should we be looking for and how do we prepare our residents for the time change with as little interruption as possible? Consider:
- For residents who prefer to “sleep in”, allow them about 30 minutes each morning when the time changes. So if the resident usually rises at 8:00 allow them to remain in bed until 8:30 for the first few days.
- Once the resident starts to acclimate to the change, start waking them at 8:15 and then 8:00. This gradual adjustment will more than likely go unnoticed however if you attempt to wake them a full hour early you might meet resistance.
- Adjust meal times to accommodate the change in time. If breakfast is usually served at 8:00, consider serving at 8:30 for a week and then 8:15 and finally back to 8:00. This will allow staff to get residents to meals timely and discourage “in room dining”.
- Make rounds to ensure staff are not delivering breakfast trays to rooms and leaving them at the bedside. No one enjoys a cold breakfast!
- Observe residents who are a high risk for falls to identify any subtle changes timely and adjust the wake/sleep cycle to see if that is the reason for the change.
- Be observant to bedtime rituals. Remember, you may be trying to get residents down for the night at 9:00 but their internal clock says it is 8:00. You may benefit from following the morning plan in reverse.
- Some centers have had success by including additional post-dinner activities the week of the time change. This provides additional supervision, distractions for the residents and allows caregivers more time to accommodate residents who are not adjusting well.
- Warm milk and cookies, never underestimate the value of our childhood favorites, studies have shown they work!
- Decrease stimulation from televisions, radios and computers during the post-dinner hours. These devices can interfere with resting cycles and sleep.
Remember, falls happen when residents are “out of sorts” or not sleeping well. Time changes can contribute to falls and as caregivers we need to be aware of the risks and adjust accordingly. If you need assistance with tracking, trending and root cause analysis for the falls in your center please contact our QA Reader team for a demo of what we can do to assist! Happy Spring!
