A UCLA study currently underway at a nursing home in South Central Los Angeles seeks to improve sleep in nursing homes. It is often not uncommon for residents to be awakened hourly, often due to noise and light changes associated with nighttime care routines.
The study is designed to promote sound slumber in two ways - through a nighttime-incontinence management program coupled with noise-abatement intervention. The study, which is funded by the National Institute on Aging, is being tested in eight nursing homes in the Los Angeles area over 4 years. Preliminary results after 2 years of testing suggest that the intervention increases residents' average length of time asleep at night. It also produces an increase in the longest sleep periods for residents.
Currently, the study is being tested at Garden Plaza Convalescent Hospital in South Central Los Angeles, where approximately 40 incontinent residents have agreed to participate. Under normal-care conditions, these residents - like most nursing home residents - are checked for wetness every 2 hours at night and then changed, if necessary. This helps keep residents dry and reduces their risk of pressure sores. However, an unintended consequence of this routine is that most residents are regularly awakened from sleep.
As part of the study, Garden Plaza residents are provided incontinence care primarily during time periods that they are awake. Nurses' aides check incontinent residents hourly during nighttime hours. Those residents who happen to be awake are either helped to the toilet, if they desire, or are checked and changed, if necessary. Residents found sleeping after several consecutive checks are awakened for incontinence as a precaution against pressure sore development.
As part of the study's noise abatement intervention, nighttime staff at Garden Plaza take part in inservice training sessions designed to heighten their sensitivity to sleep and noise issues. The research team also provides feedback on noise levels twice per nighttime shift, to encourage nursing home staff to reduce overall noise levels. Additionally, the noise level of telephones, buzzers and intercom systems are reduced after 9 PM each night, and squeaky linen carts are replaced with less noisy alternatives.
Other nursing homes currently participating in the study are the Jewish Home for the Aging and Topanga Terrace. Additional sites will be added as the study continues.