The Nursing Home at Night: Effects of an Intervention on Noise, Light, and Sleep

Schnelle, John F.; Alessi, Cathy A.; Al‐Samarrai, Nahla R.; Fricker, Ronald D.; Ouslander, Joseph G.

doi:10.1111/j.1532-5415.1999.tb07235.x

Cited by 112 publications

(118 citation statements)

References 17 publications

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“…The empirical evidence of the negative impact on sleep in shared rooms in hospitals is fairly strong (Duffin, 2002;Ulrich & Zimring, 2004), although in nursing homes the evidence is weaker (Schnelle, Alessi, Al-Samarrai, Fricker, & Ouslander, 1999).…”

Section: Results Of the Literature Reviewmentioning

confidence: 99%

Exploring the Cost and Value of Private Versus Shared Bedrooms in Nursing Homes

Calkins¹,

Cassella²

2007

The Gerontologist

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Purpose: There is debate about the relative merits and costs of private versus shared bedrooms in nursing homes, particularly in light of the current efforts at creating both cost-efficient and person-centered care facilities. The purpose of this project was to explore the extent to which there is evidence-based information that supports the merits of three different bedroom configurations: traditional shared, enhanced shared, and private. Design and Methods: We developed a framework of four broad domains that were related to the different bedroom configurations: psychosocial, clinical, operational, and construction or building factors. Within each dimension, we identified individual factors through the literature, interviews, and focus groups, with the goal of determining the breadth, depth, and quality of evidence supporting the benefits of one configuration over another. Results: The vast majority of factors identified in this study, regardless of whether there was solid empirical data, information from the focus groups, or other anecdotal evidence, indicated better outcomes associated with private rooms over shared rooms in nursing homes. Cost estimates suggest that construction cost (plus debt service) differences range from roughly $20,506 per bed for a traditional shared room to $36,515 for a private one, and that such differences are recouped in less than 2 years if beds are occupied, and in less than 3 months if a shared bed remains unoccupied at average private-pay room costs. Implications: Despite limited empirical evidence in some areas, this project provides the foundation for an evidence-based life-cycle costing perspective regarding the relative merits of different bedroom configurations.

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Section: Results Of the Literature Reviewmentioning

confidence: 99%

Exploring the Cost and Value of Private Versus Shared Bedrooms in Nursing Homes

Calkins¹,

Cassella²

2007

The Gerontologist

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“…These studies have shown that it is extremely difficult to change the long-term care environment, and despite considerable efforts by researchers, the environment remains quite noisy at night. 35,37,38 An alternative approach is to use multi-component interventions to address both internal physiological causes of sleep disturbance and external environmental factors. One such study tested a short-term (5-day) intervention combining daytime light exposure and physical activity, a structured and regularly-timed bedtime routine, reduced time in bed during the day plus provision of nighttime nursing care in a manner that minimizes disruption to sleep.…”

Section: Non-pharmacological Treatment Of Sleep Problemsmentioning

confidence: 99%

Sleep Disturbances in Long-Term Care

Martin¹,

Ancoli‐Israel²

2008

Clinics in Geriatric Medicine

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SYNOPSISNighttime sleep disruption is characteristic of long-term care residents, is typically accompanied by daytime sleepiness and may be caused by a multitude of factors. Causal factors include medical and psychiatric illness, medications, circadian rhythm abnormalities, sleep disordered breathing and other primary sleep disorders, environmental factors and lifestyle habits. There is some suggestion that these factors are amenable to treatment; however, further research on the implementation of treatments within the long-term care setting is needed. Additional work is also needed to understand the administrative and policy factors that might lead to systemic changes in how sleep is viewed and sleep problems are addressed in long-term care settings.A growing number of older adults reside in long-term care facilities. In this setting, residents commonly suffer from nighttime sleep disruption, which is often accompanied by daytime sleepiness and may be caused by a multitude of factors. Importantly, sleep disturbance is associated with negative health outcomes, including risk for falling, and elevated mortality risk among long-term care residents. A number of factors contribute to sleep disturbance in the long-term care setting including medical and psychiatric illness, medications, circadian rhythm abnormalities, sleep disordered breathing and other primary sleep disorders, environmental conditions (e.g., noise and light) and lifestyle habits. Based on research with older adults in the community and work conducted within long-term care settings, there is some suggestion that these factors are amenable to nonpharmacological treatments. Further research on the broad implementation of treatments for sleep problems within the long-term care setting is still needed. Additional work is also needed to understand the administrative and policy factors that might lead to systemic changes in how sleep is viewed and sleep problems are addressed in long-term care settings.

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“…The effect that increased noise has on patients has been evaluated in a variety of hospital settings, most notably in pediatric and adult intensive care units and nursing homes. 9,10 Noise has been shown to increase blood pressure, heart rate, respiratory rate, and body temperature. It has also been associated with failure to thrive, impaired immune function, delayed wound healing, and increased stress levels.…”

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confidence: 99%