Providing Good Care at Night for Older People: Practical Approaches for Use in Nursing and Care Homes

Sue Davies PhD MSc BSc RGN RHV (Associate Professor, Winona State University, Winona, Minnesota, USA)

Quality in Ageing and Older Adults

ISSN: 1471-7794

Article publication date: 16 September 2011



Davies PhD MSc BSc RGN RHV, S. (2011), "Providing Good Care at Night for Older People: Practical Approaches for Use in Nursing and Care Homes", Quality in Ageing and Older Adults, Vol. 12 No. 3, pp. 189-190.



Emerald Group Publishing Limited

Copyright © 2011, Emerald Group Publishing Limited

There is very little published research describing life in a care home at night. This book is, therefore, a very welcome addition to the available literature. Informed by the findings of an action research project funded by the Joseph Rowntree Foundation, “Providing good care at night for older people” aims to provide night staff in care homes, their managers and inspectors with information, knowledge and skills that will help towards the provision of positive night‐time care. However, this resource is relevant to a much wider audience than those working in care homes and would be valuable reading for any student or practitioner caring for older adults at night, within any care setting. Relatives and friends supporting those who live in care homes would also find much of value here as they seek to work in partnership with care staff.

A fundamental premise of the book is that night and day within a care home are experienced very differently by both residents and staff. Night‐time can be particularly difficult and confusing for people with dementia, and strategies for enhancing night‐time experiences are discussed in detail. These include the use of night‐time key worker systems and life story work to ensure an individualized approach. Pain management, the use of sedatives and end‐of‐life care all receive detailed consideration. One particularly useful section includes ideas for evening activities for residents who do not necessarily want to retire to bed early.

There is an excellent section raising awareness of factors contributing to noise at night. The issue of “night‐time checking” and the importance of an individualized approach is also given particular attention. Other issues which are addressed in detail include the importance of management presence at night, availability of training for night staff and the health impacts of working at night.

A minor criticism is that I would have liked to see further details about the research study on which the book is based. While I appreciate that the book is written as more of a practical manual, drawing upon a wide range of research evidence, this information could have been included as an appendix. The authors could also have included more information about the management of change, or at least suggestions of other resources for managers inspired to implement some of the many positive suggestions within the book.

One issue that is perhaps missing is that of double/multiple room occupancy. While most care homes in the UK now offer exclusively single rooms, this is not always the case in other countries. This can have particular implications when residents are confused or when a particular resident needs additional care at night.

I found this book immensely readable and full of practical suggestions. Helpful case studies throughout illustrate key points and could be used in training sessions to raise awareness. A whole chapter is devoted to night‐time care prompts for inspectors, for example “Are people's night‐time nutritional and hydration wishes and needs recorded and met during the night”, “Does the home provide sufficient stimulation and exercise through the day to help them sleep at night?” While aimed at inspectors, this chapter could also provide a useful checklist for homes to assess their own performance in night‐time care. In my opinion, this book should be an essential purchase for every care home.

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