Hostname: page-component-78c5997874-v9fdk Total loading time: 0 Render date: 2024-11-17T13:10:32.841Z Has data issue: false hasContentIssue false

Time spent in bed at night by care-home residents: choice or compromise?

Published online by Cambridge University Press:  28 January 2011

REBEKAH LUFF*
Affiliation:
Centre for Research on Gender and Ageing (CRAG), University of Surrey, Guildford, UK.
THERESA ELLMERS
Affiliation:
Centre for Research on Gender and Ageing (CRAG), University of Surrey, Guildford, UK.
INGRID EYERS
Affiliation:
Zentrum für Altern und Gesellschaft, Hochschule Vechta, Germany.
EMMA YOUNG
Affiliation:
Acute Stroke and Brain Injury Unit, St. Peter's Hospital, Chertsey, UK.
SARA ARBER
Affiliation:
Centre for Research on Gender and Ageing (CRAG), University of Surrey, Guildford, UK.
*
Address for correspondence: Rebekah Luff, School of Social Sciences, University of Southampton, Southampton, SO17 1BJ, UK. E-mail: [email protected]

Abstract

This paper examines the amount of time that care-home residents spend in bed at night, focusing on how residents' bedtimes and getting-up times are managed. Using a mixed-methods approach, diary data were collected over 14 days from 125 residents in ten care homes in South East England. The findings indicate that residents spent, on average, nearly 11 hours in bed at night, significantly more time than was spent sleeping. There was greater variance in the amount of time residents who needed assistance spent in bed than there was for independent residents. Detailed investigation of six care homes, each with 8 pm to 8 am night shifts, showed that bedtimes and getting-up times for dependent residents were influenced by the staff's shift patterns. Analysis of qualitative interviews with 38 residents highlighted a lack of resident choice about bedtimes and many compromises by the residents to fit in with the care-home shift and staffing patterns. The social norm of early bedtimes in care homes also influenced the independent residents. It is argued that the current system in care homes of approximately 12-hour night shifts, during which staff ratios are far lower than in the daytime, promotes an overly long ‘night-time’ and curbs residents' choices about the times at which they go to bed and get up, particularly for the most dependent residents.

Type
Submitted Articles
Copyright
Copyright © Cambridge University Press 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alessi, C., Schnelle, J., MacRae, P., Ouslander, J. G., Al-Samarrai, N., Simmons, S. F. and Traub, S. 1995. Does physical activity improve sleep in impaired nursing home residents? Journal of the American Geriatrics Society, 43, 10, 1098–102.CrossRefGoogle ScholarPubMed
Ancoli-Israel, S., Parker, L., Sinaee, R., Fell, R. and Kripke, D. 1989. Sleep fragmentation in patients from a nursing home. Journals of Gerontology: Medical Sciences, 44, 1, M18–21.CrossRefGoogle ScholarPubMed
Arber, S., Hislop, J. and Williams, S. 2007. Gender, sleep and the life course. Sociological Research Online, 12, 5, 19. Available online at http://www.socresonline.org.uk/12/5/19.html [Accessed 29 July 2010].CrossRefGoogle Scholar
Bates-Jensen, B. M., Schnelle, J. K., Alessi, C. A., Al-Samarrai, N. R. and Levy-Storms, L. 2004. The effects of staffing on in-bed times of nursing home residents. Journal of the American Geriatrics Society, 52, 6, 931–8.Google Scholar
Bowers, H., Clark, A., Crosby, G., Easterbrook, L., Macadam, A., MacDonald, R., Macfarlane, A., Maclean, M., Patel, M., Runnicles, D., Oshinaike, T. and Smith, C. 2009. Older People's Vision for Long-term Care. Joseph Rowntree Foundation, York, UK. Available online at http://www.jrf.org.uk/publications/older-people-vision-long-term-care [Accessed 29 July 2010].Google Scholar
Brown-Wilson, C., Davies, S. and Nolan, M. R. 2009. Developing personal relationships in care homes: realising the contributions of staff, residents and family members. Ageing & Society, 29, 7, 123.Google Scholar
Care Quality Commission (CQC) 2008. Guidance for Inspectors: Night Time Care Prompts Care Homes. CQC, Newcastle upon Tyne, UK. Available online at http://www.cqc.org.uk/guidanceforprofessionals/socialcare/careproviders/guidance.cfm?widCall1=customWidgets.content_view_1&cit_id=34772 [Accessed 19 February 2010].Google Scholar
Department of Health 2001. National Service Framework for Older People. Stationery Office, London.Google Scholar
Department of Health 2002. Care Homes for Older People: National Minimum Standards. Third edition, Stationery Office, London. Available online at http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4005819 [Accessed 19 February 2010].Google Scholar
Department of Health 2006. Our Health, Our Care, Our Say: A New Direction for Community Services. Stationery Office, London.Google Scholar
Department of Health 2010. Building the National Care Service. Stationery Office, London.Google Scholar
Eyers, I. 2007. Extracting the essence of formal caregiving: a comparative study of formal care givers in English and German care homes. In Paoletti, I. (ed.), Family Caregiving to Older Disabled People: Relational and Institutional Issues. Nova Science Publishers, New York, 273–94.Google Scholar
Fetveit, M. D. and Bjorvatn, B. B. 2002. Sleep disturbances among nursing home residents. International Journal of Geriatric Psychiatry, 17, 7, 604–9.CrossRefGoogle ScholarPubMed
Finlay, W. M. L., Walton, C. and Antaki, C. 2008. Promoting choice and control in residential services for people with learning disabilities. Disability and Society, 23, 4, 349–60.Google Scholar
Glaser, B. G. and Strauss, A. 1967. The Discovery of Grounded Theory: Strategies for Qualitative Research. Aldine, Chicago.Google Scholar
Ice, G. 2002. Daily life in a nursing home: has it changed in 25 years? Journal of Aging Studies, 16, 4, 345–59.Google Scholar
Kerr, D., Wilkinson, H. and Cunningham, C. 2008. Supporting Older People in Care Homes at Night. Joseph Rowntree Foundation, York, UK.Google Scholar
Laing and Buisson. 2009. Care of elderly people UK: Market Survey 2009. Laing and Buisson, London.Google Scholar
Martin, W. and Bartlett, H. 2007. The social significance of sleep for older people with dementia in the context of care. Sociological Research Online, 12, 5, 11. Available online at http://www.socresonline.org.uk/12/5/11.html [Accessed 29 July 2010].Google Scholar
Meadows, R. 2005. The negotiated night: an embodied conceptual framework for the sociological study of sleep. Sociological Review, 53, 2, 240–54.Google Scholar
Meadows, R., Luff, R., Eyers, I., Venn, S., Cope, E. and Arber, S. 2010. An actigraphic study comparing community dwelling poor sleepers with non-demented care-home residents. Chronobiology International, 27, 4, 842–54.Google Scholar
Moran-Ellis, J., Alexander, V. D., Cronin, A., Dickinson, M., Fielding, J., Sleney, J. and Thomas, H. 2006. Triangulation and integration: processes, claims and implications. Qualitative Research, 6, 1, 4559.Google Scholar
National Care Homes Research and Development Forum. 2007. My Home Life. Help the Aged, London. Available online at http://myhomelifemovement.org/downloads/mhl_review.pdf [Accessed 29 July 2010].Google Scholar
Schnelle, J. F., Cruise, P. A., Alessi, C. A., Ludlow, K., Al-Samarrai, N. R. and Ouslander, J. G. 1998. Sleep hygiene in physically dependent nursing home residents: behavioral and environmental intervention implications. Sleep, 21, 5, 515–23.Google ScholarPubMed
Schwarz, B. 1970. Notes on the sociology of sleep. Sociological Quarterly, 11, 4, 485–99.CrossRefGoogle Scholar
Scourfield, P. 2007. Helping older people in residential care remain full citizens. British Journal of Social Work, 37, 7, 1135–52.CrossRefGoogle Scholar
Taylor, B. 1993. Unconsciousness and society: the sociology of sleep. International Journal of Politics, Culture and Society, 6, 3, 463–71.CrossRefGoogle Scholar
Thomas, J. 2000. Incorporating empowerment into models of care: strategies from feminist women's health centers. Research in the Sociology of Health Care, 17, 3, 139–52.Google Scholar
Valins, O. 2002. Facing the Future: The Provision of Long-term Care Facilities for Older Jewish People in the United Kingdom. Institute for Jewish Policy Research, London.Google Scholar
Williams, S. and Bendelow, G. 1998. The Lived Body: Sociological Themes, Embodied Issues. Routledge, London.Google Scholar