More Information on Overnight Care

Why Overnight Care?

If your loved one is prone to wander at night, has trouble sleeping through the night, or tends to wake up disoriented, or may have intensive care needs and you’re looking for an overnight caregiver to watch over during the night, Home Instead has an overnight caregiver in store for you and we would like to help you out.

Overnight care is not the same as what we consider to be a ‘normal’ night’s rest. During the night hours, older people can often experience difficulty in resting. Broken sleep patterns aggravate conditions such as dementia and have a detrimental impact on the general well-being of the sufferer and of those caregiver living with them.

These overnight disruptions can undermine your loved one’s confidence and sense of independence in living at home. They can feel anxious and disoriented as a result.

For those living with conditions such as dementia and Alzheimer’s these concerns are common. Sundowning is a term that refers to how those living with these conditions, mostly seen in the elderly, can end up disoriented and confused from late afternoon through the evening and night.

Whatever the reasons, your loved one needs attentive care and could be at risk when unattended at night.  And you might want to consider having an overnight caregiver.

Getting up through the night regularly is very wearying especially when the primary caregiver is a family member who is also providing care throughout the day or working outside the home.

Relying on a foreign domestic helper is not the solution because FDW also becomes overloaded with both day and night tasks. Even when the family is going away on holidays, overnight care would allow your domestic helper enough rest to take on the caregiver role during the day.

What is needed is a team approach that includes a plan for the entire needs of the care recipient day and night, and includes a long-term view that is preventive, sustainable, and provides for quality of life for the care recipient and family.

At Home Instead we assess your needs and create a Care Plan that can include both specialist and non-specialist caregivers to maximize the quality of life and cost-effectiveness.

Our overnight CAREgiver or Care Nurse stays overnight and looks after a patient from late evening until early morning. You can rest easy knowing that our night care professional is on hand to manage the caregiving needs of your loved one through the night. We have both active and in-active night service for carers.

The long term quality of life

At Home Instead we focus on long-term care and quality of life for seniors who wish to stay at home.

This could mean managing chronic conditions like what we do on dementia care or in some cases follow-up of acute events resulting in hospitalization both of which means ongoing follow-up with the doctor and hospital visits.

Maintaining continuity of the follow-up as well as preventive care is critical to the long-term outcome, yet these visits are disruptive and time-consuming, especially with sometimes long waiting times at clinics. A simple consultation can take hours or even most of a day. For seniors and others with mobility constraints, travel is also difficult. With our experienced caregivers whether daily basis or overnight caregivers, who are trained to provide quality care not only to assist in the activities of daily living or mobility assistance, but we are also dedicated to helping maintain our client’s living standards on a long-term basis.

Active Overnight Care

Active overnight care is when our overnight caregiver or night carer is awake for active duties all night to assist care recipients and ensure their safety.

This form of care is best for our seniors who have intensive care needs such as complex care, palliative care, or high needs.  An overnight caregiver is part of our home care services that is also ideal for seniors with mental health needs and may be in danger of hurting themselves through the night or are confused between day and night.

In-Active Overnight Care

The overnight caregiver doesn’t need to be awake all the time to provide supervision but will be available in case of a need or an incident during inactive overnight care.

This is one of the caregiver options that are ideal for the elderly who are mostly alright during the night and may require limited assistance such as assistance to safely go to the toilet. It is not uncommon for elders to fall during the night on their way to the toilet.

Sometimes frail and weak individuals might really struggle to get back up without any help. The number of hip fractures among the elderly in Singapore has more than doubled in the last decade.

There are many individuals such as elderly people who often wake up confused throughout the night and may try to get out of their sack too quickly. This is often the case for those who suffer from illnesses such as Alzheimer’s and dementia. These seniors are also prone to wandering during the early hours.

Some conditions such as Parkinson’s disease are also associated with anxiety where the elderly is unable to go back to sleep after waking up to go to the toilet. Our overnight caregiver can help re-settle and re-assure the elder encouraging them back to sleep so that they get more sleep and feel well and alert the following day.

We understand that no two of our care recipients will have the exact same needs for care and support. That is why we tailor our overnight care packages to each of our client’s individual needs. Packages can include specialist care for conditions such as Dementia, Parkinson’s Disease, and Stroke.

Why Does Aging Affect Sleep?

According to the Sleep Foundation, it’s common for older adults to experience changes in the standard and duration of their sleep. Many of these changes occur due to changes in the body’s internal clock. A master clock in a part of the brain called the hypothalamus is composed of about 20,000 cells that form the suprachiasmatic nucleus (SCN)3.

The SCN controls 24-hour daily cycles, called circadian rhythms. These circadian rhythms influence daily cycles, like when people get hungry, when the body releases certain hormones, and when a person feels sleepy or alert.

As people get older, their sleep changes due to the effects of an aging SCN4. Deterioration in the function of the SCN can disrupt circadian rhythms, directly influencing when people feel tired and alert.

The SCN receives information from the eyes, and light is one of the most powerful cues for maintaining circadian rhythms. Unfortunately, research shows that many older people have insufficient exposure5 to daylight, averaging around one hour each day. Daylight exposure may be even more restricted for seniors who live in nursing homes as well as those with Alzheimer’s disease.

Changes in the production of hormones, such as melatonin and cortisol, may also play a role in disrupted sleep in older adults. As people age, the body secretes less melatonin, which is normally produced in response to darkness that helps promote sleep by coordinating circadian rhythms.

Health Conditions and Sleep

Mental and physical health conditions may also interfere with sleep. Conditions that commonly affect sleep in older people include depression, anxiety, heart disease, diabetes, and conditions that cause discomfort and pain, such as arthritis.

The relationship between physical health and sleep is complicated by the fact that many older adults are diagnosed with more than one health condition. In fact, the 2003 National Sleep Foundation Sleep in America Poll looked at 11 common health conditions and found that 24% of people between 65 and 84 years old reported being diagnosed with four or more health conditions. Those with multiple health conditions were more likely to report getting less than six hours of sleep, having poor sleep quality, and experiencing symptoms of a sleep disorder.

Sleep issues may also be related to the side effects of medications. Almost 40% of adults over the age of 65 take five or more medications. Many over-the-counter and prescription drugs can contribute to sleep issues. For example, antihistamines and opiates may cause daytime drowsiness, while medications such as antidepressants and corticosteroids may keep older people awake and contribute to the symptoms of insomnia. The interactions of multiple medications may cause unanticipated effects on sleep.

What Can I Do to Help My Loved One?

Other than getting professional help or an overnight caregiver, there are a few things a family caregiver can do at home:

• Placing motion sensor lights in their bedroom and passageway
• Making sure their paths are clutter-free
• Checking that the house is securely locked
• Putting a drink and snack beside their bed
• Monitoring caffeine intake in the afternoon and evening
• Ensuring they’re receiving enough fresh air and exercise
• Making sure they’re not taking any disorientating sleeping pills
• Providing adult incontinence underwear and waterproofing their mattress

Reduce the risk of injury

Darkness is an obvious hazard overnight, and this increases the risk of loved ones falling and injuring themselves.

Consider placing motion sensor lights in the bedroom and passageway, so that your loved one can see where they’re going if they get up to go to the bathroom or get a drink of water. Make sure their path from the sack to the bathroom and kitchen is clutter-free, and there are no loose rugs that they could trip over.

Seniors with conditions such as Alzheimer’s or another form of dementia may wake to feel disoriented and confused. Sometimes this gives way to restlessness, and they may feel the urge to go outside. Make sure the house is securely locked, with no easy, obvious, access to keys, as a nighttime deterrent to possible wandering.

Make sure you establish the root cause of their overnight wandering to see if there’s a simple way to mitigate the risk of it happening. For example, rather than the person having to make a trip to the kitchen for a glass of water, put a drink and an easy-to-eat snack beside their bed instead.

Managing incontinence

Incontinence – or lack of bladder control – is a common problem experienced by older people. While you can’t control this condition, you can provide your loved one with comfort and support, including adult incontinence underwear and waterproofing for the mattress to protect against damage.

You may consider having an option to pad their bed, which saves changing linen in the middle of the night to lessen disruption and discomfort.