Family Caregivers: Getting the Rest You Need To Be the Best You Can Be

For caregivers who spend their days looking after a loved one suffering from serious illness or injury, nights can be anything but restful. You might be getting up several times a night to help your loved one get to the bathroom safely, or, just as taxing, lying awake worried that he’s going to get up any minute. Or maybe you find yourself bolting upright with a sudden concern about a new symptom or a medication refill. It’s all in a night’s often unrestful work.

Today is World Sleep Day, and with all that’s going on in the world these days, no one needs to remember the importance of sleep — and practice its lost art — more than family caregivers. The challenge and unrelenting nature of caregiving can really take its toll on sleep, making it hard to get through the day — let alone attend to the care of another person. Sleep deprivation can also put you at greater risk for depression, weight gain, and other mental and physical health stressors. The prospect of a sound night’s sleep can seem particularly distant for Alzheimer’s caregivers: A recent study by the University at Buffalo Nursing School found that 9 in 10 people caring for a loved one with dementia experience poor sleep.

Home healthcare nurses and aides at Partners in Care, an affiliate of the Visiting Nurse Service of New York, where I work, know what’s at stake when a family caregiver’s sleep is disrupted, and they have considerable experience helping caregivers — and those they care for — sleep better at night. Here are some sleep strategies that we hope will serve as helpful reminders to practice self-care, especially when caring for others. For both caregiver and the person being cared for, it helps to:

Separate Day and Night — Create the right environment for sleeping and for waking, and make sure to separate daytime and nighttime settings, if at all possible. Spending the whole day in bed — and even in pajamas — can make sleep more difficult at night. It helps to be as active as possible during the day. For a loved one who can get out, even having them join you doing errands in the car can break up the day — and make the night a little easier. For caregivers, an active day can be the best medicine for a restful night.

Create Bedroom Best Practices — At night, the room should be darkened but also have adequate safety lighting, including nightlights or LED strips under cabinets or on the floor, and lining hallways and doorways. The room should also be kept comfortably cool and free of hazards such as throw rugs and clutter, especially along pathways.

If you or someone you are caring for does get up at night, it’s helpful to have a second space in the bedroom for nighttime waking. This could have a safe, comfortable chair, additional lighting, and a small table with books, newspapers or puzzles. Both here and in bed, avoid looking at TV, computer or phone screens; they are well-reported to interfere with sleep.

Attend to Mental Health — Depression and anxiety can cause — and can also be exacerbated by — poor sleep, whether too much or too little. If you or the person you are caring for suffer from, or are exhibiting signs of, depression or anxiety, reach out to your doctor or other professional care provider to be connected to mental health services or counseling.

To help your loved one get through the night (which will also help you in the same mission):

Minimize Middle-of-the-Night Falls Risk — A weight-sensing bed pad alarm alerts you when your loved one is getting out of bed, so you can assist if necessary (without lying awake all night wondering). A baby monitor can also help you track movements at night, while motion-sensing lights in the bathroom, hallways and kitchen help light the way if wandering does occur.

Address Frequent Urination — First, see if there’s a medical problem that can be addressed. But for some, such as people with diabetes and on certain kinds of medications, frequent urination is a daily — and nightly — reality. Keeping a portable commode or urinal by the bedside can minimizes middle-of-the-night trips to the bathroom (although be mindful of safety precautions). Adult diapers and waterproof mattress pads can help, too.

Manage Pain — Pain can keep a loved one — or a caregiver — up at night. Talk to the doctor about the right kind of pain management, including over-the-counter medication. Bear in mind that most pain medication is best taken before the pain flares up. As with all medicines, make sure to take (or give) pain meds at the appropriate time of day.

Create a Plan for Managing Alzheimer’s Disease — People with dementia often have trouble sleeping. The Alzheimer’s Association recommends a number of non-medicine coping strategies (which are useful for anyone), including:

· Maintaining a regular schedule for meals, sleeping and waking

· Getting regular exercise, but no later in the day than four hours before bedtime

· Minimizing alcohol, caffeine and nicotine

· Provide nightlights and security objects

In addition, make sure there are no dangerous objects, such as scissors or razors, in areas where a loved one might wander. If your loved one is given to rummaging at night, you can create a safe space (a carton or corner} with familiar objects and gently direct him or her there.

Caregiver Self-Care

The cardinal rule of caregiving — make sure you attend to yourself — holds just as true at night, and here are some strategies:

Write it Down (then forget about it until morning) — Shortly before bed, make a list of your concerns — as well as actionable steps you can take to address them…tomorrow. That’s when you can actually talk to the nurse, or refill a prescription, and, with a concrete strategy for what to do, you might be able to get some sleep tonight.

Exercise — Physical activity has been proven to help people fall and stay asleep at night (don’t exercise too close to bedtime, though). It also does wonders for your peace of mind during the day, and for your overall physical health and fitness.

Practice Relaxation Exercises — There are a number of non-medicine sleep aids that caregivers find helpful. Try guided imagery (using positive mental images), soothing music, or a light program of stretching before bed.

Create a Room of One’s Own — If possible, sleep in a separate room to make sure you can get an undisturbed night’s sleep. For those who can, consider the importance of getting help in the overnight hours. This will pay dividends in the daytime, with a more rested caregiver.

Grab a Catnap — If sleep eludes you at night, a short nap in the day can help restore mental and physical wellbeing. Take care to limit your naps to 20 minutes or less, to avoid having more trouble sleeping at night — and perpetuating the cycle of sleeplessness.

An Irish proverb holds that a good laugh and a long sleep are the best cures for much of what ails us in life. With all the challenges a caregiver faces, I certainly hope that you will have a good laugh today. And by also keeping in mind these nighttime strategies, I believe that you will find your way to a long — or at least longer and more restful — sleep tonight.

Helpful reminders, I hope, for Sleep Awareness Week — and beyond.