Geriatric Quick Consult Patient Can't Sleep Do #6
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| Get patients out of bed, and consider which of the lines and tubes are really essential.
Often we keep IV lines and Foley catheters in patients longer than we really need them. Can the IV be removed or converted to a saline lock? Could the patient be managed with diapers and daily weights (to track volume status) in place of a Foley catheter? Scheduled toileting improves mobility and decreases incontinent episodes and bed changes, which are another source of awakenings. |
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GET PATIENTS OUT OF BED, REMOVE I.V. AND FOLEY AS EARLY AS POSSIBLE
Environmental changes can also make a difference. Some patients do better when they are out of their rooms or have more frequent social interaction during the day. Television and radio noises help when lying in bed, but this can become boring. Moving people closer to the nursing station, getting them up in chairs in the hallway, and having friendly visitors can really help. These measures are particularly helpful in patients with dementia. |
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| GET PATIENTS OUT OF ROOMS, MOVE CLOSER TO NURSING STATION, VISIT FREQUENTLY, INCREASE SOCIALIZATION AND STIMULATION DURING DAY
Unless the older patients can walk safely and without assistance, get a PT (or Kinesitherapy) consult to improve gait, and OT consult for upper extremities strengthening and to improve ADLs. The exercises will benefit not only their functional status, but also their sleep. |
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