Extra Credit

Assoc. Prof. Patricia Tabloski (CSON) (Photo by Lee Pellegrini)

One of the most common sleep-related complaints of elderly residents in nursing homes or medical facilities is the level of noise, Tabloski says, contributed by telephones, beepers, exit alarms, blaring televisions and radios, as well as staff and roommates. The clamor is more than an annoyance for residents with Alzheimer's or other forms of dementia, however: They tend to awaken easily and are therefore less likely to have restful sleep. An Alzheimer's victim who is over-tired and irritable is more likely to become agitated during the day, Tabloski says.

While medication might seem an obvious solution, she says, "drugs often have problematic side effects such as daytime sedation, falling, constipation and potential for physical and psychological addiction."

In her studies at nursing homes, Tabloski has found that non-intrusive strategies are equally, if not more, effective ways of enhancing residents' sleep. For example, Tabloski arranged for patients to listen to recordings of their favorite kind of music at bedtime. She also instituted what she calls a "SHHH Campaign," asking staff to lower their voices and minimize nighttime intrusions, reduce TV and radio noise and turn off unnecessary lights.

"These are common sense interventions that I hope will be easy to implement in the nursing home without excess cost or increased need for staffing," said Tabloski, who has published her research in the Journal of the American Geriatrics Society, Journal of Gerontological Nursing and American Journal of Alzheimer's Disease and Research, among others.
Care techniques that are neither labor nor capital-intensive will be sorely needed to deal with America's growing population of Alzheimer's patients, which is expected to rise from approximately four million to 14 million by mid-century, adds Tabloski. Beginning at age 65, the rate of dementia doubles every five years, she says, and the cost of caring for dementia victims is about $100 billion a year, including long-term care, drugs and support services. The financial and emotional burden on the caregivers, often the victims' middle-aged children with family and work responsibilities, is considerable.

The current overall shortage of nurses is magnified in the geriatrics field, Tabloski says, beset by lower salaries and job status as well as insufficient means for recruitment and retention of nursing home nurses. Job vacancies in long-term care are high, she notes: 23 percent for licensed practical nurses, 22 percent for registered nurses and 12 percent for certified nursing assistants.

"We're trying to reverse this by attracting more bright and interested students to become geriatric nurses, educate them about the joys of working with the elderly, and give them the skills they need to be successful in providing holistic nursing care that can improve the quality of an older person's life," said Tabloski. "We have scholarships, traineeships, faculty at the CSON with interest and education in geriatrics and ongoing research. I hope my project can serve as an example."

-Sean Smith