How to suggest hiring a night carer, and when to do it

It is not uncommon for live-in carers to be faced with calls during the night. Older people often wake more frequently than younger people, and certain medications may also leave people awake at night. 

The Sleep Foundation published a report which stated that as people age the part of the brain that controls the daily cycles of the body, including the sleep cycle, starts to deteriorate. This can cause the disruption of the circadian rhythm and start a circle of nightly disruptions.

What constitutes overnight care?

Do not be confused between overnight care with ‘normal’ nightly rest. Conditions such as dementia can have detrimental effects on the client as well as on anyone living with them. 

Sundowning, which is often a part of dementia, normally only lasts for a short time at the end of the afternoon, with a reasonable night’s sleep to follow.

Overnight care needs to be set in place when the client calls frequently during the night for the same reason. This may be the need to use the bathroom or simply to want reassurance of someone in the house with them. 

Whatever the reason, the live-in carer will not be mentally or physically able to carry out a full day's work and then be called during the night. 

Even one call per night will eventually leave the carer exhausted. While the client may fall back asleep as soon as they have been reassured, the carer will often lie awake waiting for the next call.

Overnight care will ensure that the carer can get a solid sleep of between 7 and 8 hours, while the client is taken care of by another person.

Types of overnight care

Overnight carer can be divided into two categories, namely:

  • Sleeping care
  • Waking care

Sleeping care

This is when the second carer comes into the house at a certain time, gets the client settled for bed and then is able to get some sleep themselves. Normally they will be roused when the client gets out of bed, so will have some sort of a monitor to alert them to any movement.

Waking care

This is when the night carer does not go to sleep but works the night shift, taking care of the client and their needs throughout the night. They will often be placed very close to the client so that they are in earshot of any calls or movement.

How to suggest a night carer

This is often a very difficult conversation to have, particularly with family members. What frequently transpires is that other carers have simply adapted to getting up several times through the night and the family expects every carer to do the same. They cannot see how things have gone from sleeping nights to disrupted sleep because no one has told them.  

The reason why they may be unaware is because the carer may not want the family to think they cannot do their job well. After believing that their loved one is perfectly content most nights, it may come as a shock to learn that the carer is called two, three or more times every night.

The way to approach this subject is to find one member of the family who you are comfortable talking to and discuss the alternatives. 

It is never a good idea to simply state that you have a problem with their loved one during the night. Better if you can at least come up with an alternative plan, such as a night carer.

If you work through an agency, then your best chance of solving the problem will be to talk to your support team. Mention your issue and then be sure to follow up on your conversation. 

It is always worth following up the conversation with family because a decent agency will always approach family to suggest options.

When is a night carer needed?

Ideally, the live-in carer should be able to get 8 hours sleep each night. If this is not happening, for any reason, it is a reason to seek alternative arrangements.

If the client takes medication which, when they walk around, leaves them at risk of falls, then a night carer should be considered.

If there is any chance that the client wanders out of the house and into the road, then a night carer should be in place.

If the live-in carer is called more than two times during the night, and this becomes a regular occurrence, then there is a reason for night care.

Final thoughts

Once night calls have become a regular occurrence they need to be addressed. No one can function well with constantly being called at night, and while once every so often may be acceptable, more than this is simply not a good situation.

The first place to start is with your agency, or family. They need to be aware that the situation has changed and things need readjusting. If you do not get any satisfaction from discussing your issue with an agency or family then you may want to ask yourself if you are working for the right agency or client.

Remember that often no one knows that night calls are taking place because they are not told about them. Keep your records and state your case, with a suggestion for a night carer. 

Any reasonable person will agree that not only is it unhealthy to have disturbed nights, but it is also unsafe practice for a carer who still has to carry out a busy daily routine.    





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