Sleeping Problems of the Elderly - Assignment Example

Sleep pattern assessment of community partner:- ================================== DJ’s Story:- ---------------- DJ has lived all her life in a small town . She is a widow nursing her sweet memories that date back to the days when her husband lived . In her hay days she used to wear the pants in her family consisting of her two kids (both boys) and husband , and now that she has crossed the threshold of 87 years she no longer is the same bright boastful lady ; she has grown peevish , is fussy about the smallest of things and refuses to accept that her three grandsons are incarnations of The Satan himself . Questionnaire :- ============ 1) At what time do you get up in the morning ? 2) At your age you mustn’t probably be busy doing household work when you are awake , so what is it that keeps you busy most of the time ? 3) How often do you talk to the other family members during the course of the day about yourself ? 4) Do you feel bored during the afternoon hours ? 5) At what time do you take your lunch ? 6) Over a period of one week how often do you consider taking a nap after lunch ? 7) At what time do you take your afternoon snacks ? 8) Do you have any specific nighttime rituals like reading , listening to music , singing etc. ? 9) Do you practice the same nighttime rituals that you used to do 25 years back ? 10) How often do you get up at night after going to bed ? 11) During the course of your sleep which part of the night do you find most uncomfortable……midnight , early morning hours etc . ? 12) How many times in a week do you have to depend on sleeping pills ? 13) What other medications have you been taking and for how long ? 14) Did you ever witness nighttime bed wetting ? 15) Did you ever feel that you needn’t live any longer ? 16) What you do when you are unable to sleep properly ? Reflection :- ========= All of the above questions gave an insight into the sleep disturbance , nature of disturbance faced by DJ . Questions 3 , 5 , 8 , 11 , 12 , 13 , 14 , 15 and 16 gave me the maximum information I needed . Since I didn’t confine her to answering in “yes” or “no” I could learn much beyond the scope of the questions . Open ended probing was definitely of help . Through the above questions I could develop a symptom score index of DJ’s sleep disturbances . Observations :- ============ Prior to probing DJ seemed nothing beyond a peevish aged woman , but after probing her I could conclude that she suffered from loneliness , as the rest of the family members were all either office goers or school goers . She harbors a feeling of being avoided all the time and seeks consolation in holy beads and scriptures . During afternoon hours she feels bored and waits for her grand children to come back from school and when they do so she doesn’t get their attention either because they become busy getting ready for art , music or swimming classes . Two years back she had undergone a lens transplant in the left eye and the physician had prescribed sleeping pills to her . As days passed her eye started a silent revolution and she had to continue with her sleeping pills in order to sleep properly . But , these pills have a problem the same dose doesn’t offer results for too long , so she wanted a higher dose which her sons disapproved of considering her age related digestion problems and nerve ailments . She now feels that she has had her due share of life and shouldn’t live any longer . She gets up 7 – 8 times to visit the toilet at night and feels she does so because she is unable to sleep properly and even if she dozes off she sometimes wets her bed which is embarrassing . Nursing Judgement and Diagnosis :- =========================== The probing strongly suggests that DJ has a sleep rest issue . In the course of one week she sleeps for 8 -9 hours post lunch on most of the days (4 days average / week) , this leads to long sleepless nights . She has been using high dosage of alprazolam for the last 2 years , as a result of which the drug doesn’t act properly on her ; the drug puts her to sleep during the early morning hours but the full course of sleep doesn’t get completed at a stretch . So , she sleeps through the day and not at night . She hardly gets to talk her mind to her peers , a feeling of neglect creeps in and aggravates the sleeping problem . She has a problem of bed wetting also . Due to prolonged usage of nerve relaxers her bladder muscles have failed and night time micturation has crept in . Being a widow she takes in a lot of fluids with her food , as a result of which she has to get up too many times to visit the toilet . She herself feels that sleep disturbances cause her to visit the toilet so often , whereas it’s just the other way round . She suffers from incontinence . All the above points strongly suggest that DJ suffers from sleep disorders . Nursing Interventions :- ================= DJ has been adviced to judiciously the following things so that herr problem doesn’t aggravate any further :- 1) Get up early in the morning , and during the course of the day practice the rituals that she used to do at night . 2) Watch movies or read books in the afternoon but try not to sleep . 3) Do not take more than half litre of water after sundown . 4) Take the sleeping pill just after she is done with her prayers at 8 p.m . 5) Gradually quit the habit of taking sleeping pills by having one every alternate day . Stepping in the shoes of a nurse :- ========================== I’ve been to the crematorium quite many a time , to the hospital even more but never did I counsel an old lady . Prior to this I thought I was doing a great social job by going to places related to people’s sorrow , but now I know that it feels great to counsel and advice people to let them get rid of their sorrows . I was not prepared , so I didn’t know what to ask . What I asked just occurred to me and I am surprised to see the power of probing . I didn’t know that I had the capability to be a nurse until this interview . Through this probing session not only was I able to learn about her physical problems but her emotional problems as well and the latter kind has only one remedy…..to confide in someone else . This small exercise probably reminded me of the crude humanity residing in our hearts since pristine times , the only problem is we keep it tucked under our daily desire for personal gains . Read More