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ISSN: 2167-7182
Journal of Gerontology & Geriatric Research
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Sleep Status of People in Nursing Home and Related Factors

Canan Birimoglu Okuyan*

Department of Public Health Nursing, Hatay Health School, Mustafa Kemal University, Alahan Campus, Turkey

*Corresponding Author:
Canan Birimoglu Okuyan
Department of Public Health Nursing, Hatay Health School
Mustafa Kemal University, Alahan Campus, Hatay, 31060, Turkey
Tel: +905539272035
E-mail: [email protected]

Received date: May 17, 2017; Accepted date: June 08, 2017; Published date: June 10, 2017

Citation: Okuyan CB (2017) Sleep Status of People in Nursing Home and Related Factors. J Gerontol Geriatr Res 6:433. doi:10.4172/2167-7182.1000433

Copyright: © 2017 Okuyan CB. This is an open-access article distributed under the terms of the creative commons attribution license, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Abstract

Background: Sleeping problems in the elderly are an important health problem in the growing elderly population and an important public health problem that needs to be solved in order to improve the quality of life and improve health conditions.

Aim: Investigation of sleep status and related factors in the elderly residing in nursing homes.

Methodology: In this cross-sectional study, 124 elderly individuals were taken. The research data were collected using an introductory information form. Number, percentage distributions, mean, standard deviation, t test and oneway variance analysis were used in the analysis of the data.

Results: 50.8% of the elderly participated in the survey, 44.4% are in the 71 to 80 age group, 30.6% are not illiterate, 81.5% have at least one chronic illness, of the patients are hypertension. It was determined that 58.1% of the elderly individuals had a sleeping problem, 60.5% slept for 1 to 5 hours a day, 65.3% slept during daytime and 63.7% did not feel rested after waking up.

Conclusions: The vast majority of elderly people living in nursing homes are experiencing sleep problems. It is important for elderly people to be educated and counseled in order to solve the sleeping problem and for the elderly people to be aware of the behaviors that may cause sleeping problems to prevent/reduce the sleeping problem.

Keywords

Old age; Sleep; Nursing home

Introduction

Sleeping problems in the elderly are an important health problem in the growing elderly population and an important public health problem that needs to be solved in order to improve the quality of life and improve health conditions.

Senile; It is a period when physical and mental problems arise. Sleep, which is important for life together with loss of function that occurs in all organs and systems, is also affected by the aging process [1]. When sleep disorder is not treated; Daytime drowsiness, fatigue, irritability, increased pain sensitivity, muscle tremors, decreased mental function, anxiety, depression, general health and functional impairment. This may lead to decreased quality of life and increased mortality in elderly individuals [2].

It has been reported that 30% to 60% of the prevalence of sleep disorders is in studies conducted [3,4]. It is not known whether the sleep disturbances seen in the elderly are due to individual differences or aging process. Epidemiological studies indicate that sleep disturbances increase with age and that elderly individuals living in institutions have more sleep disturbances than older elderly people, up to 65% [5-7].

An important point of the insomnia problem in the elderly population is the changes in lifestyle. Reduced physical activity leads to homeostatic factors not being sufficient, at least the basic element for sleep. Evaluation of the elderly person in terms of sleep and the identification of interchangeable risk factors is the most basic approach in preventing sleep problems. Having the opportunity to observe the elderly individual and the environment they live in, the health care provider has the opportunity to recognize the risks that may cause the sleeping problem in the elderly and to take the necessary precautions. One of the most important protective measures for the sleep problem is to determine the physiological changes that occur due to age and cause insomnia and take the necessary precautions.

In this context, the health care workers assessing elderly individuals, especially the elderly person's mobility and avoidance from behaviors that may cause insomnia, will be able to identify current and potential risks and take necessary precautions to provide training and counseling for them.

Methods

The data of this cross-sectional study were obtained from aged residents living in a public nursing home in Ankara City Center between March-June 2015. A total of 220 elderly individuals are living in the nursing home and all of the 124 elderly individuals who are dependent on the bed, demented persons (the institutional health records and the doctors of the institution are taken into consideration) and/the sample was not selected. In order to be able to work, permission was obtained from elderly individuals by informing the institution from which the research was conducted and the purpose of the work. The research data were collected by face-to-face interviewing with the participants taking volunteer-based considerations into account. The research data consist of 28 questions developed by the researchers; Data collection form that questions the demographic information, health status, social activity and social relations of elderly individuals.

Statistical package for social sciences (SPSS) 20.0 software was used for statistical analyses. Descriptive statistics, t-test were used in the analysis of the data. Statistical significance was accepted as p<0.05.

Inclusion criteria: in this study were included the elderly communicable individuals without neurological disorders, dementia, and bed dependent.

Exclusion criteria: The elderly individuals who have neurological disorders, dementia, bed dependent, and noncommunicable were not included in the study.

62.3% of the elderly are physical and 62.6% of them have good mental health. A little more than half of the elderly (52.9%) expressed satisfaction with their life, and 75% stated that they usually did not perform regular physical regular activities during the day (Table 1).

Characteristics n %
Chronic Disease
Yes 101 81.5
No 23 18.5
Constantly drug used (n=116) *
Yes 99 85.3
No 17 14.7
Number of drugs used (n=116) *
Never 17 14.7
1 5 4.3
2 10 8.6
3 11 9.5
4 7 6
5 13 11.2
6 and more 53 45.7
Physical Health Perception (n=122) *
Good 76 62.3
Moderate 34 27.9
Bad 12 9.8
Mental Health Perception (n=122) *
Good 77 62.6
Moderate 34 27.6
Bad 13 9.8
Life satisfaction (n=121) *
Satisfied 64 52.9
Not satisfied 57 47.1
Regular physical activity 
No 93 75
Yes 31 25

Table 1: Distribution of some characteristics related to health status the elderly (n=124).

It was found that 60.5% of the elderly individuals who participated in the study did sleep 1 to 5 hours, 65.3% were not sleeping during daytime, 62.1% had difficulty sleeping, 58.1% had sleep problems, 63.7% she said she did not feel rested after she woke up (Table 2).

Characteristics n %
Sleep duration
1-5 hour 75 60.5
6-12 hour 49 39.5
Daytime sleepiness
Yes 43 34.7
No 81 65.3
Sleeping difficulty
Yes 77 62.1
No 47 37.9
Sleep problems
Yes 72 58.1
No 52 41.9
Feeling rested after being awake
Yes 45 36.3
No 79 63.7
Total 124 100

Table 2: Distribution of sleep patterns of elderly individuals (n=124).

Results

50.8% of the elderly individuals participating in the survey are women, 44.4% are in the 71 to 80 age group and 30.6% are not literate. Elderly people stated that 63.7% had a pension, and 70.2% said they had social security.

81.5% of the elderly participating in the survey had at least one chronic illness. 85.3% of the elderly are taking medication, and 45.7% of drug users use 6 or more drugs (Table 1).

It was found that 65.3% were not sleeping during daytime, 62.1% had difficulty sleeping, 58.1% had sleep problems, 63.7% She said she did not feel rested after she woke up (Figure 1).

gegerontology-geriatric-research-Distribution-sleep-patterns

Figure 1: Distribution of sleep patterns of elderly individuals (n=124).

A statistically significant difference was found between the average scores of sleep characteristics according to life satisfaction of elderly people living in nursing homes (p<0.05) (Table 3).

Characteristics
  n Daytime sleepiness Sleeping difficulty Sleep problems Feeling rested after being awake
Gender
Male 61 1.59 ± 0.49 1.61 ± 0.49 1.36 ± 0.48 1.38 ± 0.49
Female 63 1.71 ± 0.45 1.57 ± 0.50 1.47 ± 0.50 1.34 ± 0.48
t-test t=-1.452 t=0.394 t=-1.302 t=0.320
p value p=0.149 p=0.694 p=0.195 p=0.750
Life satisfaction
Satisfied 64 1.60 ± 0.49 1.47 ± 0.50 1.45 ± 0.50 1.42 ± 0.49
Not satisfied 57 1.70 ± 0.46 1.68 ± 0.46 1.36 ± 0.48 1.28 ± 0.45
t-test t=-1.062 t=2.422 t=0.940 t=1.624
p value p=0.291 p=0.017 p=0.349 p=0.107
Regular physical activity
Yes 31 1.61 ± 0.50 1.55 ± 0.50 1.40 ± 0.49 1.39 ± 0.50
No 93 1.67 ± 0.47 1.67 ± 0.48 1.48 ± 0.51 1.35 ± 0.48
t-test t=0.541 t=-1.156 t=-0.836 t=-0.321
p value p=0.590 p=0.250 p=0.405 p=0.749
Constantly drug used
Yes 99 1.64 ± 0.48 1.64 ± 0.49 1.42 ± 0.49 1.37 ± 0.49
No 17 1.64 ± 0.49 1.58 ± 0.50 1.41 ± 0.50 1.29 ± 0.47
t-test t=0.005 t=0.471 t=-0.095 t=-0.627
p value p=0.996 p=0.638 p=0.924 p=0.532

Table 3: Characteristics of sleep patterns of elderly individuals (n=124).

Discussion

Sleeping problems in the elderly can be caused by age-related problems and the physical characteristics of the living environment.

Elderly living with sleep problems for any reason; Social isolation and depression. 50.8% of the elderly participated in the study, 44.4% in the age group of 71-80, when their socio demographic characteristics are examined; It is expected that the education level of the elderly will be low if the average age of the elderly is (77 ± 8.2), 30.6% is not literate, and the value determined by the average age of the elderly (77 ± 8.2).

The elderly people stated that 63.7% of them passed their pension, 70.2% said they had social security. The continuing lives of the elderly individuals, who are increasing day by day in our country and our country, and their increasing social and economic standards depend on serious monetary costs. The vast majority of the elderly has any health insurance; Depending on their working life, they may be included in a social security institution and in any case, such a situation can be considered as a great opportunity in terms of elderly health services and free medication. 81.5% of the elderly people are chronic diseases, 85.3% of them use continuous medication and 45.7% of them use 6 or more medicines.

As a result of Tokem's work; 5.3% of the elderly were treated with one drug, 21.1% with two drugs, 26.3% with three drugs and 10.5% with five drugs [8]. As a result of his work in Arslan's nursing home [9]; 16% of them used 1 to 2 drugs, 16.7% used 3 drugs, 16.7% used 4 drugs and 16.7% used 5 drugs. 62.3% of the elderly are physical and 62.6% of them have good mental health. A little more than half of the elderly (52.9%) expressed satisfaction with their life (Table 1). According to this finding, it is noticed that the majority of the elderly qualifies the health level as good and moderate. In a study conducted by Koç et al. 46.2% of the elderly stated that they perceive their health as good and 6.4% perceive it as bad [10]. In a study conducted by Bayik et al. in a health center area in Izmir in 2004, 42.5% of the 167-yearolds considered their health very good and good [11].

In many studies conducted in our country, the health perception of the elderly is evaluated and as the age progresses, the perception of health by the effects of age-related physiological changes is perceived worse by the elderly. Having any social security of the elderly and having a good income situation affects the perception of health positively and therefore it is important to be able to initiate health related behavior change in the elderly and to make this change into a lifestyle.

It was found that 60.5% of the elderly individuals who participated in the study did sleep 1 to 5 hours, 65.3% were not sleeping during daytime, 62.1% had difficulty sleeping, 58.1% had sleep problems, 63.7%. She said she did not feel rested after she woke up. Malakouti et al. reported that they had a sleeping problem at a high rate of 86.2% of the elderly [12]. In the study conducted by Fad?lo?lu et al. who live in the nursing home, the average sleep quality score was 8.02 ± 2.87 and 77% of the elderly were found to have poor sleep quality [13]. It is stated that sleep problems are more prevalent in elderly people living in long-term nursing homes such as nursing homes [14]. It is thought that sleep problems may also be caused by side effects of medications used. It was determined that the elderly was not afraid to fall (65.3%), (34.7%). Ye?ilbalkan and Karadakovan reported that 59.9% of the elderly were afraid of falling [15]. The findings of this study are similar. Meriç and Oflaz reported that the majority of the elderly was afraid to fall and that they were restricting themselves in their daily activities [16]. The elderly was a14fraid of falling and thus restricted themselves to fulfill their daily life activities [17]. We may think that the elderly is afraid of falling, and therefore that bringing restrictions on their daily lives may lead to problems in fulfilling the individual needs of the elderly, and may lead to further problems as a result of movement limitation in the course of the proceeding. Fear of falling can be considered as an important condition that increases the risk of falling as well as causing the elderly to limit their activities. This finding highlights the importance of addressing the fear of falls in the elderly and falling fear of developing independence in daily life activities.

It has been determined that 49.6% of elderly individuals have fallen within the last year. Fisher et al. reported an annual fall rate of 55.0% in the elderly [18]. Cosart reported fall rate as 48% [19]. In the last year, Shumway-Cook et al. reported 53.3% [20]. Muir has found a 50.0% drop in the last year [21]. Atman et al. (49.2%) and Keskino?lu et al. (67.0%) reported that elderly people received the first order of fall in the order of accident at home [22,23]. Our study finds similarities with studies done in our country and abroad. These findings show that dropping out in the elderly is a common problem. We can say that falls and related problems in the elderly are important and priority problems. It is observed that the oldest people who fallen have the lowest number of banyoda (51.7%) and then fallen in the room, corridor and garden respectively. Unlike study findings, Deprey's study reported that the elderly fell most in bedrooms and then in bathrooms, kitchens, and living rooms [24]. This may be due to the fact that the study was conducted abroad and May depend on the differences in domestic characteristics. Cosart similarly reported that my work fell most of the elderly [19]. Older people often fall into the bathroom, which can be attributed to the fact that the elderly individual is alone in his/her privacy. When elderly individuals are evaluated for falling, we can say that the riskiest area is the bathroom.

Conclusions and Implications

The results of this study show that the elderly people have difficulty sleeping, have sleeping problem, and they did not feel rested after waking up. It is important the elderly people to be educated and counseled in order to solve the sleeping problem. Also, it is considered the elderly people to be aware of the behaviors that may cause sleeping problems to prevent/reduce the sleeping problem.

Acknowledgements

The author thanks to the participating elderly of the nursing home. The author has no conflicts of interest to declare. This research was not supported by grant.

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