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Individualized Night Time Routines

Facilitator Instructions for Starter Exercise

WHAT: This short personalized exercise is a conversation starter as you consider how to individualize night time routines. It gives staff a personal understanding of the importance for each of us of a good night's sleep. As staff reflect on their own needs, they better understand their residents' needs and see how the change will benefit residents. Then they can think through how to make it happen.

WHY: Change is hard. Successful change requires discussion about why and how. Use this discussion to find out how the staff closest to the resident, who will implement a new approach, think it will work best. Have on-going discussions as the change evolves.

HOW: This guide includes discussion prompters to use after the personalized experience first to draw out staff's experience and reflections, and then to hear their ideas on how to do it. Allow time for each discussion. Hear from everyone. Ask for responses from quieter people. It may be tempting to brush off staff members who are openly skeptical, but putting into play major changes requires that concerns be welcomed as a contribution to the effort's success; get to the root of the concern, and note it as an area to keep an eye on.

RESOURCES: Toolkit Tip Sheet and Video Clip on Individualized Night Time Routines

Entire Toolkit and Webinar Series available at Pioneer Network store.

Preparation: Review tip sheet and video clip on Individualized Night Time Routines

Time: 10 - 20 minutes, depending on discussion time

Flipchart and marker

To provide a personal understanding of the important role sleep plays in our lives and spark ideas about ways to help residents sleep better.


In pairs, discuss:

What do you need for a good night's sleep?

As staff help people settle in on their first day, they can ask them what they need for a good night's sleep. It would put the resident at ease if you could then provide for some of their comforts. This could help make a good welcome for someone who might otherwise be sleepless that first night.

In pairs, share:

How does not having enough sleep affect you?

Point out that while what they each needed for a good night's sleep was likely different, they probably had similar experiences when they don't sleep.

Ask the group:

What is the clinical importance of sleep?

Probe its role in healing and rejuvenation – body and mind.

Explain: Sleep is restorative; it is the time our bodies heal and our minds are refreshed. To get the benefits of sleep, a four-hour period of deep sleep, often referred to as a REM (Rapid Eye Movement) cycle, is needed. When we do not get enough deep sleep, it affects mood, balance, appetite, our body's healing process, and our ability to think sharply.

Remind everyone that there are three necessities for human life - air, water, and sleep.
Humans can go 6 weeks without food, but not without sleep. Sleep deprivation is a recognized form of torture.

An easy reference for more information is Wikipedia entry on "sleep deprivation."

In small groups, brainstorm a list:

What are all the ways residents' sleep is interrupted?

Ask each group to pick one or two easy places to start to protect residents' sleep.

Share in a go-round: Ask each pair to share their ideas about an easy place to start. Make notes on the flip chart.

Begin the discussion on how to make it happen.


Where should we start?

What would we need to make this work?

Download Facilitator Instructions for Individualized Night Time Routines (PDF)

Starter Toolkit Home          Step One          Step Two          Step Three          Self-Assessment
Prepared by B&F Consulting for Pioneer Network's National Learning Collaborative on Using the MDS as the Engine for High Quality Individualized Care. Funded by The Retirement Research Foundation.