Best Practices for Overnight Supervision

The need to ensure your parent or loved one is cared for at all times during the day and even overnight, is a perfectly reasonable issue to be concerned about. Perhaps you are unable to care for your loved one personally, due to other obligations that require your time - yet you do not feel comfortable enrolling your parent or loved one in a nursing home - and if this is the case, an overnight caregiver may be a good option for you. 

Following this decision would involve knowing the most beneficial practices of overnight supervision to ensure you and your family’s peace of mind.

The first necessary steps of overnight supervision include the following:

Safety Checks

It is important to make sure the area between the bedroom and the bathroom is clear of any safety hazards that could cause a fall - one of the most serious fall injuries in the elderly is a broken hip and it can be difficult to fully recover from a hip fracture afterwards leaving many people unable to live on their own [each year, at least 250,000 older people (those 65 and older) are hospitalized for hip fractures]. If your loved one has dementia or requires the use of a hearing aid, a safety check could be essential in the case of wandering at nighttime hours, and vivid nightmares that may cause discomfort. Also, making sure that there aren’t any shadow shapes or strange noises that could trigger paranoia in someone with dementia is another method to provide the care-receiver with utmost comfort.

If your parent/loved-one has recently suffered from a stroke, the best ways to secure the safety of the home would be by minimizing clutter, making sure the lighting isn’t too dim and by taping electrical cords to the wall to prevent a fall. If they happen to be in a wheelchair, making sure that the wheelchair or walker is close to them at all times is important, as well as ensuring the floor is wheelchair friendly - disposing of any rugs, carpets, etc. that may prove to be an inconvenience. 

Respiratory Assessments

Respiratory assessments (or breathing checks) is another important practice of overnight supervision as it provides ease to the care-receiver during overnight hours and amidst sleeping. This is also where repositioning proves to be helpful - ensuring the receiver is sleeping in a comfortable and proper position that alleviates any sources of pain. It is critical to factor in repositioning as part of an overnight supervision routine, as it aids in digestion and breathing, prevents bedsores which are caused by added pressure to the skin and promotes muscle relaxation. Purchasing a specific type of mattress, such as a TempurPedic, can be a great aid in providing comfort to the care-receiver.

Medication Reminders

Medication reminders can occur either before bedtime or in the middle of the night as some medications do require to be ingested at ungodly hours. A medication reminder can be advantageous to parents or loved ones with Alzheimer’s disease, those with cognitive impairment, those who have difficulty waking up in the middle of the night to take their medication, as well as those who are physically unable to take medication by themselves. Pill boxes with assigned dates and reminder alarms are an accessible method for medication reminders.

Washrooms & Assistance

Toileting is the act of assisting someone to either the washroom, a portable commode, onto a bedpan or a urinal. It assists with urinal and bowel incontinence, and may or may not require assistance with dressing and seating. It is necessary to respect the receiver’s privacy as well as help maintain their dignity, as toileting may cause them to feel embarrassment. A portable commode or a bedpan may allow the most flexibility during nighttime hours. 

Urinary incontinence occurs in 17 percent of men over the age of 60 (totalling a number of 600,000 men) - mainly due to strokes, congenital defects, multiple sclerosis and other factors in relevance to aging.

However, women over the age of 60 are twice as likely to experience urinary incontinence - one reason many women are affected by this is due to the weakening of pelvic muscles during childbirth.  

Communication & Emergency Contacts

Communication methods are vital, and some methods that can be taken into consideration include an intercom telephone for the care-receiver to ring for assistance at their own convenience, or even a set of walkie-talkies/baby monitors can be easy, hassle-free and quite useful as long as it is not a major invasion of privacy for your elderly loved one. It is important to have an easily accessible phone with highlighted emergency numbers, in the case of an emergency. 

Meeting Emotional Needs

This is another very important factor of overnight supervision for your parent or loved one, ensuring they are comfortable and that all of their needs are being met - not just physically, but emotionally and mentally as well. It is essential for them to know they are not alone and that there is someone there to help them with tasks they are unable to do themselves. If they are prone to depression or anxiety, comforting words of reassurance or a soothing massage during nighttime hours can be beneficial for them.

After taking the essential and beneficial practices of overnight supervision into consideration, there are certain questions to ask yourself before deciding whether your loved one may or may not need overnight care: 

  • “Does the care-receiver require toileting or washroom assistance?”
  • “Does the care-receiver have dementia which causes uncomfortable episodes of nightmares?”
  • “Does the care-receiver use a wheelchair or walker?”
  • “Does the care-receiver require assistance with repositioning themselves in bed?”
  • “Is the care-receiver recovering from a stroke?”

An overnight caregiver typically consists of one or two attendees who divide the night into either 8 hours or 12 hours of caregiving each, or one attendant can reside in the home provided boarding and other needs are included. The caregiver would assist with all of the overnight supervision practices, as well as provide empathetic and respectful care. Getting a suitable caregiver may be the best option for you and your loved one if you are unable to be present overnight. 


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