Who participated?

We wanted to see how The Sleep Kit worked for people living at home in the community, and also in a long-term care setting.

• Community sample:
  • The Mini-Mental State Exam (MMSE) was administered. Scores were 44% mild dementia; 12% moderate and 44% severe.
  • Average age: 77.4 years.
  • 16 total; 7 males, 9 females.
    
  • People who are living at home with dementia and their care-partners.
  • Gathered from urban areas in New Brunswick.
• Long-Term Care Sample:
  • Gathered from York Care Centre in Fredericton, NB.
  • People living in a nursing home and staff/volunteer/family members.
  • 25 total; 9 males, 16 females.
  • Average age: 82.8 years.
  • MMSE scores: 4% mild dementia, 24% moderate, 72% severe.

How was the information gathered?

• Participants living with dementia were given a Fitbit Alta HR to wear.
• We looked at the amount of time slept, and the number of awakenings each night.
• The device was worn for a period of 19 days; 5 days to find out how they slept on average, and 14 days with The Sleep Kit.
• Effectiveness of the product, from the perspective of the caregivers/volunteers was measured with pre/post test questionnaires and a nightly sleep diary which measured the expectation and overall experiences of the caregivers/volunteers.

What did we find out?

• In long-term care:
  • A significant decrease was found in the number of restless periods before and after the implementation of The Sleep Kit.
    • 96% reported that using The Sleep Kit activities was an enjoyable experience.
    • 82% would like to continue using the The Sleep Kit.
    • Caregivers reported the most effective items:
      • Hairbrush – 82%
      • Essential Oil – 90%
      • Book – 82%
      • Lotion - 91%
• In the community:
  • 37.5% agreed or strongly agreed that their partner was more relaxed before sleep and slept better after The Sleep Kit activities.
  • 81% said The Sleep Kit promoted sleep and helped them engage with their partner.
  • 75% would continue to use The Sleep Kit.
    • Caregivers reported the most effective items:
      • Book - 75%
      • Lotion - 69%
      • Hairbrush - 56%

Most Used Items:
​

• Overall:    
  • Essential Oil 64%
  • CD 64%
  • Lotion 68% 
• Community:   
  • Herbal Pillow 63%  
  • Lotion 61%  
  • CD 56%
• Long-term care:    
  • Lotion 72%  
  • Essential Oil 70% 
  • CD 70%​

Sleep Diaries

The Sleep Kit study used the Fitbit Alta HR for quantitative data, however we also wanted to find out how The Sleep Kit was working for the care-partners. They were asked to fill out a diary each night explaining which items they used and what was working/not working. These showed that the Sleep Kit was perceived to have a positive impact on the sleep quality of participants:

• “The 'calming' activities are wonderful for [my husband] ... and for me. The background music is particularly soothing for both of us. The time we spend together on sleep activities has definitely improved his sleep! I also find that his mood through the day is much better." 

 

• “On a side note after our first night when I saw her the next day and I asked her how she slept she said “good”. Usually when you ask her how she slept it’s usually “not good” or “not at all” so I consider “good” a win!”

 

• “I read her part of the second chapter and she fell asleep in my lap.”

 

• “Overall, I personally felt that The Sleep Kit activities and interactions before bedtime, did tire her our and most nights she was sleeping quietly in her room and not pacing the hallways. I plan to continue to do the activities in the future and see for how long it continues to work. I realize it will be difficult for us to do them on a regular basis."​

Themes: Routine & Focus

Upon analyzing the diaries, two dominant themes emerged: first, the positive impact of having a established routine dictated by the contents of The Sleep Kit and second, The Sleep Kit allowed for the caregiver and participant to have a focus which enhanced the quality of caregiver/ participant interactions.

Routine:

• The routine for her was great, it was also good for me. It freed up my days. Because I knew every day that I was coming in that evening. I typically try to visit my Mom probably 5 days a week. Sometimes I would come in and I would visit with mostly everybody that was sitting around”. 
  

 

• “I would usually read to the participant for about 20 minutes to start the night off and for that entire time she was 100% focused on me. She would never call out – which is something that she does frequently.” 

 

• “The Sleep Kit is a wonderful way or providing quality time for both participant and caregiver. It is much more one on one than when I visit with my husband in the day time. As the participant is in the later stage of Alzheimer’s and in long term care, some of the items in the Kit can’t be used to the extent that they may have been earlier on in his illness. He enjoys the fact that we’re together and is interested in taking the items out of the box. He loves to have his hair brushed. It seems to relax him. Depending on his clarity at the time he’s either quite willing to use the items or sometimes not. My opinion is that The Sleep Kit is a valuable tool to be used for dementia patients and other individuals handicapped in some way. This ensures quality time for both patient and caregiver.” 

 

• “So grateful for this experience! As much as I resisted it, I have found a very helpful way to spend a meaningful and relaxing time with my husband. It has improved his sleep quality – and mine. But more than this, his mood has improved through the day… no doubt, a result of this extended time of being cared for and just being together. The activities have become “jumping-off” points for other ideas.

Focused Interaction:

• "I found the Kit to have many great ideas that I otherwise would not have thought of on my own. When we used the cards, I kept the pairs turned over and made it a bit more challenging.  Well it was a huge hit.  Mom was pretty excited to be beating me. Her smile was a genuine one and it warmed my heart to see her engaging in something other than watching TV.  So we will be continuing our card games and I'm looking forward to them."   

 

• “Wow! Tonight was very rewarding! It was so rewarding to watch her face go from strained to pure relaxation.  We even had a moment where we looked into each other’s eyes and she placed her hand over mine. It’s obvious that this time spent together is benefiting her well-being.

 

• ”So [with The Sleep Kit] I was much more focused on my Mom. We would go to her room, and it would be just a half hour just with my Mom. So, that was kind of nice. It was a more focused, intentional kind of visit."
  

This research was supported by:

The Centre for Aging and Brain Health Innovation
The New Brunswick Health Research Foundation
The Centre for Innovation & Research in Aging