Gerontological education: a pathway towards advancing the rights of older people.

Following the UN Human Rights Declaration in 1948, much effort has been undertaken to formalize the rights of older people. This article aims to highlight the role of education in advancing the rights of older people. Raising awareness and sharing knowledge about the rights of older people through rights-based education can empower students, when entering their field of work, to be advocates for rights within their employment settings and local communities. The effectiveness of a rights-based educational training for organizations working with refugees in Jordan, which took place in Amman in January 2020, is analyzed using the participant-focused Transformative Human Rights Education (THRED) as a framing structure. Our analysis found that training participants became active in promoting the rights of older people in their workplaces. The rights of older people need to be more than a conversation, and transformational change that promotes rights can occur when people feel empowered to undertake action-oriented advocacy. The case study analysis provides an example of how influential participant-centered pedagogy, such as THRED, can be to help students in gerontology programs become active agents in promoting rights of older people in their workplaces, communities, and ultimately influencing the international dialogue.

Safe and sound? Night-time checking in care homes.

Current research into sleep in care homes indicates that care-giving processes at night disturb vital sleep-a key element in the everyday wellbeing of older people. This article considers the use of technology to support the provision of relationship-centred care at night. Within the context of a large study on sleep in later life, research was carried out to gain an understanding of care staff's acceptance of technology. The findings indicate a hesitancy to rely on technology. To fulfil a professional duty of care at night, the personal assessment of a resident's wellbeing is perceived as best when performed by care-home staff. However, in night-time care, a relationship-centred approach supported by technology has the potential to improve the sleep of older people living in care homes, which in turn could improve their active participation in everyday life.

Factors affecting residents' sleep in care homes.

AIM: The aim of this study was to undertake a detailed exploration of sleep in the context of 24 hours in a care home environment, exploring the subjective experience of residents and the perceptions of staff. METHOD: Qualitative research in four care homes for older people consisting of semi-structured interviews and ethnographic observations. Interviews were conducted with 38 residents and 39 staff, and were analysed using a grounded theory approach. FINDINGS: The findings have highlighted some challenges and opportunities for developing practice in care homes to improve residents' sleep. In addition to pain and physical disabilities, the physical environment and practices in care homes can affect residents' sleep and night-time experience. CONCLUSION: Improving our understanding of residents' and staff's experiences at night in care homes can inform the development of good practice in night-time care and contribute to a positive culture of person-centred care.

Striking the balance: night care versus the facilitation of good sleep.

This article presents the key findings from an extensive research project aiming to identify the determinants of poor sleep in care homes. A mixed methods study was conducted in 10 care homes in South East England. This included 2-week daily diaries completed by 145 older residents and interviews with 50 care-home staff. This research demonstrated that the regular surveillance by qualified nurses and care assistants at night seriously impedes the quality of sleep experienced by older people living in care homes. However, nurses and social care workers have a duty of care, which would not be fulfilled if regular checks were not undertaken at night. There is a need for care-home staff to strike a balance between enabling older people living in care homes to have a good night's sleep and adhering to their own professional duty of care.

An actigraphic study comparing community dwelling poor sleepers with non-demented care home residents.

Sleep disturbances are a common problem among institutionalized older people. Studies have shown that this population experiences prolonged sleep latency, increased fragmentation and wake after sleep onset, more disturbed circadian rhythms, and night-day reversal. However, studies have not examined the extent to which this is because of individual factors known to influence sleep (such as age) or because of the institutional environment. This article compares actigraphic data collected for 14 days from 122 non-demented institutional care residents (across ten care facilities) with 52 community dwelling poor sleepers >65 yrs of age. Four dependent variables were analyzed: (i) "interdaily stability" (IS); (ii) "intradaily variability" (IV); (iii) relative amplitude (RA) of the activity rhythm; and (iv) mean 24 h activity level. Data were analyzed using a fixed-effect, single-level model (using MLwiN). This model enables comparisons between community and institutional care groups to be made while conditioning out possible "individual" effects of "age," "sex," "level of dependency," "level of incontinence care," and "number of regular daily/prescribed medications." After controlling for the effects of a range of individual level factors, and after controlling for unequal variance across groups (heteroscedascity), there was little difference between community dwelling older adults and institutional care residents in IS score, suggesting that the stability of day-to-day patterns (such as bed get-up, lunch times, etc.) is similar within these two resident groups. However, institutional care residents experienced more fragmented rest/wake patterns (having significantly higher IV scores and significantly lower mean activity values). Our findings strongly suggest that the institutional care environment itself has a negative association with older people's rest/wake patterns; although, longitudinal studies are required to fully understand any causal relationships.