It’s bedtime . . . again

John
Burton who has managed a variety of #carehomes and is author of Leading Good
Care http://www.jkp.com/uk/leading-good-care.html
reflects on the importance of bedtime routines.

image

In
1980, when I was working with some local authority children’s homes, the
borough’s training officer handed me a scruffily typed and photocopied
anonymous article called “Bedtime”. I was trying to get the staff to understand
the importance of a bedtime routine and he thought this article might help me.
I didn’t have to read for long to realise that this was my article, previously
published in “Residential Social Work” in 1975. While I was a bit miffed that
it had been copied and circulated without my name on it, I was pleased that at
least it had been read and was being used.

One
of the first of many lessons that I had to learn when I first started
residential work in the 1960s was the importance of establishing benign and therapeutically
“containing” routines, and to understand the difference between them and the
imposition of regimes of mere control that are anything but therapeutic. In
those days, residential staff really were resident, and although you might be
kept awake at night sometimes, you were truly “sleeping in” and “on call” every
night you were there. (Far from being paid for it, we even had to pay a small
amount for our “bed and board”.)

Now,
fifty or more years later, with much more learning from practice (and from
mistakes) with many different homes for different ages of people, I am still
trying to help residential teams to understand the importance of bedtime
routines.

Pyjamas
and dressing gowns

For
a long time now, it has been common in children’s homes to have “waking night
staff”, and for some of the residents to be awake and active during the night
and very reluctant to get up in the morning. I know in some homes for older
people with dementia, staff change into pyjamas and dressing gowns to give the
message that it is time for sleep. And in one of the homes that I currently
work with, the staff have tried “sleeping in”, making it clear that they are
preparing to stay overnight and will be getting up before the children in the
morning. They reported that it conveyed a helpful message that their home was
preparing for sleep, and some of the children liked the idea. Well, of course
they did.

Having
only “waking night staff” makes it much more difficult to establish the sort of
peaceful and reassuring atmosphere that we all need for a good night’s sleep,
whether we are wrestling with all sorts of fears and anxieties, and the traumas
that many children bring with them into care, or we are just finding it
difficult to sleep. The house itself needs to go to sleep with trusted grown-ups
on hand to read stories, talk quietly, reassure …  going to bed, sleeping, and getting up the
next morning to wake you for the day to come.

This,
of course, takes us to the design of the rota and the need for staff to provide
“bridges” from night to morning, and morning to coming back from school to the
evening. These are the rhythms and routines of a therapeutic home.

Published by Residential Forum

The Residential Forum is to promote the achievement of high standards of care and support for children and adults living in residential care and nursing homes, supported housing, residential schools and colleges, hospices and hostels. It contributes to improving the quality of service to the public. Members of the Forum are people of standing and experience drawn from the public, private and voluntary sectors, as well as some who can speak for service users and carers.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

%d bloggers like this: