Healthcare providers missing a golden opportunity to discuss sleep quality with older adults.

Abstract

Introduction: Sleep is essential to one's health, well-being and functioning. Older adults experience impaired sleep as a result of multi- morbidities, age-related changes, or pharmacologic management. Primary and health care providers have an appropriate skillset to provide non-pharmacological interventions to assist older adults presenting with impaired sleep. Literature regarding consultations between older patients and health providers regarding sleep and the management of sleep impairments during and following hospitalization is limited. The purpose of this study is to examine what consultations and collaborations older adults have with health professionals regarding their sleep quality and the management of any sleep impairments during and following hospitalization. Method(s): A mixed methods prospective longitudinal cohort study was completed with 311 hospitalized older adults (65 years and over) returning to community-dwelling post-discharge. Self-reported sleep quality was obtained via the Pittsburgh Sleep Quality Index. Openended questions regarding patient-provider discussions of the assessment, treatment, and mangement of sleep impairments were also examined. Participants were surveyed during their hospital admission, and at three- and six-months post-hospitalization. Result(s): Less than 20% of participants discussed sleep at any time point with any health care provider they engaged with and discussions were predominantly initiated by the participants themselves. Pharmacological-based approaches were opted for more frequently at each time point than non-pharmacological approaches. Conclusion(s): Primary and healthcare providers have considerable scope to collaborate with older adults to address underlying factors that contribute to sleep impairments and provide them with evidence- based interventions that could assist them to reduce, minimize or prevent sleep issues. Utilizing a client-centered approach for older adults presenting with sleep problems is recommended.