The Social Significance of Sleep for Older People with Dementia in the Context of Care

While the social aspects of dementia have been increasingly researched over the past decade, there has been little focus on sleep and its significance to older people with dementia within the context of care. This paper attempts to address this knowledge gap by exploring the experiences of sleep among older people with dementia and the perceptions of family carers and care staff in different care settings. The paper is drawn from a larger research project that explored the empowerment of older people with dementia, and involved 18 in-depth interviews with older people with dementia and 8 focus groups with health and social care staff and family carers. The discourses of the older people with dementia and family carers, emphasised vulnerabilities associated with sleep, thematically represented as: (1) interconnections between health, care, the body and sleep; (2) memory loss and perceptions of sleep, time and place; and (3) a sense of vulnerability around night-time, sleep and safety. The sleep discourses of the older people with dementia and their family carers focused on meanings associated with experiential dimensions of sleep and were closely connected to their social identities and roles. The key concern for the health and social care staff was the organisation of sleep, including: (1) temporal management of sleep and sleep practices, and (2) management of sleep across public/private space: safety, surveillance and privacy. The sleep discourses of the health and social care staff predominately focused on sleep practices and environmental dimensions of sleep. These different perspectives denote varying positions and concerns in relation to sleep between waking conscious actors and dormant bodies, thereby highlighting the social significance of power relations and vulnerabilities within the context of care for older people with dementia.