Noise and Lighting

Noise: Residents need a restful environment, free from unnecessary noises, particularly at night when they are trying to sleep. Losing sleep can make it difficult for frail older people to recover from illness and fight off infections. One study of patients in a nursing home found that noise was one of the most important reasons for their not being able to get enough sleep.

Elderly people often have what is called sensorineural hearing loss, meaning that they can hear sounds but can’t always make out what is being said to them. Background noise can make the problem worse, so residents need a quiet environment to be able to understand conversations.

Additional Reading: Communicating With The Hearing Impaired

Night workers who are used to chatting with other workers at the nurses’ desk need to understand that it is best not to make noise in rooms where patients are trying to rest. This goes for day staff as well if patients are napping or watching televisions, talking on the telephone, reading, or just visiting with other residents or visitors. Keep talking to a minimum, using it only to communicate professionally.

When other patients have visitors, sometimes the noise level is high enough so that their conversations can be heard next door and across the hall. When that happens, it can be helpful to have visitors move their chairs closer to the patient they are visiting, so that they are not raising their voices to be heard from a distance. If the television or radio is on, ask the resident if it is alright to turn it off while the visitors are there so that they do not feel it necessary to raise their voices to be heard over the media. If that does not do the trick, respectfully ask them to speak a little more quietly.

When one resident complains about the noise from his or he neighbor’s television or radio, respectfully tell the latter that his or her television or radio will have to be turned down a little, and turn down the volume. If he or she insists on keeping the volume high, try moving the television or radio closer to the resident. If this does not help, bring the problem to the attention of the nurse in charge. Keeping the volume high could mean that the resident has a hearing problem, and might need to have his or her ears cleaned or see an audiologist for hearing aids.

If noise from the street is a problem, it is best to keep the windows closed. Some hospitals have signs that ask drivers not to make too much noise, and if your hospital does not have such a sign, and you feel that it is needed, suggest it to the charge nurse.

Lighting: Good lighting is important to prevent falls. Nursing home residents often have eye problems such as macular degeneration or cataracts, which keep light from entering their eyes. Bad vision puts them in danger if lighting is not bright enough. Report any burned out bulbs or lamps that don’t work to your supervisor. At the same time, glaring lights can hurt residents’ eyes, so make sure to report any missing or broken lampshades. If the glare from a streetlamp shines into your resident’s room, be sure to close the curtains or shades at night.

Natural sunlight can be cheering, free and ecologically sound, so open blinds and curtains when your patient is dressed. Getting natural light during the day can help residents to feel more rested when they wake in the morning. Sunlight helps us all with what is called circadian rhythm, meaning the times that we normally are awake and asleep. Getting sunlight during the daytime can help the circadian rhythm so that residents are able to sleep well and wake up feel refreshed.


Q.   As a nursing assistant, how can you maintain a comfortable level of lighting for your patients, especially at night?

A.   When you are working as a nursing assistant, you should never turn on a bright light in a patient’s room without warning.  If a patient’s room is dark and you need to turn on any level of lighting, let the patient know before you switch the light on.  Try to use the minimal amount of lighting you can at night, while still safely and effectively carrying out your duties.

Explanation:  There will be times when you need to have lights on in a patient’s room even if they are sensitive to lighting.  BY giving a patient some warning that you need to turn the lights on our up, you can help reduce their discomfort.  At night, you should try to keep the lights low whenever possible.  Some nursing assistants even use a flashlight for certain tasks and duties so as to not disturb patients who are trying to sleep. Of course, you need to make certain you always have plenty of light to safely carry out your duties, but simply do what you can to minimize any discomfort of lighting.

Q.  What should you do if your patient is being bothered by the noise level of the TV, Radio or visitors of their roommate?

A.  If a person’s roommate is being loud in some way, you should politely ask the other patient if they can reduce the noise level to some extent.  For example, you can ask if they can turn down the volume on the TV a bit.  You can politely ask noisy visitors to talk a little quieter as well if the individuals are disturbing the other patient

Explanation:  All patients have the right to enjoy their TV or radios.  They also have the right to have visitors and to enjoy the company.  However, if someone is being particularly loud in some way, it is acceptable for the nursing assistant to kindly ask them to be a tad quieter so that their roommate is not disturbed.  Sometimes an individual has a roommate who is more sensitive to noise or who simply is feeling too poorly to have a lot of noise around them.

Q.  Should nursing assistants try to bring natural lighting into a patient’s room when possible?

A.  Nursing assistants should help to bring natural lighting into a patient’s room whenever possible.  A nursing assistant can open the blinds.  You should always ask a patient before opening up the blinds to make certain they are up for the light.  Try to open the blinds at least part way if the patient says that it is alright.  Some patients will not feel up to having the blinds wide open.

Explanation:  It is important for patient’s to receive some exposure to the sunlight.  Sunlight provides much needed Vitamin D for individuals.  Since patients cannot be out in the sunlight, it is a good idea to bring the sunlight to them.  Natural lighting can also improve the mood of individuals who are feeling a bit sad.  Sunlight provides even more lighting for a room to ensure that the staff can perform their tasks well.

This is a collaborative project and is thus a work in progress. It is constantly being updated, changed and added to.

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