Comfort, Rest, and Sleep -Pain
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Comfort, rest, and sleep are needed for well-being.
The total person is affected by comfort, rest, and sleep problems.
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Discomfort and pain can be physical or emotional.
Rest and sleep restore energy and well-being.
Illness and injury increase the need for rest and sleep.
COMFORT
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These OBRA room requirements promote comfort:
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No more than four persons in a room
A suspended curtain that goes around the bed for privacy
A bed of proper height and size for the person
A clean, comfortable mattress
Linens (sheets, blankets, spreads) that suit weather and climate
A clean and orderly room
An odor-free room
A room temperature between 71 F and 81 F
An acceptable noise level
Adequate ventilation and room humidity
Appropriate lighting
PAIN
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Pain or discomfort means to ache, hurt, or be sore.
Comfort and discomfort are subjective.
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You must rely on what the person says.
If a person complains of pain or discomfort, the person has pain or
discomfort.
Pain is a warning from the body.
Acute pain is felt suddenly from injury, disease, trauma, or surgery.
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It usually lasts less than 6 months.
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Chronic pain lasts longer than 6 months.
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There is no longer tissue damage.
Radiating pain is felt at the site of tissue damage and in nearby areas.
Phantom pain is felt in a body part that is no longer there.
Factors affecting pain
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Past experience
Pain can cause anxiety.
Anxiety increases how much pain the person feels.
Rest and sleep
The more a person thinks about the pain, the worse it seems.
Personal and family duties affect pain responses.
The value or meaning of pain
Support from others
Culture
Illness
Age
Persons with dementia may not be able to tell you about their pain.
 Report any changes in a person’s usual behavior to the nurse.
The nurse needs this information to assess the person’s pain:
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Location
Onset and duration
Intensity
Description
Factors causing pain (precipitating factors)
Factors affecting pain
Vital signs
Other signs and symptoms
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The nurse uses the nursing process to promote comfort and relieve
pain.
Distraction means to change the person’s center of attention.
Relaxation means to be free from mental and physical stress.
Guided imagery is creating and focusing on an image.
Doctors often order drugs to control or relieve pain.
YOU CAN PROMOTE REST BY:
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Nursing measures
Meeting physical needs
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Meeting thirst, hunger, and elimination needs
Assisting the person to a comfortable position and good alignment
Providing a quiet setting
Providing a clean, dry, and wrinkle-free bed
Providing a clean, neat, and uncluttered room
Meeting safety and security needs
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Keeping the signal light within reach
Explaining the reasons for care
Explaining how care is given
Following the person’s routines and rituals whenever possible
Promoting love and belonging needs
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Visits or calls from family and friends
Reading cards and letters
Promoting self-esteem needs
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Allowing personal choice in sleepwear
Assisting with hygiene and grooming as needed
SLEEP IS A BASIC NEED
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It lets the mind and body rest.
The body saves energy.
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Body functions slow.
Vital signs are lower than when awake.
Tissue healing and repair occur.
Sleep lowers stress, tension, and anxiety.
It refreshes and renews the person.
Circadian rhythm is a daily rhythm based on a 24-hour cycle.
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Health care often interferes with a person’s circadian rhythm and the
sleep-wake cycle.
There are two phases of sleep.
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NREM sleep (non-REM sleep) is the phase of sleep in which there is
no rapid eye movement.
The rapid eye movement phase is called REM sleep.
Sleep needs vary for each age-group.
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The amount needed decreases with age.
Factors affecting sleep
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Illness
Nutrition
Exercise
Environment
Drugs and other substances
Lifestyle changes
Emotional problems
Insomnia is a chronic condition in which the person cannot sleep or stay
asleep all night.
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Circadian rhythm includes a sleep-wake cycle.
There are three forms of insomnia:
 Cannot fall asleep
 Cannot stay asleep
 Awakens early and cannot fall back asleep
With sleep deprivation, the amount and quality of sleep are decreased.
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Sleepwalking
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The person leaves the bed and walks about.
The person is not aware of sleepwalking.
The event may last 3 to 4 minutes or longer.
You need to protect the person from injury and falling; guide the
person back to bed and waken the person gently.
Promoting sleep
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The nurse assesses the person’s sleep patterns.
Measures are planned to promote sleep.
Follow the care plan.
Report your observations about how the person slept.
The person is involved in planning care.
In persons with Alzheimer’s disease and other dementias:
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Night wandering is common.
Restlessness and confusion often increase at night.
QUALITY OF LIFE
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Comfort, rest, and sleep are needed for quality of life and well-being.
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OBRA has requirements that promote comfort, rest, and sleep.
The right to personal choice and taking part in planning care promote
comfort, rest, and sleep.
Residents have the right to have pain assessed and managed.