{"id":725871,"date":"2026-06-26T18:19:45","date_gmt":"2026-06-26T16:19:45","guid":{"rendered":"https:\/\/www.dynseo.com\/chutes-nocturnes-en-ehpad-pourquoi-elles-arrivent-et-comment-les-prevenir-dynseo-2\/"},"modified":"2026-06-26T18:21:23","modified_gmt":"2026-06-26T16:21:23","slug":"nighttime-falls-in-nursing-homes-why-they-happen-and-how-to-prevent-them","status":"publish","type":"post","link":"https:\/\/www.dynseo.com\/en\/nighttime-falls-in-nursing-homes-why-they-happen-and-how-to-prevent-them\/","title":{"rendered":"Nighttime Falls in Nursing Homes: Why They Happen and How to Prevent Them"},"content":{"rendered":"<p>[et_pb_section fb_built=&#8221;1&#8243; admin_label=&#8221;Article HTML&#8221; _builder_version=&#8221;4.16&#8243; custom_padding=&#8221;0px||0px||false|false&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_row admin_label=&#8221;Contenu&#8221; _builder_version=&#8221;4.16&#8243; width=&#8221;100%&#8221; max_width=&#8221;100%&#8221; 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{margin:8px 0;font-size:13px;}\n.dbi-art-44e1e0 .toc a {color:var(--nuit);font-weight:600;}\n@media(max-width:600px) {\n.dbi-art-44e1e0 .article-hero {padding:50px 16px 0;}\n.dbi-art-44e1e0 .container {padding:0 16px;}\n.dbi-art-44e1e0 .article-body p {font-size:14px;}\n.dbi-art-44e1e0 .cta-box {padding:30px 20px;}\n.dbi-art-44e1e0 .cta-box .cta-buttons {flex-direction:column;max-width:260px;margin:0 auto;}\n.dbi-art-44e1e0 .btn-cta-white, .dbi-art-44e1e0 .btn-cta-outline {width:100%;text-align:center;}\n.dbi-art-44e1e0 .internal-link {flex-direction:column;text-align:center;gap:12px;}\n}<\/p>\n<\/style>\n<p><script type=\"application\/ld+json\">{\"@context\":\"https:\/\/schema.org\",\"@type\":\"Article\",\"headline\":\"Chutes nocturnes en EHPAD : pourquoi elles arrivent et comment les pr\u00e9venir\",\"description\":\"Guide complet sur les chutes nocturnes \u2014 lever nocturne, nycturie, hypotension orthostatique, confusion nocturne, \u00e9clairage, surveillance, protocole de lever s\u00e9curis\u00e9.\",\"author\":{\"@type\":\"Organization\",\"name\":\"DYNSEO\",\"url\":\"https:\/\/www.dynseo.com\"},\"publisher\":{\"@type\":\"Organization\",\"name\":\"DYNSEO\"},\"datePublished\":\"2026-03-06\",\"dateModified\":\"2026-03-06\"}<\/script><\/p>\n<div class=\"dbi-art-44e1e0\">\n<header class=\"article-hero\">\n<div class=\"article-hero-inner\">\n<nav class=\"article-breadcrumb\">\n      <a href=\"https:\/\/www.dynseo.com\/en\/\">Home<\/a> &rsaquo;<br \/>\n      <a href=\"https:\/\/www.dynseo.com\/en\/healthcare-professionals\/\">Professionals<\/a> &rsaquo;<br \/>\n      Nighttime falls Nursing home<br \/>\n    <\/nav>\n<p>    <span class=\"article-category\">\ud83e\uddba FALL PREVENTION<\/span><\/p>\n<h1>Nighttime falls in Nursing home&nbsp;: <span class=\"hl\">why they happen<\/span> and how to prevent them<\/h1>\n<div class=\"article-meta\">\n      <span>\ud83d\udcc5 March 2026<\/span><br \/>\n      <span>\u23f1 17 min read<\/span><br \/>\n      <span>\ud83e\uddd1\u200d\u2695\ufe0f By the DYNSEO team<\/span>\n    <\/div>\n<\/p><\/div>\n<div class=\"article-hero-curve\"><\/div>\n<\/header>\n<div class=\"container\">\n<article class=\"article-body\">\n<div class=\"toc\">\n<h4>\ud83d\udccb Summary<\/h4>\n<ol>\n<li><a href=\"#pourquoi-nuit\">Why nighttime concentrates the most serious falls<\/a><\/li>\n<li><a href=\"#lever-nocturne\">Nighttime rising: the most dangerous moment<\/a><\/li>\n<li><a href=\"#nycturie\">Nocturia: understanding and treating the nighttime urge to urinate<\/a><\/li>\n<li><a href=\"#hypotension-nuit\">Nocturnal orthostatic hypotension<\/a><\/li>\n<li><a href=\"#confusion-nocturne\">Confusion and nighttime disorientation<\/a><\/li>\n<li><a href=\"#somniferes-nuit\">The danger of sleeping pills at night<\/a><\/li>\n<li><a href=\"#eclairage-nuit\">Nighttime lighting: securing the path in the dark<\/a><\/li>\n<li><a href=\"#surveillance-nuit\">Nighttime monitoring: organization and tools<\/a><\/li>\n<li><a href=\"#protocole-lever\">The two-step safe rising protocol<\/a><\/li>\n<li><a href=\"#famille-nuit\">What families can do<\/a><\/li>\n<\/ol>\n<\/div>\n<pee>Three o&#8217;clock in the morning. A resident gets up alone to go to the bathroom. The room is dark. He has just woken up from a deep sleep. His evening medications are still active. He gets up too quickly. His blood pressure drops. He staggers. He falls. And he may have remained on the floor for several hours before being discovered.<\/pee>\n<pee>This scenario \u2014 banal in its tragic repetition \u2014 illustrates why nighttime falls deserve special attention. They are not just falls that happen at night \u2014 they accumulate specific risk factors that make them more likely and often more serious than daytime falls. Understanding them is the first step to preventing them.<\/pee>\n<h2 id=\"pourquoi-nuit\">1. Why nighttime concentrates the most serious falls<\/h2>\n<pee>Nighttime falls account for between 20 and 30% of all falls in Nursing homes \u2014 a significant proportion for a period that only represents 30 to 40% of the time. They are proportionally more serious&nbsp;: the person is often alone, the detection delay can be long (several hours), and complications related to the time spent on the floor (hypothermia, rhabdomyolysis, pressure sores, dehydration) add to the direct injury.<\/pee>\n<pee>Several factors combine to create this aggravated risk&nbsp;: the transition from sleep to wakefulness causes transient disorientation, evening medications (sleeping pills, anxiolytics) are still active, orthostatic hypotension is more pronounced after several hours of immobilization, lighting is reduced, the person is often poorly shod (socks, slippers), and the vigilance of the staff is naturally reduced.<\/pee>\n<h2 id=\"lever-nocturne\">2. Nighttime rising: the most dangerous moment<\/h2>\n<pee>Nighttime rising is the moment of the night when the vast majority of falls occur \u2014 particularly in the first 30 seconds after the person has left their bed. This brief interval concentrates a maximum of simultaneous risk factors&nbsp;: disorientation upon waking, orthostatic hypotension, darkness, slow reflexes, and often a perceived urgency (urge to urinate) that prompts them to get up too quickly.<\/pee>\n<div class=\"nuit-timeline\">\n<div class=\"nuit-step\">\n<div class=\"nuit-step-num\">1<\/div>\n<div class=\"nuit-step-content\">\n<h4>The awakening<\/h4>\n<pee>Transient disorientation \u2014 the person does not know where they are, what time it is, sometimes even who they are. This confusion is normal upon deep awakening but is more pronounced and lasting in elderly people and in residents with dementia.<\/pee>\n    <\/div>\n<\/p><\/div>\n<div class=\"nuit-step\">\n<div class=\"nuit-step-num\">2<\/div>\n<div class=\"nuit-step-content\">\n<h4>The sitting transition<\/h4>\n<pee>Getting out of bed requires sitting on the edge \u2014 a moment of significant instability, especially if the person is still drowsy and does not take the time to stabilize their position before getting up.<\/pee>\n    <\/div>\n<\/p><\/div>\n<div class=\"nuit-step\">\n<div class=\"nuit-step-num\">3<\/div>\n<div class=\"nuit-step-content\">\n<h4>The standing transition<\/h4>\n<pee>The transition to a standing position triggers orthostatic hypotension \u2014 blood pressure drops, vision blurs, legs feel weak. This transient discomfort lasts from a few seconds to a minute. It is the peak of risk.<\/pee>\n    <\/div>\n<\/p><\/div>\n<div class=\"nuit-step\">\n<div class=\"nuit-step-num\">4<\/div>\n<div class=\"nuit-step-content\">\n<h4>The movement<\/h4>\n<pee>Path to the bathroom in darkness or semi-darkness, often without technical assistance, often in socks. Potential obstacles unseen. Urinary urgency pushes to go quickly.<\/pee>\n    <\/div>\n<\/p><\/div>\n<\/div>\n<h2 id=\"nycturie\">3. Nocturia: understanding and treating the nighttime urge to urinate<\/h2>\n<pee>Nocturia \u2014 the need to get up one or more times at night to urinate \u2014 is the primary cause of nighttime rising in elderly people, and thus one of the main risk factors for nighttime falls. It affects the vast majority of elderly people to varying degrees. Understanding its causes often allows for reduction.<\/pee>\n<div class=\"key-points\">\n<h3>\u2726 Common causes of nocturia and action points<\/h3>\n<ul>\n<li><strong>Diuretics taken in the evening<\/strong> \u2014 moving them to the morning or midday can significantly reduce nighttime nocturia (to be discussed with the doctor)<\/li>\n<li><strong>Excessive fluid intake too late<\/strong> \u2014 encourage good hydration during the day, but reduce intake in the 2 hours before bedtime<\/li>\n<li><strong>Overactive bladder<\/strong> \u2014 treated with anticholinergics or pelvic floor rehabilitation (be cautious with anticholinergics that can worsen confusion in elderly people)<\/li>\n<li><strong>Prostatic hypertrophy<\/strong> in men \u2014 to be evaluated and treated if not yet addressed<\/li>\n<li><strong>Lower limb edema<\/strong> \u2014 nighttime lying down mobilizes edema towards the kidney, increasing nighttime diuresis. Elevating the legs in the late afternoon and wearing compression stockings can help.<\/li>\n<li><strong>Place a urinal or commode within immediate reach<\/strong> \u2014 for residents at very high risk, avoiding movement is sometimes the best prevention<\/li>\n<\/ul>\n<\/div>\n<h2 id=\"hypotension-nuit\">4. Nocturnal orthostatic hypotension<\/h2>\n<pee>Orthostatic hypotension is more pronounced at night for several reasons&nbsp;: several hours of immobilization in a lying position have allowed for a redistribution of blood towards the trunk, relative dehydration at night (no drinking since the evening) reduces blood volume, and some evening medications have their peak action at night.<\/pee>\n<div class=\"soft-box\">\n  <pee><strong>The reflex to teach all at-risk residents&nbsp;: the three-step rising.<\/strong> 1\/ Sit up in bed, legs dangling at the edge, wait 20 to 30 seconds. 2\/ Stand up very slowly while firmly holding onto the bell or the edge of the bed. 3\/ Remain standing without moving, hand on a stable support, wait another 20 seconds before starting to walk. This simple protocol \u2014 repeated until it becomes automatic \u2014 significantly reduces the risk of falls related to orthostatic hypotension.<\/pee>\n<\/div>\n<h2 id=\"confusion-nocturne\">5. Confusion and nighttime disorientation<\/h2>\n<pee>Nighttime confusion is common among residents with dementia \u2014 and can also occur in residents without pre-existing cognitive disorders during infectious episodes, metabolic imbalances, or when introducing certain medications. A confused resident at night may get up without realizing the risk, attempt to leave their room, lean on unstable furniture, or fail to find their way to the bathroom.<\/pee>\n<div class=\"famille-box\">\n<div class=\"famille-box-label\">\ud83c\udf19 What families can report<\/div>\n<div class=\"famille-box-title\">\u00ab&nbsp;Mom gets up several times at night and no longer knows where she is.&nbsp;\u00bb<\/div>\n<pee>This observation is an important signal to communicate to the team \u2014 even if the resident has not yet fallen. Repeated nighttime confusion justifies a medical review (medications, cognitive assessment, infectious evaluation) and an adaptation of the environment and monitoring.<\/pee>\n<div class=\"soignant-box\">\n<div class=\"soignant-box-title\">\u2726 Specific measures for confused residents at night<\/div>\n<pee>Night light or soft permanent light in the room. Clear visual markers to the bathroom. Reassuring presence during rising if the resident rings. For severely demented residents&nbsp;: assess the relevance of a bed exit sensor with caregiver alarm. Avoid restraints \u2014 they increase agitation and the risk of falls.<\/pee>\n  <\/div>\n<\/div>\n<h2 id=\"somniferes-nuit\">6. The danger of sleeping pills at night<\/h2>\n<pee>The paradox of sleeping pills is well documented&nbsp;: prescribed to improve sleep quality and thus reduce chaotic nighttime rising, they actually increase the risk of nighttime falls due to their persistent sedative effect upon rising. A person waking under the influence of a sleeping pill \u2014 because they need to urinate, because they are hot, because they are confused \u2014 gets up with diminished reflexes, reduced coordination, and altered awareness of their own abilities.<\/pee>\n<pee>Reviewing sleeping pills in residents at high risk of nighttime falls is often one of the most effective interventions \u2014 and the most delicate to implement, as stopping a long-term sleeping pill must be gradual and accompanied by alternative measures (sleep hygiene, behavioral therapies, treatment of nighttime pain that disrupts sleep).<\/pee>\n<h2 id=\"eclairage-nuit\">7. Nighttime lighting: securing the path in the dark<\/h2>\n<pee>Well-thought-out nighttime lighting can prevent a significant number of nighttime falls. The goal is not to light the room as in broad daylight \u2014 which would disrupt sleep \u2014 but to provide sufficient brightness for the person to see where they are stepping without being blinded.<\/pee>\n<div class=\"key-points\">\n<h3>\u2726 Effective nighttime lighting devices<\/h3>\n<ul>\n<li><strong>LED night light with motion detector<\/strong> \u2014 automatically turns on when the resident moves, without having to find a switch in the dark<\/li>\n<li><strong>LED strip on the floor<\/strong> along the path bed \u2192 bathroom \u2014 light at floor level, without glare, sufficient to guide footsteps<\/li>\n<li><strong>Light switch<\/strong> easily accessible from the bed \u2014 for residents who prefer to turn it on themselves<\/li>\n<li><strong>Permanent night light in the bathroom<\/strong> at night \u2014 so the person can see upon entering without having to search for the switch<\/li>\n<li><strong>Avoid transitions from total darkness to bright light<\/strong> \u2014 visual adaptation is slow in elderly people and the moment of transient blindness is dangerous<\/li>\n<\/ul>\n<\/div>\n<h2 id=\"surveillance-nuit\">8. Nighttime monitoring: organization and tools<\/h2>\n<pee>Nighttime monitoring is a real constraint in Nursing homes \u2014 night teams are reduced, and it is impossible to be in every room at all times. The organization of this monitoring must be designed to maximize early detection of risky situations without imposing too frequent rounds that would disrupt sleep.<\/pee>\n<div class=\"info-box\">\n  <pee><strong>Technological tools to assist nighttime monitoring&nbsp;:<\/strong> Bed exit sensors (mats under the mattress or weight sensors that alert when the resident leaves their bed). Motion detectors in the room. Surveillance cameras (with strict regulatory framework \u2014 consent from the resident and\/or guardian, limited use to security). Fall detection bracelets with automatic alarm. These tools do not replace human presence \u2014 they allow targeting interventions where they are truly needed.<\/pee>\n<\/div>\n<h2 id=\"protocole-lever\">9. The two-step safe rising protocol<\/h2>\n<pee>The safe rising protocol is a simple procedure that all care staff and the residents themselves can learn and apply. It consists of systematically waiting before getting up and ensuring stable support before each movement. Its transmission to the resident \u2014 repeated, patient, adapted to their cognitive abilities \u2014 is a complete caregiving mission.<\/pee>\n<div class=\"article-quote\">\n  <pee>\u00ab&nbsp;We posted a small reminder with pictograms for the two-step rising above the bed of each at-risk resident. Simple, non-intrusive. After three months, half of the residents were doing it spontaneously. Nighttime falls decreased by a third in the unit.&nbsp;\u00bb<\/pee>\n<div class=\"quote-author\">\u2014 Coordinating nurse, Nursing home Brittany<\/div>\n<\/div>\n<h2 id=\"famille-nuit\">10. What families can do<\/h2>\n<pee>Families are generally not there at night \u2014 but they can contribute to the prevention of nighttime falls in several ways&nbsp;: by communicating the nighttime habits of their loved one to the team (how many times do they usually get up, do they have nightmares, are they confused upon waking), by ensuring that nighttime footwear is appropriate (slippers with non-slip soles rather than socks), by reporting any changes observed during visits (more restless sleep, new nocturia, unusual fatigue suggesting disturbed sleep), and by encouraging their loved one to use the bell before getting up.<\/pee>\n<p><a href=\"https:\/\/www.dynseo.com\/en\/courses\/preventing-falls-identifying-risks-taking-daily-action-and-reorganizing-the-environment-en\/\" class=\"internal-link\"><\/p>\n<div class=\"internal-link-icon\">\ud83c\udf93<\/div>\n<div class=\"internal-link-content\">\n<div class=\"internal-link-label\">Certified training<\/div>\n<div class=\"internal-link-title\">Preventing falls: identifying risks, acting daily, and reorganizing the environment<\/div>\n<div class=\"internal-link-desc\">DYNSEO Qualiopi training \u2014 nighttime falls, nighttime monitoring, nocturia, safe rising protocols. For the entire Nursing home team.<\/div>\n<\/p><\/div>\n<div class=\"internal-link-arrow\">\u2192<\/div>\n<p><\/a><\/p>\n<div class=\"cta-box\">\n<h3>\ud83c\udf93 Train your team in nighttime prevention<\/h3>\n<pee>The DYNSEO training \u201cPreventing falls\u201d includes a module dedicated to nighttime falls \u2014 organization of monitoring, safe rising protocols, lighting, nocturia. Certified Qualiopi.<\/pee>\n<div class=\"cta-buttons\">\n    <a href=\"https:\/\/www.dynseo.com\/en\/courses\/preventing-falls-identifying-risks-taking-daily-action-and-reorganizing-the-environment-en\/\" class=\"btn-cta-white\">\ud83d\udccb View the program<\/a><br \/>\n    <a href=\"https:\/\/www.dynseo.com\/formations\/\" class=\"btn-cta-outline\">All trainings \u2192<\/a>\n  <\/div>\n<\/div>\n<div class=\"article-tags\">\n  <a href=\"#\" class=\"article-tag\">nighttime falls Nursing home<\/a><br \/>\n  <a href=\"#\" class=\"article-tag\">safe nighttime rising<\/a><br \/>\n  <a href=\"#\" class=\"article-tag\">nocturia elderly people<\/a><br \/>\n  <a href=\"#\" class=\"article-tag\">nocturnal orthostatic hypotension<\/a><br \/>\n  <a href=\"#\" class=\"article-tag\">nighttime lighting safety<\/a><br \/>\n  <a href=\"#\" class=\"article-tag\">night monitoring Nursing home<\/a><br \/>\n  <a href=\"#\" class=\"article-tag\">DYNSEO training<\/a>\n<\/div>\n<\/article>\n<\/div>\n<\/div>\n<p>[\/et_pb_code][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":4,"featured_media":410101,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"[et_pb_section fb_built=\"1\" admin_label=\"Article HTML\" _builder_version=\"4.16\" custom_padding=\"0px||0px||false|false\" global_colors_info=\"{}\"][et_pb_row admin_label=\"Contenu\" _builder_version=\"4.16\" width=\"100%\" max_width=\"100%\" custom_padding=\"0px||0px||false|false\" global_colors_info=\"{}\"][et_pb_column type=\"4_4\" _builder_version=\"4.16\" global_colors_info=\"{}\"][et_pb_code admin_label=\"HTML import\u00e9\" _builder_version=\"4.16\" global_colors_info=\"{}\"]<style 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s\u00e9curis\u00e9.\",\"author\":{\"@type\":\"Organization\",\"name\":\"DYNSEO\",\"url\":\"https:\/\/www.dynseo.com\"},\"publisher\":{\"@type\":\"Organization\",\"name\":\"DYNSEO\"},\"datePublished\":\"2026-03-06\",\"dateModified\":\"2026-03-06\"}<\/script>\n<div class=\"dbi-art-44e1e0\">\n<header class=\"article-hero\">\n  <div class=\"article-hero-inner\">\n    <nav class=\"article-breadcrumb\">\n      <a href=\"https:\/\/www.dynseo.com\/\">Home<\/a> &rsaquo;\n      <a href=\"https:\/\/www.dynseo.com\/professionnels-de-sante\/\">Professionals<\/a> &rsaquo;\n      Nighttime falls Nursing home\n    <\/nav>\n    <span class=\"article-category\">\ud83e\uddba FALL PREVENTION<\/span>\n    <h1>Nighttime falls in Nursing home&nbsp;: <span class=\"hl\">why they happen<\/span> and how to prevent them<\/h1>\n    <div class=\"article-meta\">\n      <span>\ud83d\udcc5 March 2026<\/span>\n      <span>\u23f1 17 min read<\/span>\n      <span>\ud83e\uddd1\u200d\u2695\ufe0f By the DYNSEO team<\/span>\n    <\/div>\n  <\/div>\n  <div class=\"article-hero-curve\"><\/div>\n<\/header>\n\n<div class=\"container\">\n<article class=\"article-body\">\n\n<div class=\"toc\">\n  <h4>\ud83d\udccb Summary<\/h4>\n  <ol>\n    <li><a href=\"#pourquoi-nuit\">Why nighttime concentrates the most serious falls<\/a><\/li>\n    <li><a href=\"#lever-nocturne\">Nighttime rising: the most dangerous moment<\/a><\/li>\n    <li><a href=\"#nycturie\">Nocturia: understanding and treating the nighttime urge to urinate<\/a><\/li>\n    <li><a href=\"#hypotension-nuit\">Nocturnal orthostatic hypotension<\/a><\/li>\n    <li><a href=\"#confusion-nocturne\">Confusion and nighttime disorientation<\/a><\/li>\n    <li><a href=\"#somniferes-nuit\">The danger of sleeping pills at night<\/a><\/li>\n    <li><a href=\"#eclairage-nuit\">Nighttime lighting: securing the path in the dark<\/a><\/li>\n    <li><a href=\"#surveillance-nuit\">Nighttime monitoring: organization and tools<\/a><\/li>\n    <li><a href=\"#protocole-lever\">The two-step safe rising protocol<\/a><\/li>\n    <li><a href=\"#famille-nuit\">What families can do<\/a><\/li>\n  <\/ol>\n<\/div>\n\n<p>Three o'clock in the morning. A resident gets up alone to go to the bathroom. The room is dark. He has just woken up from a deep sleep. His evening medications are still active. He gets up too quickly. His blood pressure drops. He staggers. He falls. And he may have remained on the floor for several hours before being discovered.<\/p>\n\n<p>This scenario \u2014 banal in its tragic repetition \u2014 illustrates why nighttime falls deserve special attention. They are not just falls that happen at night \u2014 they accumulate specific risk factors that make them more likely and often more serious than daytime falls. Understanding them is the first step to preventing them.<\/p>\n\n<h2 id=\"pourquoi-nuit\">1. Why nighttime concentrates the most serious falls<\/h2>\n\n<p>Nighttime falls account for between 20 and 30% of all falls in Nursing homes \u2014 a significant proportion for a period that only represents 30 to 40% of the time. They are proportionally more serious&nbsp;: the person is often alone, the detection delay can be long (several hours), and complications related to the time spent on the floor (hypothermia, rhabdomyolysis, pressure sores, dehydration) add to the direct injury.<\/p>\n\n<p>Several factors combine to create this aggravated risk&nbsp;: the transition from sleep to wakefulness causes transient disorientation, evening medications (sleeping pills, anxiolytics) are still active, orthostatic hypotension is more pronounced after several hours of immobilization, lighting is reduced, the person is often poorly shod (socks, slippers), and the vigilance of the staff is naturally reduced.<\/p>\n\n<h2 id=\"lever-nocturne\">2. Nighttime rising: the most dangerous moment<\/h2>\n\n<p>Nighttime rising is the moment of the night when the vast majority of falls occur \u2014 particularly in the first 30 seconds after the person has left their bed. This brief interval concentrates a maximum of simultaneous risk factors&nbsp;: disorientation upon waking, orthostatic hypotension, darkness, slow reflexes, and often a perceived urgency (urge to urinate) that prompts them to get up too quickly.<\/p>\n\n<div class=\"nuit-timeline\">\n  <div class=\"nuit-step\">\n    <div class=\"nuit-step-num\">1<\/div>\n    <div class=\"nuit-step-content\">\n      <h4>The awakening<\/h4>\n      <p>Transient disorientation \u2014 the person does not know where they are, what time it is, sometimes even who they are. This confusion is normal upon deep awakening but is more pronounced and lasting in elderly people and in residents with dementia.<\/p>\n    <\/div>\n  <\/div>\n  <div class=\"nuit-step\">\n    <div class=\"nuit-step-num\">2<\/div>\n    <div class=\"nuit-step-content\">\n      <h4>The sitting transition<\/h4>\n      <p>Getting out of bed requires sitting on the edge \u2014 a moment of significant instability, especially if the person is still drowsy and does not take the time to stabilize their position before getting up.<\/p>\n    <\/div>\n  <\/div>\n  <div class=\"nuit-step\">\n    <div class=\"nuit-step-num\">3<\/div>\n    <div class=\"nuit-step-content\">\n      <h4>The standing transition<\/h4>\n      <p>The transition to a standing position triggers orthostatic hypotension \u2014 blood pressure drops, vision blurs, legs feel weak. This transient discomfort lasts from a few seconds to a minute. It is the peak of risk.<\/p>\n    <\/div>\n  <\/div>\n  <div class=\"nuit-step\">\n    <div class=\"nuit-step-num\">4<\/div>\n    <div class=\"nuit-step-content\">\n      <h4>The movement<\/h4>\n      <p>Path to the bathroom in darkness or semi-darkness, often without technical assistance, often in socks. Potential obstacles unseen. Urinary urgency pushes to go quickly.<\/p>\n    <\/div>\n  <\/div>\n<\/div>\n\n<h2 id=\"nycturie\">3. Nocturia: understanding and treating the nighttime urge to urinate<\/h2>\n\n<p>Nocturia \u2014 the need to get up one or more times at night to urinate \u2014 is the primary cause of nighttime rising in elderly people, and thus one of the main risk factors for nighttime falls. It affects the vast majority of elderly people to varying degrees. Understanding its causes often allows for reduction.<\/p>\n\n<div class=\"key-points\">\n  <h3>\u2726 Common causes of nocturia and action points<\/h3>\n  <ul>\n    <li><strong>Diuretics taken in the evening<\/strong> \u2014 moving them to the morning or midday can significantly reduce nighttime nocturia (to be discussed with the doctor)<\/li>\n    <li><strong>Excessive fluid intake too late<\/strong> \u2014 encourage good hydration during the day, but reduce intake in the 2 hours before bedtime<\/li>\n    <li><strong>Overactive bladder<\/strong> \u2014 treated with anticholinergics or pelvic floor rehabilitation (be cautious with anticholinergics that can worsen confusion in elderly people)<\/li>\n    <li><strong>Prostatic hypertrophy<\/strong> in men \u2014 to be evaluated and treated if not yet addressed<\/li>\n    <li><strong>Lower limb edema<\/strong> \u2014 nighttime lying down mobilizes edema towards the kidney, increasing nighttime diuresis. Elevating the legs in the late afternoon and wearing compression stockings can help.<\/li>\n    <li><strong>Place a urinal or commode within immediate reach<\/strong> \u2014 for residents at very high risk, avoiding movement is sometimes the best prevention<\/li>\n  <\/ul>\n<\/div>\n\n<h2 id=\"hypotension-nuit\">4. Nocturnal orthostatic hypotension<\/h2>\n\n<p>Orthostatic hypotension is more pronounced at night for several reasons&nbsp;: several hours of immobilization in a lying position have allowed for a redistribution of blood towards the trunk, relative dehydration at night (no drinking since the evening) reduces blood volume, and some evening medications have their peak action at night.<\/p>\n\n<div class=\"soft-box\">\n  <p><strong>The reflex to teach all at-risk residents&nbsp;: the three-step rising.<\/strong> 1\/ Sit up in bed, legs dangling at the edge, wait 20 to 30 seconds. 2\/ Stand up very slowly while firmly holding onto the bell or the edge of the bed. 3\/ Remain standing without moving, hand on a stable support, wait another 20 seconds before starting to walk. This simple protocol \u2014 repeated until it becomes automatic \u2014 significantly reduces the risk of falls related to orthostatic hypotension.<\/p>\n<\/div>\n\n<h2 id=\"confusion-nocturne\">5. Confusion and nighttime disorientation<\/h2>\n\n<p>Nighttime confusion is common among residents with dementia \u2014 and can also occur in residents without pre-existing cognitive disorders during infectious episodes, metabolic imbalances, or when introducing certain medications. A confused resident at night may get up without realizing the risk, attempt to leave their room, lean on unstable furniture, or fail to find their way to the bathroom.<\/p>\n\n<div class=\"famille-box\">\n  <div class=\"famille-box-label\">\ud83c\udf19 What families can report<\/div>\n  <div class=\"famille-box-title\">\u00ab&nbsp;Mom gets up several times at night and no longer knows where she is.&nbsp;\u00bb<\/div>\n  <p>This observation is an important signal to communicate to the team \u2014 even if the resident has not yet fallen. Repeated nighttime confusion justifies a medical review (medications, cognitive assessment, infectious evaluation) and an adaptation of the environment and monitoring.<\/p>\n  <div class=\"soignant-box\">\n    <div class=\"soignant-box-title\">\u2726 Specific measures for confused residents at night<\/div>\n    <p>Night light or soft permanent light in the room. Clear visual markers to the bathroom. Reassuring presence during rising if the resident rings. For severely demented residents&nbsp;: assess the relevance of a bed exit sensor with caregiver alarm. Avoid restraints \u2014 they increase agitation and the risk of falls.<\/p>\n  <\/div>\n<\/div>\n\n<h2 id=\"somniferes-nuit\">6. The danger of sleeping pills at night<\/h2>\n\n<p>The paradox of sleeping pills is well documented&nbsp;: prescribed to improve sleep quality and thus reduce chaotic nighttime rising, they actually increase the risk of nighttime falls due to their persistent sedative effect upon rising. A person waking under the influence of a sleeping pill \u2014 because they need to urinate, because they are hot, because they are confused \u2014 gets up with diminished reflexes, reduced coordination, and altered awareness of their own abilities.<\/p>\n\n<p>Reviewing sleeping pills in residents at high risk of nighttime falls is often one of the most effective interventions \u2014 and the most delicate to implement, as stopping a long-term sleeping pill must be gradual and accompanied by alternative measures (sleep hygiene, behavioral therapies, treatment of nighttime pain that disrupts sleep).<\/p>\n\n<h2 id=\"eclairage-nuit\">7. Nighttime lighting: securing the path in the dark<\/h2>\n\n<p>Well-thought-out nighttime lighting can prevent a significant number of nighttime falls. The goal is not to light the room as in broad daylight \u2014 which would disrupt sleep \u2014 but to provide sufficient brightness for the person to see where they are stepping without being blinded.<\/p>\n\n<div class=\"key-points\">\n  <h3>\u2726 Effective nighttime lighting devices<\/h3>\n  <ul>\n    <li><strong>LED night light with motion detector<\/strong> \u2014 automatically turns on when the resident moves, without having to find a switch in the dark<\/li>\n    <li><strong>LED strip on the floor<\/strong> along the path bed \u2192 bathroom \u2014 light at floor level, without glare, sufficient to guide footsteps<\/li>\n    <li><strong>Light switch<\/strong> easily accessible from the bed \u2014 for residents who prefer to turn it on themselves<\/li>\n    <li><strong>Permanent night light in the bathroom<\/strong> at night \u2014 so the person can see upon entering without having to search for the switch<\/li>\n    <li><strong>Avoid transitions from total darkness to bright light<\/strong> \u2014 visual adaptation is slow in elderly people and the moment of transient blindness is dangerous<\/li>\n  <\/ul>\n<\/div>\n\n<h2 id=\"surveillance-nuit\">8. Nighttime monitoring: organization and tools<\/h2>\n\n<p>Nighttime monitoring is a real constraint in Nursing homes \u2014 night teams are reduced, and it is impossible to be in every room at all times. The organization of this monitoring must be designed to maximize early detection of risky situations without imposing too frequent rounds that would disrupt sleep.<\/p>\n\n<div class=\"info-box\">\n  <p><strong>Technological tools to assist nighttime monitoring&nbsp;:<\/strong> Bed exit sensors (mats under the mattress or weight sensors that alert when the resident leaves their bed). Motion detectors in the room. Surveillance cameras (with strict regulatory framework \u2014 consent from the resident and\/or guardian, limited use to security). Fall detection bracelets with automatic alarm. These tools do not replace human presence \u2014 they allow targeting interventions where they are truly needed.<\/p>\n<\/div>\n\n<h2 id=\"protocole-lever\">9. The two-step safe rising protocol<\/h2>\n\n<p>The safe rising protocol is a simple procedure that all care staff and the residents themselves can learn and apply. It consists of systematically waiting before getting up and ensuring stable support before each movement. Its transmission to the resident \u2014 repeated, patient, adapted to their cognitive abilities \u2014 is a complete caregiving mission.<\/p>\n\n<div class=\"article-quote\">\n  <p>\u00ab&nbsp;We posted a small reminder with pictograms for the two-step rising above the bed of each at-risk resident. Simple, non-intrusive. After three months, half of the residents were doing it spontaneously. Nighttime falls decreased by a third in the unit.&nbsp;\u00bb<\/p>\n  <div class=\"quote-author\">\u2014 Coordinating nurse, Nursing home Brittany<\/div>\n<\/div>\n\n<h2 id=\"famille-nuit\">10. What families can do<\/h2>\n\n<p>Families are generally not there at night \u2014 but they can contribute to the prevention of nighttime falls in several ways&nbsp;: by communicating the nighttime habits of their loved one to the team (how many times do they usually get up, do they have nightmares, are they confused upon waking), by ensuring that nighttime footwear is appropriate (slippers with non-slip soles rather than socks), by reporting any changes observed during visits (more restless sleep, new nocturia, unusual fatigue suggesting disturbed sleep), and by encouraging their loved one to use the bell before getting up.<\/p>\n\n<a href=\"https:\/\/www.dynseo.com\/courses\/prevenir-les-chutes-reperer-les-risques-agir-au-quotidien-et-reorganiser-lenvironnement\/\" class=\"internal-link\">\n  <div class=\"internal-link-icon\">\ud83c\udf93<\/div>\n  <div class=\"internal-link-content\">\n    <div class=\"internal-link-label\">Certified training<\/div>\n    <div class=\"internal-link-title\">Preventing falls: identifying risks, acting daily, and reorganizing the environment<\/div>\n    <div class=\"internal-link-desc\">DYNSEO Qualiopi training \u2014 nighttime falls, nighttime monitoring, nocturia, safe rising protocols. For the entire Nursing home team.<\/div>\n  <\/div>\n  <div class=\"internal-link-arrow\">\u2192<\/div>\n<\/a>\n\n<div class=\"cta-box\">\n  <h3>\ud83c\udf93 Train your team in nighttime prevention<\/h3>\n  <p>The DYNSEO training \u201cPreventing falls\u201d includes a module dedicated to nighttime falls \u2014 organization of monitoring, safe rising protocols, lighting, nocturia. Certified Qualiopi.<\/p>\n  <div class=\"cta-buttons\">\n    <a href=\"https:\/\/www.dynseo.com\/courses\/prevenir-les-chutes-reperer-les-risques-agir-au-quotidien-et-reorganiser-lenvironnement\/\" class=\"btn-cta-white\">\ud83d\udccb View the program<\/a>\n    <a href=\"https:\/\/www.dynseo.com\/formations\/\" class=\"btn-cta-outline\">All trainings \u2192<\/a>\n  <\/div>\n<\/div>\n\n<div class=\"article-tags\">\n  <a href=\"#\" class=\"article-tag\">nighttime falls Nursing home<\/a>\n  <a href=\"#\" class=\"article-tag\">safe nighttime rising<\/a>\n  <a href=\"#\" class=\"article-tag\">nocturia elderly people<\/a>\n  <a href=\"#\" class=\"article-tag\">nocturnal orthostatic hypotension<\/a>\n  <a href=\"#\" class=\"article-tag\">nighttime lighting safety<\/a>\n  <a href=\"#\" class=\"article-tag\">night monitoring Nursing home<\/a>\n  <a href=\"#\" class=\"article-tag\">DYNSEO training<\/a>\n<\/div>\n<\/article>\n<\/div>\n\n<\/div>[\/et_pb_code][\/et_pb_column][\/et_pb_row][\/et_pb_section]","_et_gb_content_width":"","footnotes":""},"categories":[2915],"tags":[],"class_list":["post-725871","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-les-conseils-des-coachs"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Nighttime Falls in Nursing Homes: Why They Happen and How to Prevent Them - DYNSEO - Educational apps &amp; 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