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The Hardest Part of Caregiving Nobody Talks About: Nighttime Care

By Taylor Donaldson, RN — Chief Customer Happiness Officer, Joe & Bella

The Hardest Part Of Caregiving Nobody Talks About: Nighttime Care &Raquo; Nighttime Caregiving 1 Scaled

When families ask me what Caregiving is really like, I always share the hard truth:

The hard part isn’t the appointments.

It’s not the paperwork, the medications, or even the difficult conversations.

It’s 3 AM.

It’s the sound down the hall that wakes you up, and you’re not sure if it’s something or nothing.

It’s lying there doing the math: if I fall asleep right now, I can still get four hours.

It’s the guilt of wanting one full night of Sleep, and feeling terrible for wanting it.

In my years as a geriatric nurse, I watched incredible, devoted Family caregivers slowly come undone, not from one big moment, but from hundreds of interrupted nights.

So today, I want to talk about why nighttime caregiving is genuinely harder and what actually helps.

Why Nighttime Caregiving Gets Harder as We Age

This isn’t just caregiving fatigue. There’s real biology behind it.

As we get older, our circadian rhythms shift. Older adults tend to get sleepy earlier and wake earlier, but they also experience lighter, more fragmented sleep.

Nighttime disorientation is common and can be startling for everyone in the house. For those living with dementia, this confusion is often referred to as sundowning, a phenomenon where symptoms worsen in the late afternoon and evening.

Medications that seem fine during the day can cause restlessness, frequent trips to the bathroom, or vivid dreams after dark.

In other words: nighttime disturbances aren’t a failure of caregiving. They’re often just biology.

Caregiver Sleep Deprivation: Why Your Rest Matters

First, and please understand this: your sleep is medical.

A caregiver running on empty makes more mistakes, feels more resentment, and burns out faster. Protecting your sleep isn’t selfish. It’s part of the care plan.

According to research on caregiver Burnout, chronic sleep deprivation affects decision-making, emotional regulation, and physical Health. When you don’t sleep, the quality of care suffers for everyone.

Practical Tips for Better Sleep While Caregiving

Here are a few strategies that actually help families manage nighttime caregiving:

1. Simplify the Nighttime Routine

The fewer steps between your loved one and comfortable sleep, the better.

Adaptive clothing that’s easy to get in and out of without fumbling with buttons or zippers in the dark makes a real difference at 2 AM for everyone involved. Look for clothing with side zippers, magnetic closures, or elastic waistbands.

Gripper socks can help too, especially at night, by reducing the risk of slips when getting out of bed.

2. Create a Handoff (Even a Small One)

If there’s a partner, sibling, or occasional helper, a rotating “on-call” night once or twice a week can be transformative. You don’t need full-time help to get one full night of sleep.

Consider:

  • Alternating nights with a spouse or family member
  • Hiring overnight care one night per week
  • Using respite care services periodically

3. Talk to Their Doctor About Timing

Medication schedules, fluid intake, and evening light exposure can all be adjusted. Many families don’t realize these are levers they can pull.

Ask about:

  • Moving diuretic medications to earlier in the day
  • Reviewing medications that may cause nighttime restlessness
  • Sleep aids or supplements that might be appropriate
  • Adjusting evening routines to support better sleep

4. Address Sundowning Symptoms

If your loved one experiences increased confusion or agitation in the evening:

  • Keep the environment well-lit before bedtime
  • Maintain consistent daily routines
  • Limit caffeine and sugar in the afternoon
  • Reduce stimulation in the evening hours

5. Give Yourself Permission to Grieve the Sleep You’ve Lost

Acknowledging the toll of sleep deprivation, instead of just pushing through, is often the first step toward actually improving it.

When to Seek Additional Support

If nighttime caregiving is becoming unmanageable, it may be time to:

  • Consult with a geriatric care manager
  • Explore in-home care options
  • Consider adult day programs to help regulate sleep-wake cycles
  • Join a caregiver support group to share strategies

You’re Not Alone

I’ve sat with a lot of exhausted caregivers over the years.

The ones who were hardest on themselves were always, without exception, the most devoted.

If you’re reading this at an unreasonable hour, you’re doing something really hard.

And you’re not alone in it.

Take care of yourself, too.

 


 

About the Author: Taylor Donaldson, RN is Joe & Bella’s Chief Customer Happiness Officer and a former geriatric nurse specializing in elder care and family caregiver support.

Related: If nighttime dressing and undressing is part of what’s making things harder, explore our collection of adaptive clothing for seniors designed with easy-on, easy-off features that eliminate fumbling in the dark.

Originally Published on https://joeandbella.com/blogs/news

Ben Graham Joe & Bella VP of Marketing

Ben Graham is the Vice President of Marketing at Joe & Bella, an adaptive-apparel company for older adults that focuses on creating innovative and fashionable apparel. Joe & Bella was recently awarded the “Most Innovative Older Adult Clothing Brand: 2022” by Global Health and “2022 Best New Apparel Brand” by Boomer Venture Summit. Joe & Bella’s first adaptive clothing line, CareZips, won the 2022 "Best New Product”award by Today’s Caregiver Magazine and Caregiver.com. Ben was previously Vice President of Marketing and Partnerships at Collaborata, an innovative marketing-research firm that brought corporate partners together to find solutions to business problems. Collaborata focuses on topics including caregiving, aging, diversity, and equity with clients such as AARP, Procter & Gamble, Bank of America, Target, and Nike. Ben spent many years, together with his family, providing care for his two grandparents who lived for nearly a decade in assisted living and memory care.

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