Problem solving scenario 3

Fela wakes in the night, and is becoming very vocal. He does not appear to have gone to the loo. What should staff do?

  • Check the camera in Fela’s bedroom to see if he is sitting up, his facial expression.
  • Vocally prompt him to go to the toilet from outside his door using few words in low tone e.g.  “toilet, Fela.”
  • When he is in the toilet, check the bed to see if it’s wet or if the bedding has come away from the corners, anything else out of the ordinary which could be causing him discomfort e.g. where is weighted blanket? Has eye mask fallen off? Is there blood on his pillow from scratching his keloids? Is CD player working properly as music should be on repeat.  
  • Avoid putting on overhead light – rely on light from staircase or blue lamp in bedroom on table facing downwards.
  • If Fela has wet the bed, you will need to change the bed as quickly as possible. Reassure Fela that everything is okay, and you are changing the bed, but keep conversation to a minimum so as not to stimulate his brain as he may not be fully awake.
  • Prompt Fela to sit on the toilet, put wet clothes in the basket and hand him new clothes one at a time.
  • Prompt him back to bed, and remind him it is time to sleep.
  • If Fela is showing signs of hitting his head, furrowed brow from camera or in person, when he returns to bed you can quickly apply some tiger balm to his forehead and behind his ears.
  • If Fela has been picking his keloids, turn over pillow with blood, hand him a small tub of aloe propolis or keloid cream when he returns to bed so he can self-apply.
  • Remove wet clothes and bedding from room, close door.
  • Avoid returning constantly to check on Fela as it could become a game. Allow him time to fall asleep.


N.B. Bright light will wake Fela up making it difficult to return to sleep. The eye sends signals to the brain that it’s time to get up; this is what the sun does in the morning.

Avoid applying witch hazel or aloe vera as this will have too jarring an effect because they will create a cold sensation. This will wake Fela more; also he may become overstimulated by the attention of staff, and keep being noisy to continue to get attention and more TLC.