Managing sleep disturbances in adult family homes: recruitment and implementation of a behavioral treatment program.

This article describes a sleep education program (SEP) designed to teach owner/operators and direct-care staff working in adult family homes (AFHs) how to improve the sleep and nighttime behavior of older residents with dementia. There have been no sleep intervention studies conducted in AFHs, and strategies that are known to improve sleep in community-dwelling older adults or nursing home residents may not be feasible or effective in AFHs because of their unique care environment. The SEP was developed on the basis of experiences treating sleep disturbances in community-dwelling older adults with dementia (the Nighttime Insomnia Treatment and Education in Alzheimer's Disease study). In this article, we address both the clinical and empirical challenges faced by researchers recruiting and intervening in AFHs, raise issues pertinent to assessment of residents and staff, and discuss implications for evaluating the impact of behavioral treatments for sleep-wake disturbances in AFH residents.