Imagine being in a deep, restful sleep, only to be jolted awake in the early hours of the morning by a staff member insisting that you must get up for a shower. You are disoriented, exhausted, and have no choice in the matter. For many aged care residents, this is not an occasional disruption – it is a daily reality.
In some aged care facilities, residents are being forcibly woken as early as 5 AM to be showered – solely for the convenience of staff. This practice is not just unethical; it is a form of institutional abuse that violates the dignity and autonomy of some of the most vulnerable members of society.
The justification for this practice varies. Some facilities have long-standing routines that mandate residents be showered before breakfast, while others enforce it to lighten the workload for morning shift staff.
Regardless of the reasoning, the outcome is the same: residents are deprived of their right to sleep and their basic autonomy is disregarded.
Sleep deprivation is well-documented as a serious health concern. Research from the University of New South Wales has already highlighted how another common aged care practice – repositioning residents every two hours to prevent bedsores – can cause severe agitation and distress, disrupting natural sleep rhythms.
The researchers describe this ongoing disruption as “unintentional institutional elder abuse.”
The Australian Journal of Ageing has published findings demonstrating that disrupted sleep patterns in aged care settings contribute to behavioural and psychological symptoms of dementia (BPSD), including agitation, aggression, and increased confusion.
Given that a significant proportion of aged care residents live with dementia, it is imperative to adopt care models that promote natural sleep cycles rather than disrupt them for arbitrary routines.
Physically, sleep deprivation can lead to weakened immune systems and slower recovery from illnesses, making elderly individuals even more vulnerable in aged care environments.
According to the Sleep Health Foundation, adequate sleep supports cardiovascular health, metabolic function, and overall quality of life. When residents are woken prematurely for showers, their body’s natural circadian rhythm is disrupted, leading to grogginess and increased fall risk—a particularly serious concern in aged care.
Many aged care workers argue that they are simply following procedures. Some report that they are pressured to complete tasks as quickly as possible, fearing backlash from the morning shift if showers are left undone.
In an online aged care worker forum, one worker candidly admitted: “We have to wake them up. Thought it was the same for all facilities. Always has been in my 15 years of nursing. Wake up, shower before breakfast.”
Another stated: “If not done, day staff would complain to the manager.”
But while staff shortages and high workloads are legitimate concerns, they do not justify mistreating residents.
The fundamental issue is that the system prioritises efficiency over person-centred care. If staffing levels were adequate and care minutes properly allocated, there would be no need to wake residents at inhumane hours.
Some aged care providers are already moving towards more ethical, resident-focused models of care. Facilities implementing the “homemaker model” allow residents to wake naturally and shower when they feel ready, rather than adhering to a rigid schedule designed for staff convenience.
One aged care worker described the benefits of this approach: “Residents can cook their own toast and make their own coffee in the dining room. Staff assist them as they wake up, rather than forcing them into a one-size-fits-all routine.”
This model fosters independence, respects personal preferences, and aligns with basic human dignity. It is their home – we merely work in it.
Aged care reform must address the cultural shift required to eliminate these outdated and harmful practices. In countries such as the Netherlands and Denmark, aged care models prioritise individual autonomy, with residents deciding when to wake, eat, and bathe.
Studies from the European Journal of Ageing suggest that such approaches result in higher satisfaction among residents and lower stress levels among staff.
Australia has made great strides in recent years, with fewer and fewer homes opting to wake residents for showers. However, there needs to come a time when this practice is no longer an option at all.
The question is no longer whether we should change this practice, but why it is still happening in the first place.
