Noise How noisy is too noisy?


Excessive noise in care settings can have a detrimental effect on residents’ health and wellbeing. Tim Dallinger of Social Care Consultants Ltd explains why care homes should be taking this issue seriously


Care homes can be such noisy places. As a hearing-impaired person, I am quite noise sensitive, and I know that sounds really strange. I visited a care home recently to support them with some compliance issues and I was conscious of the constant noise. Most of the time I can tune out the noise, but this time I decided to listen to see if I could identify the various sources of the noise. I could hear the call bells, the TV (on volume 99) from the bedroom next door to the manager’s office, and staff speaking loudly both to each other and to people who live in the care home.


It is difficult to obtain data on noise


levels in care homes, as few studies have been carried out, but if we look at the equivalent noise levels in hospitals this gives us a useful comparison. According to the Dementia Services Development Centre at the University of Stirling, noise levels in hospitals have increased over the last 40 years, seeing a rise from 57 to 72 decibels (dB). Even in intensive care units, which cater to the most vulnerable patients, noise levels over 100dB have been measured. Some examples of excessive noise include dropping a stainless-steel bowl, which creates a noise level of around 108 dBs – more than the 100 dBs caused by a nearby car horn. Raising/lowering a bed rail can be as loud as 90dB; this is actually as loud as a lawnmower, which requires the user to wear ear protection. Just the simple act of dropping rubbish in a foot-operated bin has a noise level 53-82dB, which is as loud as a busy street.


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The World Health Organisation (WHO) that noise levels in healthcare


settings do not exceed 40-50dB in the daytime. At night they should be below 30-35dB. It is important to note that dB


40


are logarithmic, so 50dB is 10 times more powerful than 40dB, and 60dB is 100 times more powerful than 40dB. From this, we can conclude that health and care settings have become much noisier and that the noise levels are often in excess of recommended limits.


What is the impact of excessive noise? Excessively loud noise can have significant negative effects on individuals, both physically and mentally. Physically, exposure to loud noise can lead to hearing damage, including permanent hearing loss. Prolonged exposure to high decibel levels may damage the delicate structures of the inner ear. On a mental and emotional level, loud noise can cause stress, anxiety, and fatigue. It interferes with concentration, disrupts sleep patterns, and may contribute to irritability and mood disturbances. Chronic exposure to loud noise has also been linked to increased risk of cardiovascular issues such as hypertension. In various settings, including workplaces, residential areas, and public spaces, managing and


Dropping rubbish in a foot- operated bin has a noise level 53-82dB, which is as loud as a busy street


minimising excessively loud noise is essential to safeguarding individuals’ overall health and wellbeing. How often do we think about the impact of this noise on people who live in care homes, and what action do we take to reduce noise and provide a pleasant living and working environment? Excessive noise in care homes can have profound negative effects on older people. Research indicates that older individuals are particularly vulnerable to the detrimental impacts of noise pollution. High noise levels have been associated with increased stress, agitation, and sleep disturbances among the elderly in care settings (Algase et al., Coss et al.2, 3


).


These disruptions can further exacerbate cognitive decline and contribute to a decline in overall wellbeing (Cohen-Mansfield et al.4


). Noisy environments can cause


emotional overload and confusion, and can lead to occurrences of behaviour which services find challenging. Of all stimuli, noise has the most damaging effect on people with dementia (Dewing5


).


There is good noise and bad noise. Good noise, such as engaging conversations, soothing music, and laughter, contributes to a vibrant and supportive environment, fostering social connections and mental stimulation. Conversely, excessive or disruptive noise, like loud alarms or unnecessary clamour, can be detrimental,


www.thecarehomeenvironment.com March 2024


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