{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T15:34:05Z","timestamp":1790609645786,"version":"4.1.0"},"reference-count":44,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T00:00:00Z","timestamp":1774310400000},"content-version":"vor","delay-in-days":23,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R33AG058926"],"award-info":[{"award-number":["R33AG058926"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["K24AG070106"],"award-info":[{"award-number":["K24AG070106"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Persons living with dementia (PLWD) frequently experience prolonged stays in the emergency department (ED), an environment poorly suited to their complex needs. Sleep disruption is common in this setting and may heighten delirium risk. While inpatient sleep interventions show promise, their adaptation to the ED remains unexplored. This study used a co\u2010design approach to identify strategies to promote sleep for PLWD boarding overnight in the ED.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a qualitative co\u2010design study using semi\u2010structured interviews and focus groups with ED nurses, technicians, caregivers of PLWD, and community advisors. Participants were recruited from two Massachusetts EDs, a post\u2010acute rehabilitation facility, and a community advisory board. Transcripts were analyzed thematically using a combined inductive\u2010deductive approach informed by the Consolidated Framework for Implementation Research (CFIR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty\u2010six participants (15 ED clinicians, 3 caregivers, 8 community advisors) contributed perspectives. Three overarching domains emerged: (1) current practices\u2014participants described the ED as a noisy, brightly lit, and disruptive environment that undermines sleep; (2) potential solutions\u2014stakeholders suggested structured nighttime routines, clustering of care tasks, noise and light reduction strategies, delirium carts offering non\u2010pharmacologic interventions, and greater caregiver involvement; and (3) barriers and facilitators\u2014participants emphasized staffing constraints, lack of dementia\u2010specific training, and the need for local \u201cchampions\u201d to sustain interventions. Community advisors stressed tailoring approaches to individual patient needs and involving caregivers in decision\u2010making.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Through participatory co\u2010design, we identified multilevel strategies to improve sleep for PLWD boarding in the ED. Interventions that reduce environmental stimulation, integrate familiar routines, and enhance staff dementia training may mitigate sleep disruption and delirium risk. Future work will evaluate implementation feasibility and downstream effects on patient outcomes across diverse ED settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/acem.70274","type":"journal-article","created":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T04:46:35Z","timestamp":1774413995000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Co\u2010Design of a Sleep Improvement Intervention for Persons Living With Dementia Boarding in the Emergency Department"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4106-7055","authenticated-orcid":false,"given":"Adrian D.","family":"Haimovich","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine Beth Israel Deaconess Medical Center  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie","family":"Jansen","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Beth Israel Deaconess Medical Center  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Nessen","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-0518-2706","authenticated-orcid":false,"given":"Sumin","family":"Yoon","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sydney","family":"Mulqueen","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Beth Israel Deaconess Medical Center  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kylee","family":"Maclean","sequence":"additional","affiliation":[{"name":"Hinda and Arthur Marcus Institute of Aging Research and Department of Medicine Hebrew SeniorLife  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Kerman","sequence":"additional","affiliation":[{"name":"Department of Medicine Beth Israel Deaconess Medical Center  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah D.","family":"Berry","sequence":"additional","affiliation":[{"name":"Hinda and Arthur Marcus Institute of Aging Research and Department of Medicine Hebrew SeniorLife  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anita","family":"Chary","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,24]]},"reference":[{"issue":"8","key":"e_1_2_12_2_1","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1016\/j.jamda.2022.05.024","article-title":"Optimal Emergency Department Care Practices for Persons Living With Dementia: A Scoping Review","volume":"23","author":"Dresden S. 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