rhythm to the greatest extent possible. In facilities residents with personal sleep rituals frequently cannot realise their ideas of good sleep for varied reasons. Loneliness, little external stimulation, frequent or long naps during the day and a lack of exposure to light promote sleep disorders, which are increased by pain, the need to urinate, noise in the environment or physical impairments. In some nursing homes, the attempt is made to address individual sleep-wake rhythm by having increased activities in the late afternoon or sometimes even at night, or by letting residents sleep longer in the morning. Nonmedication-based offerings that promote health and sleep, providing a variety in the everyday life of the nursing home and fostering wellbeing and natural tiredness towards evening (e.g. outdoor excursions, ergo therapy, aromatherapy, music therapy, painting therapy or garden therapy, psychosocial care) are not used everywhere or not systematically enough. In large facilities, occupational offerings and leisure activities, as well as facilitation of physical activity, often provide more diversity, but are organised according to groups or categories and are not coordinated according to individual preferences for a meaningful daily structure so that not everyone can or wants to benefit from them equally. In some facilities, there are no offerings or only sporadic ones. This was observed particularly in Carinthia and in Burgenland. Many residents with restricted mobility go outdoors only when relatives, volunteers or persons performing civilian service take them out, even during warmer weather. The nursing staff usually does not have time for this. This occurs even when green spaces, raised planting beds or dementia gardens have been designed to create incentive for physical activity. Particularly less mobile residents therefore tend to spend too much time in bed because making them mobile requires individual attention that staff often cannot provide with the resources available. It must be taken into account that the sleep requirement of persons with dementia can decline in the course of their illness to around six hours per night (average figure). As a rule, it is impossible to compel them to sleep more by natural means. In the opinion of the NPM, sleep-inducing medication should generally never be the first choice, as they continue to have an effect the next day and cause a numbness or sleepiness that also increases the risk of falls. With regard to a facility in Lower Austria Commission 5 criticised that it does not correspond to a normal daily rhythm for many when everyone gets breakfast at 9 a.m. and lunch is already served at 11:30 a.m. It is also wrong to deprive persons of breakfast who do not wake up until 9 a.m. and to reprimand them for getting up late as Commission 3 reported about a facility in Styria. Dinner for everyone at 4:15 p.m. or 4:30 p.m., at which time sleeping pills are handed out to immobile residents, is clearly too early. During a visit by Commission 6 in a facility in Burgenland, at 3:30 p.m. only four persons were still having dinner in the communal room. All the other residents were already in their rooms and for the most part ready for bed. Commission 6 saw for itself that the kitchen in this facility had been Findings by the commissions 33