How do you keep elderly from rolling out of bed? A guide to preventing falls

According to the Centers for Disease Control and Prevention (CDC), falls are a major health concern for older adults, and those occurring from bed are a significant risk. Understanding how do you keep elderly from rolling out of bed is crucial for ensuring their safety and providing peace of mind for both the individual and their caregivers. This comprehensive guide explores multiple practical and compassionate solutions to mitigate this risk.

Quick Summary

This guide provides practical strategies and product options to prevent older adults from rolling out of bed, addressing fall risks through safety rails, wedges, and low-profile beds. It also covers the use of bed alarms and creating a safer bedroom environment with proper lighting and assistive devices.

Key Points

• Start with Assessment: Determine the root cause of nighttime restlessness, such as dementia, medication side effects, or nocturia, to choose the right interventions.

• Use Protective Barriers: Install adjustable bed rails or place soft foam wedges/pool noodles under the sheets to create a safe, physical boundary.

• Lower the Bed Height: Consider using a low-profile bed frame or adjustable hospital bed to reduce the impact of a fall, minimizing the distance to the floor.

• Install Bed Alarms: Utilize weight-sensitive bed pads or motion sensor alarms to alert caregivers when an individual is attempting to leave the bed.

• Optimize the Bedroom Environment: Improve lighting with nightlights, remove clutter from walking paths, and ensure the mattress provides firm, supportive comfort.

• Explore Low-Tech Aids: Simple changes like providing a bedside commode for frequent urination or keeping assistive devices within reach can prevent unnecessary nighttime trips.

Assess the Root Cause of Nighttime Mobility

Before implementing specific solutions, it’s important to understand why an elderly individual might be rolling or getting out of bed. Reasons can vary widely and include cognitive impairment like dementia, medication side effects, frequent urination (nocturia), disorientation, or general restlessness. Tailoring a solution to the specific cause is more effective than a one-size-fits-all approach. Consulting with a healthcare professional can help identify the underlying issues.

Use Safety and Barrier Devices

For many, a physical barrier is the most direct way to prevent rolling out of bed. There are several options to consider, from traditional bed rails to more discreet alternatives.

• Bed Rails and Assist Rails: Traditional bed rails, similar to those found in hospitals, can be used on a regular bed. Many come with adjustable or collapsible features. Half-length rails are popular as they prevent falls but still allow the user to exit the bed freely at the foot. Assist rails, or bed canes, are smaller handles that help a person sit up or get in and out of bed with stability.

• Bed Bumpers and Wedges: For a softer, less obtrusive barrier, foam wedges or bolsters can be placed under the fitted sheet along the edge of the mattress. A budget-friendly option is to use pool noodles and place them in the same manner, creating a gentle ridge that alerts the sleeper they are near the edge.

• Low-Profile Beds: One of the most effective strategies is to minimize the distance to the floor. Low-profile beds, or hospital beds with adjustable heights, reduce the risk of injury if a fall occurs. Some specialized beds can even lower to just a few inches from the ground.

Employ Bed and Motion Alarms

For individuals with cognitive issues, a bed alarm can alert caregivers the moment the person attempts to get up. This provides valuable time to intervene before a fall happens.

• Weight-Sensing Bed Pads: These pads are placed under the mattress or fitted sheet. When pressure is removed from the pad, an alarm sounds to notify a caregiver.

• Wireless Alarms with Pagers: For caregivers who are in another room, a wireless sensor pad that communicates with a portable pager or remote monitor is an excellent option. This ensures they are instantly alerted without the alarm noise startling the sleeper.

• Motion Sensor Alarms: Infrared sensors can be placed beside the bed to trigger an alarm when motion is detected. These are especially useful for preventing wandering in addition to falls.

Create a Safe and Supportive Sleep Environment

The entire bedroom layout and atmosphere can play a significant role in preventing falls and ensuring a restful night.

• Optimize Lighting: Use motion-activated nightlights in the bedroom, hallway, and bathroom. A bedside lamp with an easy-to-use switch should also be within reach. This helps orient the person and reduces tripping hazards when they are disoriented or get up at night.

• Declutter the Floor: Keep the path from the bed to the bathroom completely clear of clutter, cords, and loose rugs. Even small objects can become major tripping hazards in the dark.

• Ensure Proper Bed Height and Mattress Firmness: The bed should be low enough so that the individual can sit on the edge with their feet flat on the floor and their knees at a 90-degree angle. A mattress that is too soft can make it difficult to change position and get out of bed safely, so a medium-firm mattress is often recommended.

• Improve Nighttime Routine and Comfort: A calming, consistent bedtime routine can help reduce confusion and restlessness. For those with frequent nighttime bathroom needs, a bedside commode can eliminate the need for a risky, hurried trip to the bathroom. Supportive pillows can also help with positioning and comfort.

Comparison of Bed Safety Options

Feature	Bed Rails	Bed Bumpers/Wedges	Bed Exit Alarms	Low-Profile Beds	Environmental Changes
Cost	Varies, typically affordable	Low cost (pool noodles) to moderate (specialized foam)	Moderate to high	High	Low cost, mostly labor
Invasiveness	Can feel restrictive or "hospital-like"	Non-invasive, placed under sheets	External monitor and sensor pad	Significant bedroom change	Minimal disruption
Primary Function	Physical barrier, grasping support	Passive barrier, soft reminder	Active alert for caregivers	Fall height reduction	Fall prevention, orientation
Caregiver Dependency	Low (if for support) to moderate (if full rails)	Low	High (requires monitoring response)	Low	Low
Best For	Independent use for stability, rolling prevention	Mild rolling prevention, resistance to hard rails	Cognitive decline, wandering, high fall risk	Severe fall risk, frequent getting in/out of bed	Everyone, foundational safety step

Implement Safety with Compassion

When introducing any safety measure, it's vital to do so with sensitivity. Many older adults value their independence and may resist changes they perceive as limiting. Explain the purpose of the changes, framing them as a way to enhance safety and promote restful sleep, rather than as a form of restraint. If an individual is resistant to metal rails, suggesting softer, less visible options like bed bumpers or a low bed can be a more agreeable solution. Involving the person in the decision-making process will increase their acceptance and adherence to new safety protocols.

Consult with Professionals

Sometimes the solution requires professional insight. A physical therapist can recommend exercises to improve balance and strength, while an occupational therapist can suggest further home modifications to enhance mobility. If medications are a concern, a doctor can review dosages or switch to alternatives that cause fewer side effects like dizziness or disorientation at night.

Conclusion

Effectively addressing the issue of how do you keep elderly from rolling out of bed requires a multi-faceted approach. By combining physical barriers like bed rails or wedges, technological aids such as bed exit alarms, and strategic environmental modifications, caregivers can significantly reduce the risk of falls. A supportive and empathetic approach is key to implementing these changes successfully, ensuring the elderly individual feels safe and respected. The right combination of tools and a safe sleep environment can provide peace of-mind for everyone involved, promoting a safer, more restful night.

Frequently Asked Questions

Are bed rails safe for elderly individuals?

Yes, when used correctly and after proper assessment, bed rails can be very safe. However, they should not be used as a restraint. For some individuals, particularly those with dementia, bed rails can present a risk of entrapment, so softer alternatives like foam bumpers or wedges may be safer.

What are alternatives to bed rails for the elderly?

Effective alternatives to bed rails include using foam wedges or pool noodles placed under the fitted sheet, using a low-profile bed to minimize fall height, and implementing bed alarms that alert caregivers when motion is detected.

How can bed alarms help prevent falls?

Bed alarms use a pressure-sensitive pad or motion sensor to notify a caregiver the moment an elderly individual tries to exit the bed. This allows for immediate intervention, preventing the person from getting up unassisted and falling.

Is it better to have a low bed for fall prevention?

Yes, for individuals at high risk of falling, a low-profile or adjustable hospital bed is often recommended. This reduces the distance to the ground, significantly minimizing the risk of serious injury if a fall does occur.

How do environmental changes help prevent falls from bed?

Simple environmental changes like installing motion-activated nightlights, clearing pathways of clutter, and keeping assistive devices close by can help orient the person and prevent tripping hazards in the dark, reducing the likelihood of a fall.

Can medication side effects cause falls from bed?

Yes, some medications can cause dizziness, grogginess, or disorientation, increasing the risk of a fall during the night. Consulting with a doctor to review and potentially adjust medications is an important step in fall prevention.

What if an elderly person resists safety measures?

Resistance is common, especially if the person feels a loss of independence. Introduce changes with empathy, focusing on their safety and well-being. Start with less intrusive options, like discreet bed bumpers or softer environmental changes, and involve them in the decision-making process to increase acceptance.