How do you stop an elderly person from getting out of bed? A Comprehensive Safety Guide

According to the CDC, over one in four adults age 65 and older falls each year, with many falls occurring at night. Understanding why and how do you stop an elderly person from getting out of bed safely is crucial for preventing injury and maintaining a loved one's independence.

Quick Summary

Safely preventing an elderly person from exiting their bed alone involves a multi-faceted approach, including environmental modifications, bed alarms, implementing consistent routines, and addressing underlying medical conditions like nocturia or sundowning.

Key Points

• Identify the cause: Determine if confusion, nocturia, pain, or sundowning are the reasons for getting out of bed before implementing solutions.

• Modify the environment: Lower the bed, use motion-activated nightlights, and remove tripping hazards like clutter and rugs to reduce fall risks.

• Use bed alarms and sensors: Deploy pressure-sensitive pads or motion sensors to alert caregivers when a person is attempting to leave the bed, allowing for a timely and safe response.

• Establish a calming routine: Implement a predictable daytime and nighttime routine to minimize restlessness and confusion, especially for individuals with dementia.

• Address underlying issues: Consult a healthcare professional to review medications, manage sleep disorders, and treat physical discomfort that may be causing nighttime unrest.

• Consider non-restrictive barriers: Use bed wedges, body pillows, or pool noodles to provide a gentle reminder of the bed's edge without acting as a physical restraint.

• Place essentials nearby: Keep a bedside commode, phone, glasses, and walker within easy, safe reach to reduce the need for getting up during the night.

Understanding the Reasons for Getting Out of Bed

To address the behavior effectively and with compassion, it is essential to first understand the root cause. A senior getting out of bed frequently at night is not necessarily willful but often a symptom of an underlying issue. Common reasons include:

• Confusion or disorientation: This is especially prevalent in individuals with dementia or Alzheimer's, who may wake up disoriented and believe it's time to start their day or go somewhere else.
• Sundowning syndrome: Characterized by increased confusion and agitation in the late afternoon and evening, sundowning can lead to restlessness and a greater desire to wander at night.
• Nocturia: The need to use the bathroom frequently at night is a major cause for getting out of bed and increases fall risk, especially when the person is tired or disoriented.
• Physical discomfort: Pain from arthritis, body aches, or an uncomfortable mattress can lead to restlessness and the desire to move or get up.
• Side effects of medication: Some medications, or combinations of medications, can cause dizziness, drowsiness, or wakefulness, contributing to confusion and an unstable gait.
• Anxiety and boredom: A lack of daytime stimulation can result in pent-up energy, while anxiety can cause sleeplessness and pacing.

Creating a Safe and Supportive Bedroom Environment

Modifying the bedroom can significantly reduce fall risk and provide a sense of security.

• Lower the bed: A low-profile bed reduces the distance to the floor, minimizing the risk of serious injury if a fall does occur. When seated on the edge, the person's feet should be flat on the floor and their knees at a 90-degree angle for safe entry and exit.
• Ensure optimal lighting: Install motion-activated nightlights along the path to the bathroom and a lamp that is easy to turn on from the bed. Sufficient lighting helps reduce confusion caused by shadows.
• Reduce clutter: Keep pathways clear of items like clothes, wires, and furniture. If throw rugs are necessary, secure them with double-sided tape or non-slip backing to prevent tripping.
• Place a fall mat: A cushioned mat placed beside the bed can soften a fall, potentially preventing a serious injury.
• Utilize bed barriers: For those who tend to roll out of bed, consider alternatives to traditional bed rails, which can sometimes be seen as a restraint. Long body pillows, wedge pillows, or pool noodles placed under a fitted sheet can act as a gentle physical reminder of the bed's edge.

Utilizing Technology for Bedside Safety

Technology can provide an added layer of security by alerting caregivers when a senior is attempting to get out of bed.

• Bed alarms: Pressure-sensitive bed pads, placed under the mattress or sheet, trigger an alarm when the person's weight is removed. Some systems use wireless alerts to notify a caregiver on a remote pager.
• Floor sensor pads: These are placed on the floor next to the bed and alert a caregiver when pressure is applied, indicating the person has gotten out of bed.
• Motion sensor alarms: These devices create a field around the bed and trigger an alarm when the person breaks the field by attempting to stand. They can be more sensitive but also more prone to false alarms from other movements.
• Smart home devices: Voice-activated lights or motion-activated systems can reduce the need for a senior to get out of bed for simple tasks like turning on a light.

Establishing Consistent Routines and Addressing Underlying Issues

Behavioral strategies and medical consultation are vital for long-term safety and well-being.

• Create a structured daily routine: A predictable schedule of meals, activities, and bedtime can reduce anxiety and confusion, especially for individuals with dementia. Maximizing activity during the day, such as walks or social engagement, can help promote better sleep at night.
• Manage sundowning: Strategies include increasing daytime light exposure, minimizing noise and stimulating activities in the evening, and playing soothing music. Consistent routines are key to managing this symptom.
• Provide a bedside commode: For seniors who need to use the restroom frequently at night, placing a commode nearby eliminates the need for a potentially hazardous walk in the dark.
• Review medications: Consult with a doctor or pharmacist to review all medications, as side effects can impact balance and sleep. Dosage or timing adjustments may help.
• Address physical discomfort: Ensure the person is comfortable in bed. Check that the room temperature is comfortable and the mattress is not sagging. Gentle stretches or a warm, decaffeinated drink before bed can also be soothing.

Choosing the Right Safety Measure: A Comparison Table

Feature	Bed Alarms (Pads/Mats)	Bed Rails/Barriers	Consistent Routine/Behavioral	Professional Consultation
Primary Function	Alerts caregiver of exit	Prevents rolling out, provides grip	Addresses root cause of restlessness	Identifies underlying issues
Effectiveness	High for alerting caregivers	High for preventing rolling	High for reducing underlying causes	High for holistic improvement
Dignity	Can be intrusive (alarm sound)	Can be seen as restrictive	Preserves dignity, empowering	Upholds dignity, collaborative
Cost	Varies, relatively affordable	Low (pool noodles) to mid-range (rails)	Free (requires time/effort)	Covered by insurance, often necessary
Best For	Seniors with mobility issues, dementia	Those who accidentally roll out	Individuals with sundowning, confusion	Anyone with new or escalating issues
Considerations	False alarms, habituation	Potential for entrapment, restraint	Requires consistency, trial and error	Requires active caregiver participation

For additional resources on safe caregiving practices, consult the Centers for Disease Control and Prevention's STEADI initiative.

Conclusion

Preventing an elderly person from getting out of bed safely is a priority for caregivers. Instead of focusing solely on physical restraints, a compassionate and holistic approach is far more effective. By combining environmental modifications, leveraging technology like bed alarms, and addressing the root causes through routine and medical consultation, caregivers can create a dignified and secure environment. This comprehensive strategy not only prevents falls but also improves the overall quality of life for the senior in your care.

Frequently Asked Questions

Is it safe to use bed rails to stop an elderly person from getting out of bed?

While bed rails can prevent rolling out of bed, they are not always the safest option. They can sometimes cause entrapment or injury, and can be seen as a restraint. Alternatives like bed alarms, low beds, or barrier pillows are often safer and more dignified.

What is sundowning and how does it affect someone getting out of bed?

Sundowning is a state of increased confusion, anxiety, and agitation that occurs in the late afternoon and evening, primarily in people with dementia. It disrupts sleep-wake cycles and can cause a person to feel restless and attempt to get out of bed.

Can medication side effects cause an elderly person to get out of bed at night?

Yes, many medications can cause side effects like dizziness, drowsiness, or confusion, which can disrupt sleep patterns and increase the risk of an elderly person getting out of bed and falling. Regular medication reviews with a doctor are important.

What are some practical, low-cost ways to prevent an elderly person from falling out of bed?

Affordable options include using pool noodles or rolled-up blankets under the fitted sheet as a gentle barrier, placing a fall mat on the floor, and improving lighting with inexpensive motion-activated nightlights.

How do bed alarms for the elderly work?

Bed alarms typically use pressure-sensitive pads placed under the mattress. When the person's weight is removed, the change in pressure triggers an alarm, either audible in the room or sent wirelessly to a caregiver's pager.

How can a consistent routine help with nighttime wandering?

A predictable daily routine provides structure and reduces anxiety for seniors, especially those with dementia. Maximizing daytime activity and maintaining consistent sleep and wake times can lead to improved nighttime sleep and less restlessness.

What should I do if an elderly person wakes up disoriented and wants to get out of bed?

Approach them calmly and speak in a reassuring voice. Use redirection by offering a familiar activity, a light snack, or gentle music. Avoid arguing or correcting their perception of the time or situation, as this can increase agitation.