How do you stop elderly from sliding down in bed?

Over 1 in 4 older adults report falling every year, and in-bed sliding is a significant contributor to injury for those with limited mobility. Understanding how to stop elderly from sliding down in bed is critical for providing safe and effective senior care. This guide offers practical advice and product recommendations to ensure your loved one's safety and comfort.

Quick Summary

Address the root causes of sliding by ensuring proper bed positioning, utilizing supportive equipment like adjustable hospital beds and specialized mattresses, and implementing correct patient repositioning techniques. Non-slip linens and bed rails can also enhance safety and stability.

Key Points

• Elevate the Knees: Bending the knees with a pillow or bed adjustment cradles the patient, preventing them from sliding down when the head is raised.

• Use Non-Slip Bedding: Swap slippery sheets for high-friction options and use sheet holders to keep linens in place and prevent movement.

• Consider an Adjustable Bed: An electric hospital bed allows for precise positioning and reduces the physical strain of repositioning for both patient and caregiver.

• Implement Safe Repositioning: Use friction-reducing sheets and mechanical lifts, especially for immobile patients, to prevent skin shearing and caregiver back injury.

• Position Strategically: Use wedges and body pillows to create a supportive 'nest,' align the spine, and relieve pressure on vulnerable areas.

• Reduce Shearing: Avoid raising the head of the bed more than 30-45 degrees, as this increases the risk of shearing force on the skin.

• Encourage Gentle Movement: In-bed exercises like leg and ankle movements improve circulation and help the individual maintain better control over their body.

Understanding the Risks of Sliding in Bed

Sliding, also known as migrating, can cause discomfort and serious health complications for elderly and bed-bound individuals. When a person slides down in bed, their body weight shifts and concentrates on the sacrum, coccyx, and buttocks. This creates friction and shear forces that can lead to skin damage and pressure ulcers, or bedsores. It also increases the risk of falls and injury, especially during transfers or when the head of the bed is elevated. Proper preventative measures are vital for maintaining skin integrity and overall safety.

Practical Positioning and Equipment Solutions

Utilize Specialized Beds and Mattresses

Using an adjustable bed frame is one of the most effective solutions, as it allows caregivers to adjust the bed's position to prevent sliding. An electric hospital bed, for instance, can elevate the knees, which cradles the patient's bottom and prevents them from moving toward the foot of the bed when the head is raised.

• Adjustable Hospital Beds: Look for models with a 'Fowler function,' which automatically adjusts pressure in the mattress to reduce skin shearing when the head of the bed is raised.
• Low-Friction Mattresses: Consider purchasing a mattress with a low-shear, low-friction cover. These covers prevent the skin from 'grabbing' and tearing as the patient moves.
• Air Mattresses: Specialized alternating pressure mattresses or air-assisted positioning devices can help distribute pressure more evenly and reduce the risk of bedsores from sliding.

Employ Strategic Use of Pillows and Wedges

Strategic use of pillows and foam wedges can provide stable support and fill gaps that cause sliding.

• Elevate the Knees: Place a pillow or wedge underneath the knees to create a bend in the leg. This helps prevent the patient from sliding down when the head of the bed is inclined.
• Create a Nest: A U-shaped body pillow or multiple pillows placed alongside the senior can create a feeling of security and prevent rolling.
• Prop the Heels: Placing a pillow lengthwise under each leg can float the heels off the mattress, reducing pressure and shear on these vulnerable areas.

Implement Non-Slip Linens and Accessories

Standard bedsheets can be slick, contributing to sliding. Opt for materials that increase friction and grip the mattress.

• Non-Slip Bed Linens: Bed linens with a silicone backing or textured surface can provide increased friction.
• Sheet Holders: Devices designed to clip sheets securely to the mattress can prevent them from shifting and creating a slippery surface.
• Pool Noodles: A cost-effective DIY solution is to place a pool noodle under the fitted sheet along the sides of the bed. This creates a gentle bumper to prevent rolling and reminds the person not to get too close to the edge.

Safe Repositioning Techniques for Caregivers

Manual lifting can cause back strain for caregivers and shear injury for the patient. Utilize these techniques for safer repositioning.

• Use Lift Equipment: For heavier or immobile patients, use a ceiling-mounted or mobile lift. The American Nurses Association advocates for eliminating manual lifting in healthcare settings due to injury risk.
• Friction-Reducing Sheets: A slide sheet placed under the patient makes it much easier to move them without dragging their skin across the mattress.
• Trendelenburg Position: If medically appropriate and approved by a healthcare professional, temporarily tilting the bed with the head lower than the feet can assist with repositioning.
• Engage Patient Assistance: For those who can help, encourage them to bend their knees and bridge their hips up or use a trapeze bar to help with movement.

Comparison of Bed Types for Senior Care

Feature	Standard Bed	Home Hospital Bed
Adjustability	None	Full electronic control (head, foot, and height)
Safety	Requires external rails or aids	Integrated safety rails, lower height settings, and sometimes auto-adjust features
Pressure Relief	Can be inadequate for immobile patients	Designed with low-shear, pressure-reducing surfaces; compatible with specialty air mattresses
Patient Comfort	Standard comfort, but limited for those with pain or mobility issues	Provides versatile positioning to alleviate pressure and improve circulation
Cost	Lower initial cost	Higher initial investment, but may be covered by insurance or durable medical equipment benefits
Aesthetics	Wide range of styles	Can have a more clinical appearance, though residential-style options are available

Additional Preventative Measures

Consider the Patient's Health

• Assess Medications: Certain medications can cause dizziness, confusion, or restlessness, increasing the risk of sliding and falls. Consult a physician if you suspect a medication is a contributing factor.
• Encourage Exercise: Simple, in-bed exercises like leg lifts and ankle pumps can improve circulation and build strength, giving the individual more control over their position. The National Institute on Aging offers many resources for senior health.
• Regular Skin Checks: Frequently inspect the skin, especially over bony areas like the tailbone, elbows, and heels, for any redness or signs of damage.

Optimize the Environment

• Ensure Proper Lighting: Install motion-activated nightlights to help with nighttime orientation and prevent falls during trips to the bathroom.
• Maintain Bedside Access: Keep essential items, such as a phone, glasses, or remote, within easy reach to prevent the person from straining or overreaching.

When to Seek Professional Guidance

If you've implemented these strategies and the problem persists, it may be time to consult with a healthcare professional, a physical therapist, or a geriatric care manager. A professional can offer personalized recommendations and assess whether an underlying medical issue is contributing to the sliding. Sometimes, a specialized mattress or different bed type is necessary for a patient's specific needs.

Conclusion

Effectively addressing the issue of an elderly person sliding down in bed requires a multi-faceted approach. By combining the right equipment, proper positioning, and safe repositioning techniques, caregivers can significantly reduce the risks of injury, bedsores, and discomfort. Regularly assessing the situation and working with healthcare experts ensures that your loved one receives the safest and most dignified care possible.

Frequently Asked Questions

What is the primary cause of an elderly person sliding down in bed?

The primary cause is a combination of gravity, low mobility, and shear forces. When the head of the bed is elevated, a person's body weight shifts downward, causing them to slide. This is exacerbated by slippery linens or a non-supportive mattress.

How can pillows be used to prevent a person from sliding?

Place a firm pillow or foam wedge under the knees to create a natural bend, which stops the person from sliding. Pillows can also be used to create side bumpers or support the arms and back for better alignment and stability.

What are shear forces and why are they important?

Shear forces are caused by the skin sticking to a surface while underlying tissue and bone move. When a person slides, this force can stretch and damage deep tissue, which is a major cause of pressure ulcers. Minimizing sliding is key to preventing shearing.

Are bed rails a good solution to prevent sliding?

Bed rails can be effective for preventing falls out of bed but are not designed to stop a person from sliding downwards. In fact, relying solely on rails can create a feeling of entrapment and cause a person to try and climb over them, leading to a more dangerous fall.

Can certain types of mattresses help prevent sliding?

Yes. Mattresses with low-friction covers are designed to reduce the shear forces that contribute to sliding. Alternating pressure or low-air-loss mattresses can also help by distributing pressure more evenly and preventing skin breakdown.

How should a caregiver safely reposition a patient who has slid down?

The safest method is to use a slide sheet or a mechanical lift to lift the person rather than pulling. When lifting, use gravity to your advantage by briefly tilting the bed into a slight Trendelenburg position (head slightly lower than feet) if safe for the patient.

What role does bedding play in preventing sliding?

Slippery or loose-fitting sheets can increase sliding. Using sheets with a textured or non-slip backing, along with sheet holders, ensures the linen stays firmly in place. Always ensure sheets are wrinkle-free to avoid pressure points.