How to Lower a Bed for an Elderly Person Over 23 Inches

According to the National Institute on Aging, falls are a leading cause of injury among older adults, with many occurring in the bedroom. Adjusting the bed to an optimal height is a crucial step in fall prevention and enhancing mobility. This guide will walk you through how to lower a bed for an elderly person to improve safety, comfort, and independence.

Quick Summary

Several methods exist to lower a bed for enhanced safety and accessibility, including removing the box spring, using a low-profile foundation, replacing the bed frame, or cutting wooden legs. This can significantly reduce fall risk and strain for seniors when getting in and out of bed. The optimal height should allow the person's feet to be flat on the floor when seated on the edge.

Key Points

• Assess Ideal Height: The perfect bed height allows the senior to sit on the edge with feet flat on the floor and knees at a 90-degree angle, typically 20-23 inches.

• Remove or Replace Box Spring: A simple method to lower bed height by 4 to 9 inches involves swapping a standard box spring for a low-profile version or a bunkie board.

• Consider a Platform Bed: For a complete update, a platform bed frame provides a lower profile and eliminates the need for a box spring entirely.

• Modify Wooden Legs Carefully: For solid wood frames, a professional can cut the legs to the desired height, but this requires precision and is permanent.

• Utilize Ultra-Low Beds for High-Risk Seniors: Individuals with severe mobility issues may benefit from ultra-low adjustable beds, which reduce fall distance and can be set to just inches off the floor.

• Add Supportive Aids: Supplement a lower bed with safety rails, bed canes, or trapeze bars for additional support when transferring.

• Combine with Other Safety Measures: Always pair bed height adjustment with other bedroom safety steps, such as night lights and clearing pathways, to create a safer environment.

Why Proper Bed Height is Critical for Seniors

As we age, a person's mobility often declines, and a standard-height bed can become a safety hazard. If a bed is too high, there is a greater risk of falling while getting in or out. If it's too low, the physical exertion required to stand up can strain joints and muscles. The ideal bed height allows a person to sit on the edge with their feet flat on the floor and their knees at a 90-degree angle. For most seniors, this translates to a mattress height between 20 and 23 inches.

Method 1: Remove or Replace the Box Spring

This is often the simplest and most cost-effective way to lower a bed, particularly for modern bed frames designed with a box spring. A standard box spring can add 6 to 9 inches of height.

Step-by-Step:

1. Remove the existing mattress and box spring.
2. Place the mattress directly onto the bed frame's support slats. If the slats are too far apart, this method may not provide adequate mattress support and could damage the mattress over time.
3. For better support, replace the standard box spring with a low-profile box spring (around 4-5 inches thick) or a bunkie board.
4. Alternatively, use a series of solid wood slats to create a firm platform for the mattress.
5. Once the new foundation is in place, position the mattress and test the height.

Method 2: Replace or Modify the Bed Frame

If removing the box spring isn't an option, or if the current frame is still too high, replacing the frame or modifying its legs are viable solutions.

Choosing a new frame:

• Platform Beds: These frames are designed to be low to the ground and do not require a box spring. They provide a low-profile, modern look.
• Adjustable Beds with Hi-Low Features: Some advanced adjustable bases can raise and lower the entire sleep surface with the push of a button, providing maximum flexibility and ease of access.

Modifying existing frames:

• Replace Legs: For frames with removable legs, purchase and install shorter, compatible legs. This is a straightforward fix, but you must ensure the new legs are equally stable and compatible with the frame's hardware.
• Cut Wooden Legs: For solid wooden bed frames, a professional carpenter can safely and evenly cut the legs to the desired height. This requires precision to maintain the frame's structural integrity and is not recommended for frames made of particleboard or with complex leg structures.

Method 3: Use Floor or Ultra-Low Beds

For individuals with severe mobility issues or a high risk of falling, especially at night, an ultra-low bed can be the safest option.

• Floor Beds (or Mattress on Floor): Placing the mattress directly on the floor eliminates the risk of falling from any height. While not suitable for everyone due to the difficulty of getting up, it can be a temporary solution or a permanent one with assistive aids.
• Ultra-Low Hospital Beds: These beds, often used in professional care settings, can be lowered to just a few inches above the floor. This provides the shortest possible distance for a fall and can also be equipped with features like side rails and adjustable positioning.

Comparison of Bed Lowering Methods

Feature	Remove Box Spring	Replace Frame (Platform Bed)	Modify Wooden Legs	Ultra-Low Adjustable Bed
Cost	Low	Medium to High	Medium (Professional Labor)	High
Ease of Implementation	High	Medium	Low (Requires Skill)	Medium (Professional Installation)
Best for	Most standard beds	A new bedroom setup	Specific wooden frames	Individuals with highest fall risk
Flexibility	Limited	Minimal	None (Permanent)	Highest (Push-button control)
Side Effects	Potential for poor mattress support if slats are too wide	Less under-bed storage	Risk of destabilizing frame if not done correctly	Bulkier than standard beds

Conclusion

Lowering a bed is a practical and effective way to significantly enhance safety and independence for an elderly person. The best approach depends on the individual's specific needs, the existing bed setup, and budget. Simple fixes like replacing a box spring offer an immediate and affordable solution, while investing in an adjustable hi-low bed provides the most comprehensive features for long-term care. Before making a change, always measure carefully and prioritize stability. Consulting with a healthcare provider or occupational therapist can also help determine the ideal bed height and the safest method for your loved one. By taking these steps, you can create a safer and more comfortable bedroom environment and reduce the risk of fall-related injuries.

Additional Safety Enhancements

Once the bed height is addressed, consider these additional measures to maximize bedroom safety:

• Install bed rails or bed canes for sturdy support when getting in and out.
• Use non-slip mats or socks to prevent tripping, especially on hard floors.
• Install night lights or motion-activated lighting for safe nighttime navigation.
• Clear all clutter and tripping hazards, such as electrical cords, from the floor.
• Consider a fall mat next to the bed to soften the impact if a fall does occur.

Choosing the Right Bed Height for the Elderly

Frequently Asked Questions

What is the optimal bed height for an elderly person?

The optimal bed height for an elderly person is typically 20 to 23 inches from the floor to the top of the mattress. At this height, a person can sit on the edge with their feet flat on the floor and their knees at a 90-degree angle, making it easier and safer to stand up and sit down.

Can I simply remove the box spring to lower the bed?

Yes, for many beds, removing the box spring and placing the mattress directly on the frame is the simplest way to lower the bed height significantly. You must ensure the frame has a suitable support system (like strong, closely spaced slats) to prevent mattress damage and sagging.

What is a bunkie board and how does it help?

A bunkie board is a thin, solid platform (typically 1-2 inches thick) that replaces a standard box spring. By using a bunkie board, you can lower the bed significantly while still providing a solid, supportive foundation for your mattress.

Is it safe to cut the legs of a wooden bed frame?

If done by a skilled professional, cutting the legs of a wooden frame can be a safe and permanent way to lower a bed. However, it is not recommended for frames made of particleboard and requires precision to ensure the frame remains stable and level.

Are adjustable beds a good option for lowering a bed?

Yes, adjustable beds with a 'hi-low' feature are an excellent option for maximum flexibility. They can be raised and lowered to many different height settings with a remote control, making them ideal for seniors with changing mobility needs.

What are the risks of using a bed that is too low for a senior?

A bed that is too low can put excessive strain on joints and muscles when trying to get out of bed. It can also lead to difficulty standing up from a seated position, increasing the risk of falls.

What alternatives are there to bed rails for safety?

Alternatives to bed rails include using a trapeze bar to help with repositioning, placing foam bumpers under the fitted sheet to prevent rolling out, or using a concave mattress. For those at high risk of entrapment, alternatives are often safer.