What do you do when someone keeps falling out of bed?

According to the CDC, over one in four older adults report falling each year, and many are unable to get up without assistance. Knowing what do you do when someone keeps falling out of bed is crucial for preventing serious injury and ensuring the well-being of a loved one.

Quick Summary

Address the underlying causes of repeated falls, which can include medical issues, medication side effects, and environmental hazards. Implement practical strategies such as modifying the bed, using safety barriers, and improving room lighting to create a safer sleep environment and reduce the risk of injury.

Key Points

• Assess Underlying Causes: Investigate whether falls are caused by health issues, medication side effects, or environmental factors.

• Modify the Bed: Consider a lower bed, fall mats, or safe bed rails to minimize injury risk.

• Improve Lighting: Use nightlights and ensure a clear, well-lit path from the bed to the bathroom.

• Review Medications: Consult a doctor or pharmacist to identify any drugs that may cause dizziness or confusion.

• Use Fall-Detection Technology: Bed alarms or pressure-sensitive pads can alert caregivers when a person is exiting the bed.

• Establish a Routine: Consistent routines and a clutter-free environment can reduce nighttime confusion and disorientation.

Understanding the Root Causes of Falls

Before implementing solutions, it is essential to determine why someone is repeatedly falling out of bed. Addressing the underlying issue is the most effective long-term strategy for preventing future incidents.

Physical and Medical Factors

Several health conditions and physical changes can contribute to an increased risk of nighttime falls:

• Balance Issues: Conditions that affect balance and gait, such as Parkinson's disease, inner ear problems (vertigo), or stroke recovery, can make movement unpredictable.
• Medication Side Effects: Certain medications, including sedatives, antidepressants, blood pressure medications, and tranquilizers, can cause dizziness, drowsiness, confusion, or restless leg syndrome.
• Cognitive Decline: Dementia and other forms of cognitive impairment can lead to confusion, disorientation, or agitation, causing individuals to forget they are in bed or attempt to get out unsafely.
• Weakness and Frailty: Muscle weakness and general frailty, common in older adults, can make it difficult to maneuver in bed or get up without losing balance.
• Vision Impairment: Poor night vision or age-related vision changes can cause a person to misjudge the distance to the floor or miss an obstacle.

Environmental Factors

The sleeping environment itself can pose significant risks. Simple changes can dramatically improve safety:

• Bed Height: A bed that is too high can make it difficult for feet to touch the floor upon sitting up, leading to unsteadiness.
• Clutter: Tripping hazards such as loose rugs, power cords, or furniture near the bed can cause a fall if the person becomes disoriented.
• Poor Lighting: Dark bedrooms or pathways to the bathroom can lead to disorientation and missteps during nighttime awakenings.

Immediate Actions Following a Fall

If a loved one has just fallen out of bed, follow these steps to ensure their safety:

1. Stay Calm: Reassure the person and assess the situation calmly. Panicked movements can exacerbate injuries.
2. Assess for Injury: Before attempting to move them, check for any visible injuries, such as cuts, bruises, or signs of a fracture. Ask if they feel any pain.
3. Do Not Rush to Move Them: If they appear to be seriously hurt or disoriented, do not move them. Cover them with a blanket and call for emergency medical assistance.
4. Help Them Up Safely: If they seem uninjured and can follow instructions, assist them in getting up slowly. Use a sturdy chair or another person for support. Never pull them up by their arms, as this can cause shoulder injuries.

Proactive Prevention Strategies

Modifying the Sleep Environment

Making changes to the bed and room setup can create a much safer space.

Feature	Benefits	Drawbacks
Bed Rails / Bedside Bumpers	Provides a physical barrier and a handhold for entry/exit. Non-restrictive options are available.	Can feel confining. May increase the risk of injury if a person attempts to climb over.
Pool Noodles / Bed Wedges	An inexpensive and soft barrier that reminds the person of the bed's edge.	Less secure than rails. May not be effective for individuals who are actively trying to exit the bed.
Bed Alarms	A pressure-sensitive pad that alerts caregivers when a person leaves the bed.	Can be startling for the user. May not prevent the fall itself, but offers an alert.
Lower Beds / Floor Mattresses	Minimizes the impact and severity of a fall. The shorter distance to the floor reduces injury risk.	Can make it difficult for some individuals to get up from the bed.
Fall Mats	Soft, cushioned mats placed next to the bed to absorb impact during a fall.	Can be a tripping hazard if not properly secured. May shift over time.

Addressing Health Concerns

Consulting with healthcare professionals is a critical step in a comprehensive fall prevention plan. For comprehensive fall prevention strategies, refer to the CDC's guidance on Preventing Falls Among Older Adults.

• Talk to a Doctor: Schedule an appointment with their primary care physician to discuss the frequency of falls. They can review the person's medication list and check for any new or worsening medical conditions.
• Medication Review: Ask the doctor or pharmacist to review all prescriptions and over-the-counter medications for potential side effects that affect balance or alertness.
• Consider Physical Therapy: A physical therapist can create a personalized plan to improve strength, balance, and mobility.

Establishing Safe Routines

Simple routines can make a big difference in nighttime safety:

• Consistent Bedtime: Stick to a regular sleep schedule to minimize nighttime confusion.
• Clear the Path: Ensure the path from the bed to the bathroom is clear of all obstacles. Move furniture, secure cords, and remove loose rugs.
• Ample Lighting: Install motion-activated nightlights along the pathway to the bathroom and in the bedroom itself. Keep a lamp with an easy-to-reach switch on the bedside table.

Choosing the Right Equipment

The right equipment can make a significant impact on safety.

• Hospital Beds: Adjustable hospital beds can be lowered to a minimum height, and many come with built-in rails and other features to enhance safety.
• Bed Alarms: These devices, such as pressure-sensitive pads under the mattress, can be a lifesaver for caregivers who need to monitor someone remotely. They provide an alert when pressure is removed from the bed.
• Fall Mats: For those who don't tolerate rails, placing cushioned, non-slip mats on the floor next to the bed can absorb impact and reduce the risk of serious injury.

Conclusion: A Multi-Faceted Approach to Safety

When faced with the difficult situation of a loved one repeatedly falling out of bed, the best approach is not a single solution but a combination of strategies. A thorough medical evaluation, a thoughtful modification of the home environment, and the implementation of assistive technologies are all key components. By taking proactive steps to understand the causes and create a safer sleep space, you can significantly reduce the risk of falls, protect your loved one from harm, and achieve greater peace of mind.

Frequently Asked Questions

Can medication cause someone to keep falling out of bed?

Yes, many medications can cause side effects like dizziness, drowsiness, and confusion, which significantly increase the risk of falling. It's crucial to review all current medications with a doctor or pharmacist to identify any potential issues.

Are bed rails a good solution for preventing someone from falling out of bed?

Bed rails can be effective as a reminder and barrier, but they are not always the best solution. They can pose a risk if a person tries to climb over them. Non-restrictive bumpers or pool noodles may be a safer alternative for some, and a lower bed or fall mat can also help mitigate injury.

What is the safest way to help someone who has fallen out of bed?

First, ensure the person is calm and assess for any injuries. If they appear hurt or disoriented, do not move them and call for emergency medical help. If they seem okay, help them to get up slowly and with support. Avoid pulling them up by their arms.

How can I improve bedroom lighting to prevent falls?

Install motion-activated nightlights along the path from the bed to the bathroom. Keep a lamp with an easy-to-use switch on the bedside table so it is always within reach. Good lighting helps with nighttime orientation and prevents missteps.

What if the person falling has dementia?

Individuals with dementia may experience confusion and disorientation, increasing fall risk. In addition to environmental modifications like low beds and fall mats, consistent routines, ample lighting, and the use of a bed alarm can be effective strategies. Avoiding restrictive rails that could cause agitation is often recommended.

What are some alternatives to bed rails?

Alternatives to bed rails include placing pool noodles or wedge pillows under the fitted sheet to create a soft bumper. A low bed or a mattress placed directly on the floor can also reduce injury severity. In addition, using fall mats next to the bed can cushion any impact.

What is a bed alarm and how does it help?

A bed alarm is a pressure-sensitive pad placed on the mattress that alerts a caregiver when the person gets up or removes their weight from the bed. It allows caregivers to assist the person before a fall occurs, rather than just reacting after one.