There are multiple factors that contribute to an adult falling out of bed. But no matter what the cause or causes may be, there are precautions that can be taken to help prevent injuries from these type of falls.
How To Prevent Elderly From Falling Out Of Bed
There are 9 products we can recommend for fall prevention from beds for older adults. In this article we’ll go over each one of these, their pros and cons to help you decide which one(s) may be helpful for you and/or your senior loved one.
|Bed Rails||Easy to install and use||May not be suitable for some older people with dementia / Alzheimer’s|
|Low Beds||A simple and inexpensive solution||Is often a very firm feel to the mattress|
|Posey Beds||Not suitable for anyone with claustrophobia||Most suitable for seniors with severe dementia / Alzheimer’s|
|Floor Fall Mats||Cushions a possible fall from the bed||Difficult to walk on when standing up from the bed|
|Wedges, Rolls, Bolsters||Suitable for anyone who is against use the rails on their bed||May not work for older adults with severe dementia / Alzheimer’s|
|Pool Noodles||An inexpensive solution to replace Bed Rolls||May not work with larger sized persons|
|Bed Alarms||A great way to monitor if your senior loved one gets off the bed||Does not “prevent” falls – only “alerts” the caregiver of movement off the bed|
As an Occupational Therapist, I used to work with Physical Therapists on a fall risk assessment of our patients to determine the level of cognitive and physical abilities the patient was able to perform as well as to assess the environment (their bedroom) to see what would be needed to make falling out of bed as preventable as possible.
For anyone who is dealing with the problem of an elderly person falling out of bed while sleeping or while they are attempting to get up, know that there are some things you can do to protect and try to stop your geriatric loved one(s) from these type of falls.
What you may end up using will depend on the physical and cognitive deficit(s) they are dealing with.
1. Bed Rails For Seniors
Bed rails are usually what most people immediately think of when it comes to protection from falling out of bed. And they are a very good option, but again, not for everyone.
When I was working in rehabilitation facilities and hospitals as an Occupational Therapist I had several patients who injured themselves as they tried to get out of the bed by sliding down to the end of the bed, or trying to climb over the bed rail or getting their arm or leg caught in the bed rail.
But, having said that – if you feel it’s an option for your parent, then let me give you some information on the different types of bed rails available.
Transfer Bed Rails (aka Assist Bed Rails)
Transfer bed rails are the smallest and least intrusive type of rails. Their main purpose is really to make transferring into and out of bed easier for both the elderly person and the caregiver.
They work best with seniors who are cognitively aware of their environment and are the least likely to fall out of bed.
My 98 year old mom-in-law uses this transfer bed rail that we purchased at Amazon to help her in and out of bed. She’s very independent, still lives alone and is very cognitively intact so we don’t worry (well, at least not too much) about her falling from the bed. It’s been working very well for her.
Standard Bed Safety Rails
The standard bed rails that most people think of are longer but they don’t fit the entire length of the bed. Most hospital beds come equipped with these type of rails.
But you don’t necessarily have to get a hospital bed, you can add these type of safety rails to your existing bed.
One such option, right from Amazon is this bed rail safety side guard. It requires installation onto a wooden platform so it would work well with a platform bed but not a metal bed frame.
But for a low price, it does fold which makes it much easier for your mom or dad to get in and out of the bed.
The only precaution I would give with these types of add-on rails is that when they are folded down – they do tend to “stick out” from the bed frame. As a result, when your elderly parent swings their legs over to the side of the bed where the folded rail is, they may bruise or cut their skin on the folded railing.
Full Length Side Rails
A third type of bed rail is the full length version which again, you can install onto a standard bed.
Most of them, like this one from 4MDMedical.com mounts to the fabric spring of the bed and is secured with two spring-loaded cross bars.
Again, because are constructed with bars, be aware that if your parent is able to understand that they are not to attempt getting out of the bed while this safety rail is up. You don’t want them getting caught between the bars and injuring themselves.
Grab Bars Can Be Considered
If the bed is situated in such a way that a grab bar may be used then you can certainly consider this type of equipment vs. a bed rail. I would recommend more non-traditional type of grab bars such as the the Moen Flip Up Bathroom Grab Bar or the Stander Security Pole & Curve Grab Bar.
Both of these might work better for your situation.
2. Platform or Low Beds
High beds are a safety concern. This qualitative study used pre-existing nurse interview data and confirmed nurses’ awareness of the importance of keeping patient beds in the lowest position. Lowering the bed helps promote patient safety and prevent falls. – National Center for Biotechnology Information
Best Bed Height For Seniors
The general rule of thumb to the best bed height is 20 – 23 inches from the floor to the top of the mattress. BUT the truth is, that these recommendations are based on wheelchair heights, not necessarily that of older adults.
For this reason I believe that there is no “best bed height for seniors.” Instead, what I say is that the height of the bed is relative to the person who is using that bed. And note that this changes as the person gets older.
Best Bed For Elderly Persons
So, the “best bed” for an elderly person should accommodate their height and a mattress that is most comfortable for them.
But having said that – Platform Beds are one type of bed that can be very well suited for older adults.
Pros And Cons Of Platform Beds For Seniors
The benefit of a platform or a low bed is that if a fall occurs, it’s not a far distance to the ground which minimizes injury. You can also add a bedside fall mat on the floor beside the bed for extra precaution.
Another benefit is that they don’t require a box spring giving you a savings if you have to replace the mattress.
The downside of using these types of beds is that because the mattress sits on slats, it tends to be a very firm type of support. If your loved one sleeps on their side, it may be uncomfortable.
A solution for this might be to add a 2 or 3 inch thick mattress topper under the mattress. That’s what I did for one of my home bound patients that I treated and it worked very well.
Another issue with low beds is that depending on the height of your loved one, it may be difficult for them to get up out of bed (it may also be difficult for you to get them out of bed). So, that’s definitely something to consider. (For more on this topic check out our article on How To Safely Help An Elderly Person Get Out Of Bed)
But overall, lowering the height of the bed is an excellent solution for anyone who is a fall risk.
One other note here about beds. I would recommend to position the bed so that one side of the bed is up against the wall. This will create a barrier on one side.
About Pivot Beds
Another Option are Pivot Turning Beds – which mechanically turns and bends the mattress making it easier to get in and out of bed.
…the goal is to move them into a sitting-on-the-edge-of-the-bed position using a remote control mechanism. This makes it possible for a person lying in the bed to move it into a sitting position that can help them safely slide off the bed. – myslumberyard.com
3. Posey Beds
A solution that works for some (not for all) are Posey Beds. These beds are designed specifically for people who are at a very high risk of serious injury from falling out of bed.
This usually means anyone who suffers from severe dementia usually coupled with REM Behavior Disorder or other similar diagnosis which causes them to kick, punch and thrash about in their sleep (which of course cause cause them to fall out of bed).
A Posey Bed is most often used in hospitals, senior living facilities and nursing homes.
It is specifically designed to reduce the risk of unassisted bed exits and patient falls, prevent patients getting trapped in side rails or between the mattress and side rails, and provide a generally more controlled patient environment. – 4MDMedical.com
Not all seniors would be comfortable in a Posey Bed – if they are claustrophobic in any way – they may have a difficult time laying down in something that has 4 sides and a top. Of course, the screened areas can be zipped off, leaving it more open.
It’s a decision that you will have to make with your doctor and any other caregivers working with your elderly loved one(s).
4. Floor Fall Mats
If you can’t invest in a low bed and your senior parent will be using a standard height bed then using a twin size mattress or floor fall mat on the side of the bed is a must. This will help to cushion the fall and hopefully prevent injury or at least minimize it.
If your senior loved one gets up in the middle of the night for whatever reason a mattress may not be a viable option because stepping on that type of surface may cause them to fall.
Note: IF the elderly person DOES tend to get up often during the night – and you want to make that task safer for them – I would recommend the Smart Caregiver® Floor Mat! It’s a flat mat that can be placed on the floor, by the bed. It plugs into an outlet and when stepped on, it can turn on the light in the room AND notify you (the caregiver) that your elderly loved one has gotten up. Of course, if they fall onto the mat – it will notify you as well.
A fall mat is not as thick as a twin size mattress would be but it’s easier to stand on when the person your senior loved one gets out of bed.
Of course, you can also use a thick mattress topper here as well (they can all be cut to size) but again, it may be difficult for your elderly loved one to stand on so you will have to judge which option would work best for you.
And keep in mind, that as your senior loved one ages, their condition will likely only worsen. So, they may be able to stand on a twin mattress today, but next month, perhaps not.
A Stander Security Pole placed by bedside may also help to make it easier and safer for your senior loved one to steady themselves as they get up from the bed. This acts as a grab bar of sorts.
Note: I strongly recommend for anyone aging in place to remove throw rugs throughout the house. I understand that you may want to keep one in the bathroom and there are certain types that I would recommend for that situation but if there is a throw rug by the bedside – please remove it. You can read more about why throw rugs are dangerous for seniors by clicking here.
5. Bedside Wedges, Rolls and Bolsters
If you are a parent, you may be familiar with the use of bedside rolls. Some parents use them for their children when they first transition from a crib to a standard bed.
The same concept can help your elderly loved one from falling out of bed. For beds without rails, these products are usually fastened to the mattress and/or the bed frame.
There are a variety of different types of wedges, rolls and bolsters that you can use and what you choose will depend on the needs of your parent.
Wedge pillows are great for supporting a senior’s body, as well as for keeping them from falling out of the bed. They are usually triangle-shaped, although you can find rectangular wedges that are used for supporting and elevating the knees.
Another very interesting product is a nylon Mattress Cover that has built in wedges. The only downside that I can see with this product would be that it might be difficult to get someone in and out of the bed. It would just depend on that particular person – but I love the idea that the wedges are built in – and it’s very affordable.
6. Pool Noodles
I remember a patient who was a very sweet, elderly woman. She was maybe 5 feet tall and weighed about 90 lbs. She was quite frail and had already fallen out of her bed once.
Her family didn’t have much money but I knew that she needed something to protect her from rolling off the bed.
So, I recommended pool noodles (like these). They are inexpensive, they come in a variety of widths and can be cut or taped together to fit any size or configuration you need. Although I do recommend the Jumbo Pool Noodles – you can determine what size would fit best for your senior loved one.
The way we used these pool noodles with is as follows:
- You can use a strong wide and long ribbon and a strong tape to connect the pool noodles together but still keep them on the sides of the bed.
- You can further fasten them either to the sides of the bed with more ribbons and tape or wrap the ribbons all the way under the mattress.
- Then place the fitted sheet over the noodles
Here is a video demonstration:The precaution I would give you is that if the noodles are not large enough to keep your senior loved one in the bed then you must use a wedge or bolster meant for this purpose.
I would only recommend using the pool noodle idea if the older adult you are caring for is cognitively aware enough to understand that these are meant to keep them safe and to remind them not to get out of bed without assistance.
7. Bed Alarms
When I was practicing Occupational Therapy, bed alarms were something that only some hospitals had. But today, you can purchase them for your own home and I think that is just amazing.
Bed alarms are inexpensive and a fantastic way for you to “monitor” your senior loved one.
One that we recommend is the bed alarm made by Smart Caregiver. It’s wireless and cord free making it as safe as possible (no cords to get tangled in).
The bed alarm is a pad that is placed on top of the mattress, under the fitted sheets. It is placed directly under the shoulder blades of the person laying on the bed.
Once the person in the bed starts to get up, the pad sets off the alarm.
Since these bed alarms do not come with 2 alarms (one in their room and one for your room) I would recommend to use a baby monitor as well so that you can hear the bed alarm go off. This would work well especially if your bedroom is on a separate floor.
You may have to try several options before you find the one or combination that works for you. And please be aware that as your loved one ages, you may have to change your “formula”.
- If your senior suffers from dementia or alzheimers he/she may have a difficult time remembering any “safety rules” you try to implement. They may also be unable to comprehend what you are trying to tell them. In this case – it would be safer to lower their bed.
- If you cannot lower the bed, I would recommend to place a twin size mattress on the side of the bed to cushion a possible fall. There are mats available just for this purpose if you wish to purchase any of them.
- Another bed option that may be viable is a Posey Bed. More about these beds below.
- You can add bed rails to any kind of bed as well.
- Bedside wedges, rolls and bolsters are another solution that may be useful.
- Some caregivers have had success using pool noodles on either side of the bed.
- Bed alarms are another tool that you can use. This will alert you if your senior loved one attempts to get out of bed.
What Causes Elderly To Fall Out Of Bed?
Of course – the answer to why do elderly adults fall out of bed truly depends on the issue(s) that are causing your aging loved one to fall out of bed. They could be any number (or combination) of things such as:
- Dementia or Alzheimers
- Reaction to medication
- Morning stiffness
- Poor vision / poor lighting
- Medical conditions such as vertigo or hypotension
You need to know that it’s impossible to prevent all falls – BUT – it certainly is possible to reduce the chances of a fall. This article will outline all the information that you need to help you do all you can to prevent your elderly loved one(s) from falling out of bed.
The best prevention that you could provide may end up being a combination of tools such as bed rails and alert systems put together with precautionary intervention by the caregivers.
The interventions that you will be taking depend largely on knowing “why” they are falling out of bed in the first place.
Causes of Falls In People With Dementia or Alzheimer’s
Anyone that suffers from any form of dementia (including Alzheimer’s) is at a higher risk of falls. The reasons can be any one of these (or combination of) listed below:
- general physical weakness – although not all persons with dementia suffer from muscle weakness, the great majority do.
- changes in gait – you will sometimes see an altered gait which includes shorter steps, stumbling or tripping over their own feet, stiff knees, hips and/or ankles – all contribute to an altered gait which could increase fall risks.
- memory impairment – cognitive decline results in poor judgment which means that the individual is simply unable to assess if a situation is safe or not.
- visual / spatial problems – one factor many caregivers aren’t aware of is that Alzheimer’s can affect a person’s visuoperceptual skills which can mean that they can’t recognize common objects, they may have double vision, they can’t judge distance and they have trouble with depth of field (which makes using stairs very difficult).
Medications That Can Contribute To Falls In The Elderly
It’s not uncommon for our aging loved ones to be on multiple medications. It’s important, as caregivers, that we monitor what they are taking and how much.
The types of medications they listed are…
- Antidepressants (TCA’s and SSRI’s)
- Any medicine affecting blood pressure
- Muscle relaxants
The CDC also warns about over the counter medications and herbal supplements.
Before taking any medication or supplement, I urge you to consult with your doctor and to learn as much as you can about that particular product.
My late husband was a very health conscious person (much more than me!). But, he had insomnia and struggled for years to find anything that would help him.
I remember at one point, he began taking some herbal supplement for sleep that had a combination of herbs. It did work, but after 4 months of taking this all natural herbal concoction he developed severe jaundice and had to undergo 12 months of treatment.
So, be very careful when it comes to any over the counter medicine or supplements.
How Does Morning Stiffness Contribute To Falls
Most of us, as we age, will begin waking up with morning stiffness. It’s actually extremely common. It’s usually due to worn out joints and/or muscle tightness. Of course, there are other factors that may be causing (or contributing) to it such as arthritis.
Whatever the cause, if your senior loved one(s) attempt to get out of bed while their muscles are hurting and stiff, their knees could buckle and they could fall.
There are ways to help to prevent this and we’ll go over those later on in this article.
How Low Vision / Poor Lighting Increases The Probability Of Falls
It makes sense that if the elderly you are caring for are unable to see clearly as they get out of bed, they can easily trip over something and fall. Or perhaps they would try to reach for something such as a nightstand or walker and they over reach which could then also lead them to fall.
Again, we’ll be reviewing ways to alleviate this problem later on.
There are a multitude of medical conditions that could easily contribute to falling out of bed. Some of these are…
- Balance issues due to stroke or other neurological issue
- Parkinson’s Disease
- Heart disease
If your senior loved one(s) suffers from any of these extra precautions are indicated to avoid falling out of bed.
Tools such as bed rails and alarms are what comes to mind immediately but we will discuss these and more options later on.
Can You Die From Falling Out Of Bed?
You can certainly die from an injury, so yes, it is possible that falling out of bed could cause the type of injury that would eventually, if not immediately, cause death.
You may think that if they were to fall, the damage would be mostly physical. Perhaps a broken hip, a broken shoulder, etc.
But the truth is, the damage from a fall, for elders, is much more severe.
I mean, yes, falls could easily result in a physical injury. But for seniors, recovery from a physical injury can be extremely complicated. Not only will they recover much slower than a younger person, but recovery is rarely 100% and the risks involved with surgery for anyone in their 80’s or 90’s are much higher than the general population.
Amongst elders – hip fractures from falls present the greatest risks and the most number of deaths. Almost 250,000 persons in the USA over the age of 50 fracture their hip. Half of these seniors are not able to ever become independent again. (Medicinenet.com).
In addition to a physical injury such as a broken bone or severe bruise, the possibility of a head injury due to a fall is also very high.
A friend’s father-in-law went to see his doctor with his wife one day. On the way out, his wife left him on the sidewalk, in a wheelchair while she went to get the car. As he saw the car coming, he decided to get out of the wheelchair.
He tripped before she even got to the curb, he hit his head and suffered a traumatic brain injury. He died 3 days later.
Even a short fall for an elderly person can result in an injury severe enough that it could cause death.
Falling Out Of Bed Injuries And Symptoms
Despite all your precautions, it may happen that your senior loved one falls out of bed (or simply falls out of a chair or other situation).
So, what do you do if this happens?
- First thing is first, if they appear injured, is bleeding, seem disoriented – call 911 immediately.
- If they are unable to help you to get them up off the floor – do not attempt to do this yourself. Either get some help or if they are complaining of any pain – STOP – and wait for the paramedics to come.
- Check for signs of a head injury
- mild headache
- blurred vision
- feeling sleepy
- fluid coming from the nose or ears
- slurred speech
- balance problems
- difficulty following simple directions
- Check for signs of physical injury such as cuts and bruises. You may be able to tend to these yourself but if you feel that they need medical attention, do not hesitate to call 911 or to take them to the emergency room.
Do bed rails prevent falls? – It depends on the cognitive status of the person in the bed. If they are unable to comprehend how to use them safely then the bed rails may end up causing more harm than good. If the person is cognitively intact but they are weak, then bed rails may help them from falling out of bed.
Where can I get free medical equipment? – Medicare will cover a hospital bed but not much else. There are other options, though. Go to Eldercare.act.gov and look for help from your regional Agency on Aging. Another option is thrift stores – after my mother passed away, we donated many of her medical care items to Goodwill.
Does Medicare pay for hospital beds? – Absolutely, Medicare does pay for hospital beds but as I stated above. They only cover that piece of equipment IF your doctors and the DME suppliers are enrolled in the Medicare program.
Are bed rails covered by Medicare? – Medicare covers bed rails when they come with a hospital bed. But be aware that “Medicare will only cover your DME if your doctors and DME suppliers are enrolled in Medicare. Doctors and suppliers have to meet strict standards to enroll and stay enrolled in Medicare. If your doctors or suppliers aren’t enrolled, Medicare won’t pay the claims submitted by them.” (Medicare.gov)
According to the list of durable medical equipment that Medicare.gov lists, bed rails are NOT covered by them.
How to help an elderly person get out of bed? – You begin by log rolling the person to the edge of the bed, using a handrail of some sort helps very much, move the legs off the bed and then by placing your hand under their shoulder help them to sit up. Talk them through the steps and that gives them a chance to help you so you don’t get injured. Read our excellent article on this for more detailed instructions.