This Is Why Bed Rails Aren’t Allowed in Nursing Homes


If you’re considering moving your elderly parents to a long-term care facility or hiring a home caregiver, their safety must be on top of your mind. As a result, you may wonder why nursing homes don’t use bed rails to prevent falls from bed.

Bed rails aren’t allowed in nursing homes because they can cause severe injury or death to residents with cognitive impairment due to dementia. In situations where bed rails aren’t suitable, alternatives such as roll guards or foam bumpers may be used to prevent bedroom falls.

The rest of this article will explore the use of bed rails as a fall prevention measure for seniors. You will learn when these devices may or may not be suitable for your aging mom or dad. You’ll also learn about bedroom safety measures for your aging parents.

Why Can’t Nursing Homes Use Bed Rails?

Accidents such as rolling off the bed while sleeping or falling while attempting to get into or out of bed are major causes of injuries and deaths in nursing homes. Many believe that bed rails, also called side rails, are an effective solution to bed fall accidents.

As a result, you’d wonder why they aren’t widely used in nursing homes to prevent bed falls. Similarly, you may want to know if using side rails on your elderly parent’s bed at home would be wrong.

Nursing homes are subject to various regulations focused on the welfare of their residents. Among the heavily regulated areas in nursing homes is the use of restraints such as bed rails.

These facilities are prohibited from putting patients in beds with side rails as a disciplinary measure or for convenience. In other words, the nursing home can’t simply enclose a patient in bed with rails as an alternative to supervising or monitoring the patient.

Moreover, these facilities can’t use bed rails as a routine measure to prevent residents from falling out of their beds.   

However, don’t be surprised if you walk into a nursing facility and see bed rails. There are situations when side rails may be necessary. For example, the facility can use bed rails if the resident or their family consents. This is usually a last resort if the rails are the only option to address a medical need.

Where bed rails are used, the facility must assess their potential benefits and risk to the patient. The nursing home must outline how the potential risks will be mitigated.

In situations where side rails are used, the facility must ensure that the rails, bed frame, and mattress are compatible. A mismatch of these components can pose risks to the patient.

Therefore, nursing homes can use bed rails to prevent falls, but not at will. There must be solid grounds to justify their use, and the resident or their representative must agree to use them. 

What Is the Main Use of Bed Rails?

The main use of bed rails is to minimize the risk of falls. They can prevent frail or disabled seniors from rolling off their beds and falling to the floor. Such accidents can cause serious injuries or death. Moreover, bed falls can impact a senior’s confidence and cause stress.

Additionally, bed rails can be used as a support device to help patients get in and out of bed independently. 

Do Bed Rails Prevent Falls?

Properly fitted bed rails can prevent bedroom falls. While bedside rails are a common fall prevention measure, there remains a debate over their effectiveness in fall control.

Some analyses have shown that the rails don’t help as much in preventing bed-related falls. However, others have backed them as a great solution to reduce the risk of falls in nursing facilities or home care settings. 

What Is the Main Cause of Death From Bed Rails?

Although bed rails can prevent falls, they also pose a danger.

If there’s a gap between the rails and the mattress, the sleeping person can slide into that gap. If the person can’t extract themselves from that position, they could be trapped there for a long time. As a result, the person may be unable to breathe due to the mattress and the rails pressing their chest. That situation can result in death. 

Why Bed Rails Shouldn’t Be Used for Patients With Dementia

Side rails can cause serious injuries to people with dementia or other memory limitations if used on their beds.

A person with dementia will often try to climb over the rails if they want to get out of bed, and the rails obstruct their way. The patient can fall and hit their head on the floor when trying to climb over the rails.

Apart from falling, the person can also become entrapped between the rails and suffocate to death or suffer injuries.

How Do Nursing Homes Prevent Bed Falls?

When patients fall from their bed while sleeping, the injuries can range from broken hips to head trauma. Bed falls are a major challenge for nursing facilities.

While preventing a fall from bed may be difficult, nursing homes can prevent fall injuries. Here’re some of the ways care facilities reduce risks of bed falls in patients or prevent fall injuries.

Bed Rails 

With the doctor’s approval and consent of the resident or their family, nursing facilities can install side rails on the bed to prevent falls.

The rails must be installed properly to prevent gaps that could entrap the patient and impair their breathing.

Low Bed Height

The facility can lower the bed’s height to minimize the risk of serious injuries from bed falls. If a fall occurs over a short distance, the impact would be minimal, and the patient may not suffer severe injuries.

A lowered bed would also make it easier for seniors to firmly place their feet on the ground before attempting to rise from the bed.

Supervised Bathroom Schedules

Many nursing home fall injuries occur when residents leave their beds to use the washroom at night. The facility can assess its residents’ needs to build a personalized bathroom schedule.

As a result, staff would be on hand to assist the resident in getting out of bed to go to the toilet. Supervised toilet time can reduce the risk of bed falls and injuries.

Frequent Checks on Resident

In addition to building a toilet schedule, checking on the senior frequently can also help prevent falls and injuries.

Frequent checks help meet the patient’s needs outside their normal schedule. As a result, their needs can be addressed before they try to rise out of bed on their own to do or get what they want.

Alarm Bell

Some nursing facilities use alarm systems to learn about patients who need help getting out of bed. The alarm system runs underneath the mattress and detects pressure changes. A decrease in the mattress pressure may signal that a resident is trying to get out of bed. As a result, the alarm would go off to alert staff to come to their assistance. As a result, the alarm can help prevent a potential fall before it occurs.

As alarm bells are hardly effective in preventing falls on their own, they can be used alongside other measures to enhance bed accident prevention. 

What Should You Avoid When Working With Bed Rails?

Bed rails can be necessary to prevent bed falls in elderly people. However, they also pose a danger when installed on seniors’ beds. The most common risks of side rails on the bed are strangulation and injury.

What you should avoid when working with bed rails is leaving a gap between the rails and the mattress. The senior can fall into that gap and become trapped.

When trapped, the senior’s normal breathing can be impaired, resulting in death. Moreover, the person can sustain head and neck injuries as they struggle to extract themselves from that gap.

Therefore, ensure that the bed frame, the rails, and the mattress are compatible to prevent gaps that could trap someone. 

What To Do With a Senior Person Who Keeps Falling Out of Their Bed

Many seniors have difficulties falling asleep or maintaining deep sleep. They may want to get out of bed when they’re awake at night. Nighttime accidents are common in seniors because of their poor vision and imbalance.

Night movements pose a safety risk for elderly people. For example, they can fall when leaving the bed or getting back into it. As a result, you’d want to keep your senior parents in bed at night.

Many seniors fall due to jumping out of bed while dreaming, a condition called rapid eye movement sleep behavior disorder. A change in medication routine can also cause falls from bed in seniors.

An elderly individual who has recently had surgery also has an elevated risk of falling out of bed.

Considering the dire consequences of bed falls in seniors, you should strive to prevent these accidents before they occur.

Here’re some ways to improve bedroom safety for your aging parent at home: 

Obtain Bed Rails 

Bed rails can improve safety in a situation where the sleeping person is at risk of falling out of their bed, and there’s no risk of entrapment or strangulation.

Besides protecting against bed falls, the rails can also provide support when seniors move in and out of bed.

Since bed rails can pose a danger in some situations, ensure they’re fitted properly and no gap is left between the rails and the mattress. If you feel bedrail is a good fall prevention option for your elderly parent, I recommend OasisSpace Bed Rail for Seniors on Amazon.com. It’s easy to install and works with any bed size.

Provide Grab Bars in Bedroom for Support

Grab bars can also be ideal for reducing falls when trying to get out of bed. They may be a safer alternative to bed rails for giving the senior a handhold when getting up.

I recommend Moen 8736 Home Bathroom Grab Bar on Amazon.com for the home care grab bar system. It’s easy to stall and can be put in nearly any space you may want to use it.

That said, grab bars are only one of multiple solutions that make the bedroom safe for the elderly. I’ve written a comprehensive guide on these solutions. Some of them don’t even require buying anything. Click on the link to learn more. 14 Ways to Make a Bedroom Safe for the Elderly

Put Soft Mat on the Floor To Provide a Cushion

A floor mat around the bed can cushion fall impacts and prevent injuries when your aging mom tumbles.

Install Roll Guards

Roll guard is a bedroom safety device worth considering. This device can prevent falls from bed in your elderly parent. If the senior moves too close to the edge of the bed, the roll guard can remind them to move back to the middle.

Raise the Bed’s Edges With Foam Bumpers

Foam bumper on the sides of the bed can ensure a safe night for your senior. Bed bumpers can be an excellent fall prevention device. I recommend the Milliard Bed Bumper on Amazon.com. This non-slip foam bumper is easy to use and can be an effective bed fall prevention aid.

Try Concave Mattress

A concave mattress is another great option for bed fall prevention in seniors. This mattress type has built-in raised edges that reduce the risk of rolling out of bed during sleep.

Get Adjustable Height Bed

If you’re worried about injuries from falling from the bed, get your aging parent an adjustable-height bed. You can lower the bed to the floor to minimize the risk of injuries from falls. 

If your elderly parent also has a hard time moving and walking, you should check out my list of the best beds for the elderly with mobility issues. You’ll find multiple options with unique features. 4 Best Beds for Seniors With Mobility Issues

What Is the Best Bed Height for an Elderly Person?

The ideal bed height for seniors is 20 to 24 inches (508 to 609.6 mm). This position will allow their feet to rest flat on the floor when sitting on the bed’s edge.

For seniors at risk of falling, you can lower the bed to the floor to reduce the fall distance and minimize potential injury from a fall.

It should be easy to adjust to your desired height if you have an adjustable-height bed. Alternatively, you can replace the bed frame to achieve your desired height.

What Is the Best Sleeping Position for Your Elderly Parent?

A good night’s sleep is important for your elderly mom or dad. It can improve their health. For example, a good night’s sleep improves memory and mental health. The body’s worn-out cells and tissues are also repaired during that nighttime rest.

Therefore, besides securing your aging parent from bed falls, you should also mind their sleeping posture as it can affect their sleep quality.

Here’re a few of the recommended sleep positions for older adults:

Back Sleeping 

In this position, you lie flat on the back with the face upward. The legs are straight, and the arms are on the side of the body.

This sleeping posture is great for people with back pain. It also works well for people with neck, shoulder, hip, and knee pain. You can enhance sleep quality in this position by raising your feet a little bit with a pillow.

Raising the feet above the heart level while you sleep improves blood flow and can prevent swelling in the feet.

Right Side Sleeping  

This position involves sleeping on the right side of your body. The right arm can be under your head or stretched forward.

The right-side sleep posture is excellent for someone with pain in the neck or left side of the body. Moreover, this sleep position can improve blood circulation since it doesn’t pressure the heart.

Left Side Sleeping

In this position, you lie on the left side of the body. It works well for someone with pain in the right shoulder.

The left sleeping position can also improve breathing. Moreover, this position can aid brain waste removal and reduce your risk of developing neurological conditions such as Parkinson’s or Alzheimer’s disease.

Here’re a few sleep positions to avoid in old age: 

  • Seniors should avoid sleeping on this stomach. This position can press the chest and cause breathing challenges. 
  • Older adults should avoid sleeping with their arms crossed under the pillow. While this may be your favorite sleep posture, it poses the risk of reducing blood flow to the arms, which can lead to numb feelings.

Conclusion

Bed rails aren’t allowed in nursing homes because they can be a safety hazard to some residents. Whether moving your elderly mom to a nursing facility or hiring a caregiver to your home, your aging parent’s safety is paramount.

Bed falls are a major cause of injuries and deaths in seniors. While bed rails are a common safeguard against bed falls, they aren’t suitable for everyone. Consider a concave mattress, roll guard, foam bumper, floor mat, or grab bar as side rail alternatives for your aging parent’s bedroom safety.

tatorchip

Roger L. "Chip" Mitchell is the owner of Growing Gray USA. Having worked with seniors and their families for over a decade as the owner of ComForCare Home Care of Northwest Georgia, Chip is able to share his insights working with aging senior adults and their adult children who are now finding themselves in a new role as caregivers for their parents.

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