Things to Know Before Using a Bed Rail for an Older Adult at Home

Bed rails might be an obvious choice for caregivers who want to make an older adult’s sleeping area feel safer.

But choosing the right safety equipment isn't always as simple as it appears.

Before bringing a bed rail into the home, caregivers should understand what to look for, what questions to ask, and how to decide whether it is the right choice for their loved one.

How Bed Rails May Help

For some older adults, a properly selected bed rail can serve as a useful aid. It may provide a stable handhold when the person needs to sit up, change position, stand, or get themselves into or out of the bed.

Bed rails may also help some individuals feel more secure while sleeping or reduce the chance of accidentally rolling off the mattress.

Bed Rail Risks

The U.S. Food and Drug Administration warns that certain individuals may face a higher risk of injury when bed rails are used.

Extra caution may be needed when the older adult experiences:

• Confusion or disorientation

• Restlessness or agitation

• Poor muscle control

• Sleep disturbances

• Balance problems

• Difficulty walking safely without assistance

• Weakness or limited mobility

• Impaired judgment

• Medication-related confusion or drowsiness

• Cognitive impairment caused by Alzheimer’s disease, another form of dementia, Parkinson’s disease, multiple sclerosis, stroke, low blood pressure, or another medical condition
  

The risk may be even greater when several of these factors are present at the same time.

They are at risk of:

• Entrapment - A person’s head, neck, chest, arm, leg, or other body part may become trapped within the rail or in the space between the rail and the mattress. This can result in bodily injury, strangulation, suffocation, and even death
  

• Feeling of isolation or unnecessarily restricted - Some older adults may also feel trapped, isolated, or unnecessarily restricted. This can increase fear, frustration, or agitation
  

• Falls - A high risk person may also try to climb over the rail. This can lead to a more serious fall because they are falling from a greater height
  

• An older adult may experience bruises, cuts, scrapes, or skin tears when moving against the rail. This can be especially serious for people with fragile skin

Things To Consider Before Installing A Bed Rail

1. Before installing a bed rail, discuss the decision with the older adult’s physician or another qualified healthcare professional. They can help make an individualized assessment and offer guidance based on the person’s mobility, cognition, strength, medical condition, and reason for needing support.

   They may give you alternatives to bed rails such as:

• Roll guards or foam bumpers

• Lowering the bed closer to the floor

• Using a properly selected low bed

• Considering a concave mattress designed to reduce rolling

• Installing a bed trapeze to assist with repositioning

• Using a bedside transfer pole

• Adding a bed-exit alarm or motion sensor

• Placing motion-activated lighting near the bed

• Using a bedside commode when bathroom distance is a concern

• Improving the placement of walkers or other mobility equipment

• Arranging additional nighttime supervision

2. If a bed rail is recommended, check that the product complies with ASTM F3186-17, the Standard Specification for Adult Portable Bed Rails and Related Products. This FDA-recognized safety standard includes performance requirements designed to reduce entrapment and other hazards.

   Check with the manufacturer to confirm that the rail can safely be used with the specific:

• Bed frame

• Mattress size

• Mattress thickness

• Mattress type

• Adjustable or platform bed design

• Mattress topper, if one is used

  
  

Soft mattresses deserve particular attention because they may compress under the person’s weight and create a larger opening between the mattress and the rail.

Follow all installation instructions carefully. Use every required strap, bracket, fastener, and retention device.

Do not improvise with pillows, towels, foam, rope, or homemade straps to fill gaps or secure the rail. These materials can shift, compress, or create additional hazards.

3. Inspect the Rail Regularly

Even when a bed rail is initially installed correctly, it may loosen or shift over time.

Caregivers should inspect the bed, mattress, and rail regularly to make sure:

• The rail remains firmly attached

• Straps and fasteners are secure

• The mattress has not shifted

• No new gaps have formed

• The rail is not damaged or bent

• The person’s condition or behavior has not changed

• The rail still serves its intended purpose

• The setup should also be checked after the bed is moved, the mattress is replaced, a topper is added, or the older adult returns home from a hospitalization.

Other Safety Reminders

If the person becomes trapped or nearly trapped between the rail and mattress, reassess the situation immediately, even if no injury occurs.

Do not assume that the incident was a one-time accident.

A near miss is an important warning that a more serious event could happen next.

Bed rails should never be used as a substitute for supervision when the person requires hands-on assistance or monitoring.

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This article was made by  Elder Love USA.

As the only nonprofit agency in California offering home care services, we are dedicated to providing compassionate affordable in-home care.  

All caregivers undergo thorough background checks and training with certification.  

Our rates are lower than other providers thanks to partnerships, donations, grants, and revenue from our cleaning program.  

Our caregivers can assist with personal care, shopping, cooking, transportation, housekeeping, and case management.  

We proudly serve Riverside County, CA, San Diego County, CA, San Bernardino County, CA, Orange County, CA, Imperial County, CA, and Phoenix, AZ. 

If you’d like to learn more about how our services can benefit you or your loved one, contact us today.

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