Sleep and Bedroom Safety for Seniors

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In adults age 65 and over, injuries are most frequently caused by falling down. Every year, 36 million older adults in the U.S. report falls. Older adults living independently face an increased risk of falling, with about one-third experiencing falls each year.

Certain health conditions, medications that cause dizziness or sedation, and vision problems increase a person's risk of falling. However, many fall accidents can be attributed to unsafe conditions in the home. One Swedish study of people living in senior housing found that most injuries related to falling happened in the bedroom due to incorrectly assembled beds, inadequate lighting, and unstable furniture.

There are steps older adults and caregivers can take to remove safety hazards from the bedroom, prevent injuries, and promote healthy sleep habits. We explore the best bedroom safety practices and products that encourage safe sleep.

In and Out of Bed

Getting in and out of bed can pose significant challenges for some older adults, including individuals who have trouble walking, maintaining balance, or seeing. Conditions like postural hypotension can increase the risk of falling when getting out of bed. Due to a sudden drop in blood pressure, people with postural hypotension may feel dizzy, faint, or fall when they rise from a lying or sitting position.

Certain products are designed to make getting in and out of bed safer.

Bed Rails

Also known as support rails, bed handles, and bed assist rails, bed rails are metal or plastic bars connected to the side of a bed to provide stability and leverage. They also prevent a person from rolling out of bed as they sleep. Bed rails may help a sleeper get in and out of bed and change their position within bed more easily.

Traditional bed rails are fixed to the bed frame itself, running parallel alongside the mattress. Other varieties include smaller upright handles that slide down against the bed or between the mattress and box spring, and adjustable rails that can fold down when they are not being used. Some bed rails are designed to work specifically with adjustable or hospital-style beds, while others fit any type of bed.

Additional safety tips should be considered when shopping for bed rails.

  • Consult a doctor: Since bed rails can pose a safety risk, people considering them should first consult their doctor. A medical professional can discuss bed rail safety and help determine if bed rails are called for in a specific situation. An occupational therapist can also evaluate mobility and provide suggestions for easier bed transfers.
  • Measure the bed: Before purchasing bed rails, measure the bed to ensure that the rails being considered are tall enough to provide adequate coverage. Purchasing the right rails helps ensure bed rail safety.
  • Assess mobility: It is important to choose the right bed rail for the sleeper's mobility level. Smaller varieties may be ideal for people who occasionally need stability, while full-length bars can be a good option for those who have trouble rolling over or getting out of bed.
  • Accommodate height and body weight: A bed rail should accommodate the sleeper's height and weight. The user should be able to grasp the rail from a variety of positions, and the rail should be strong enough to bear their full body weight.
  • Consider strength required: Some bed rail models can be difficult to install and adjust for people experiencing weakness or limited mobility. People who live alone may struggle to raise and lower certain support rails without assistance.

Bed Bumpers

Bed bumpers, also called positioning wedges, are rolls or angular wedges made from foam or stuffed cloth. They sit on a mattress around its perimeter to prevent the sleeper from falling out of bed. Bed bumpers can sit on top of the sheets, or beneath a fitted sheet that helps keep them in place. Bed bumpers provide a soft alternative to bed rails for individuals who tend to roll out of bed, although they do not provide the same stabilizing leverage as support rails.

Positioning wedges can be a suitable option for people with limited mobility or cognitive issues that cause nighttime confusion. Combine bed bumpers with full-length bed rails to prevent injury or entanglement. Sometimes, the term bed bumpers is also used to refer to smaller cushioned panels or tubes that can be placed on top of bed rails to make them soft.

Personal Transfer Devices

Personal transfer devices are designed to make it easier and safer for individuals with mobility issues to get in and out of bed, use the toilet, bathe, and change seats without a caregiver's help. Some are intended for people with mild balance issues, while others provide support for individuals who cannot stand without assistance. These devices can help prevent falls in the bedroom.

  • Leg lifting straps: Ideal for individuals with hip trouble, these simple nylon straps let a person lift their own legs and feet in and out of bed. A person uses leg lifting straps by placing their feet in the middle loops and using the hand loops to maneuver.
  • Transfer poles: Transfer poles can be tension mounted from the floor to the ceiling in almost any household location, including the bedroom. They give a person something to grasp as they sit or stand, which can promote steadiness and potentially decrease falls.

Transfer Aids for Caretakers

Transitioning people from one location to another can be challenging for caregivers. Some transfer aids are designed to help caretakers safely move people in household settings. These devices should not be used without an aide's assistance.

  • Transfer boards: Caregivers can use transfer boards to help people slide from a wheelchair into bed without standing up. Made from wood or plastic, transfer boards can be flexible or firm. Some feature slots or sliding discs.
  • Gait belts: These cloth or canvas belts help caretakers prevent falls and injuries. Gait belts featuring handles or loops, called walking belts, have been found to feel more comfortable by those wearing them and reduce physical stress put on caregivers.
  • Patient lifts: Patient lifts come in two varieties: slings and stand-up lifts. They may run on electric, battery, or manual power. Caregivers use patient lifts to move individuals between seated, standing, or reclining positions.
  • Transfer chairs: Similar to patient lifts, transfer chairs help caregivers move people between positions and locations, but they must be pushed like wheelchairs. They adapt to different heights and some can be outfitted to accommodate toilets.

The type of transfer aid a caretaker uses depends on factors related to the person they are helping, such as their mobility range, height and weight, and household layout. A transfer chair might not be useful in a small apartment, for example, while larger people may need a patient lift.

Medicare Coverage Information

Medicare covers many items that can help older people get in and out of bed. These items fall under the umbrella term durable medical equipment (DME). Your doctor must prescribe the DME for home use, and both your doctor and the product supplier must be enrolled in Medicare.

You may be expected to rent some types of DME and purchase others, or you may be able to choose whether you rent or buy the item. Eligible durable medical equipment includes:

  • Hospital beds
  • Power mobility devices
  • Patient lifts
  • Walkers
  • Wheelchairs and scooters
  • Canes
  • Commode chairs
  • Crutches

Sitting Up in Bed

Although sitting up in bed can be difficult for people with mobility challenges, it is crucial that they are able to do so. Long-term bed rest and inactivity are associated with many health problems, including sepsis and loss of muscle mass. In addition, people who cannot easily sit up in bed may not be able to reach a phone or alarm in an emergency.

Older people who have difficulty sitting up can reduce safety hazards in the bedroom by using an adjustable bed and keeping key items close to the bed.

Adjustable Bed or Bed Frame

Adjustable beds and bed frames let the sleeper raise and lower the bed's head and foot with a remote control or smartphone app. Unlike many hospital beds, they do not need to be adjusted manually. The sleeper can sit up with the push of a button, making adjustable beds a suitable option for individuals with limited upper body strength or certain health conditions. Some adjustable bed frames can be paired with conventional mattresses.

Adjustable bed frames can damage some mattresses. If you plan to use your current mattress with a new frame, be sure the mattress can handle frequent bending and movement. Some beds include health and safety features that can benefit older adults, including massage settings and under-bed lighting. Couples may want to consider split frames, which allow sleepers to raise and lower each side of the bed independently.

Keep Aids Close to Bed

Keeping aids close to the bed can greatly improve home safety for elderly people, and a sturdy bedside table is an ideal place for them. Individuals who can easily access mobility aids, alarms, and similar items are better prepared for emergencies. Having necessities within arm's reach may also reduce the risk of falling, by reducing the number of times a person needs to stand.

When setting up bedside arrangements, keep in mind that older adults should be able to access phones, medical alert buttons, and bed controls while lying down and sitting up in bed. Look for adjustable tables that attach to the bed frame or slide between the mattress and box spring. Consider buying a grabber tool, which extends a person's reach and lets them grasp items that are farther away.

Medicare Coverage Information

Adjustable beds, hospital beds, and some bedding items are covered under Medicare Part B. To qualify for coverage, a participating doctor must prescribe the bed and provide documentation stating that you need the bed due to a medical condition. Medicare may cover rental costs or pay for the item outright.

Talk to your doctor to find out if Medicare will pay for your:

  • Adjustable hospital bed
  • Height-adjustable bed
  • Air-fluidized bed

Navigating the Bedroom

Mobility challenges, vision problems, pain, and other health symptoms can make it hard to get around the bedroom. Poor lighting, clutter, and unstable furniture and fixtures may further increase a person's risk of falling. There are several ways to make bedroom navigation safer for older individuals.

Adequate Space

A bedroom should be spacious enough that a person can move around freely within it, even with a mobility aid. One survey suggests that many older people find it difficult to navigate bedrooms without enough open space surrounding the bed. It may help to maximize bedroom space.

  • Declutter: Clear space by removing clutter, unnecessary furniture, and tripping hazards like long electrical cords, large decor, and area rugs.
  • Carefully measure: Measure walkers and wheelchairs to ensure that there is plenty of room to move forward, back up, and turn corners.
  • Utilize storage: Save floor space by storing items on bracketed wall shelves and in cabinets. Mount TVs on the wall, if possible.

Walking Aids

Walking aids should be placed close to the bed for easy access, but they should not prevent a person from getting out of bed or block their navigation path. Keep walkers, canes, and wheelchairs within arm's length of the bed so they can be quickly grabbed in case of an emergency. Do not leave mobility aids in a place where they are hard to see, or where someone may trip over them.

To more easily store mobility aids near the bed, look for cane holders or walker docks that attach to the bed frame. Consider using a foldable wheelchair or modifiable transfer chair as a bedroom aid. Both are easier to store in small spaces than many other options.

Non-Slip Socks

Hospital socks, also called non-slip socks, have rubber treads on the bottom to help the wearer's feet grip the floor and prevent falls. Healthcare facilities often give them to people who may slip if they wear regular socks. Non-slip socks come in a variety of styles, sizes, and colors.

Light-colored non-slip socks are easier to see in the dark, making them a good choice for people with vision problems. Some non-slip socks feature a tread all the way around the foot instead of just on the bottom of the sock, for maximum safety. Non-slip socks are available for individuals with diabetes or circulation problems. Slippers, booties, and tall boots may also come in non-slip varieties.

Task Reduction

Sometimes the easiest way to prevent falls is to decrease the number of times a person needs to stand and walk. For this reason, individuals with mobility difficulties may reduce their opportunities for falling by streamlining their daily activities.

  • Plan ahead: Perform daily tasks in one long stretch to avoid getting up repeatedly.
  • Enlist help: Ask caregivers, friends, and relatives to help with intensive household chores, cooking, and home maintenance.
  • Avoid unnecessary trips between rooms: Keep entertainment and media in the bedroom. Consider a wall-mounted TV, bookshelves over the bed, and under-bed storage for tablets and laptops.

Fall Safety

Increase fall safety by planning to both prevent and treat falls.

Tripping Hazards

Sometimes, older adults fall because they have tripped on something. Common tripping hazards in the bedroom should be removed or properly secured.

  • Electrical cords: Loose cords and cables can trip wheelchairs and walkers. Secure electrical cords and charging cables to the wall with electrical tape, or look for special hooks that attach to the wall to hold cords and keep them off the floor.
  • Floor clutter: Piles of clothing and household items take up floor space and are often hard to see in the dark, making it important to keep the bedroom neat. Throw away or donate unneeded items on a regular basis. If mobility problems make cleaning difficult, consider asking for help.
  • Rugs: Rugs become a tripping hazard when they are loose, damaged, or are not secure. Avoid rugs that lack a tread on the bottom, or secure them to the floor. Replace old, fraying rugs.
  • Flooring: Broken or loose tiles, damaged floorboards, and peeling linoleum are hazardous. Repairing damaged flooring and carpets can help prevent issues.

Alarms

Medical alert systems, also called personal emergency response systems (PERS) contact emergency services with a push of a button. The systems consist of a base unit and a necklace, bracelet, or smartwatch with an alert button that communicates with the base. When a person is in range of the base unit, they can press their alert button and instantly call for an ambulance or other assistance if they are sick or injured. Most services charge a monthly or annual fee.

Some personal emergency response systems include features like fall alarms, car crash detection, multilingual support, spouse monitoring, and global positioning system (GPS) technologies. The base unit should stay in a central location, or in the bedroom if you spend most of your time there. Some alert systems come with the option to add an extra alert button, medication alert services, or automated check-ins for additional fees.

Fall Mats

Fall mats are thick, slip-resistant pads made of high density, impact-absorbing materials. They have beveled edges to allow wheelchair access and are often placed alongside beds. They may be a good option for people who become dizzy when they stand up or have trouble getting out of bed.

When shopping for a fall mat, choose one that can be secured to any surface. If space is limited, look for a foldable variety that can be moved from room to room.

Medicare Coverage Information

Medicare does not usually cover items like non-slip socks, although some fall mats may be eligible if you purchase them from certain suppliers. If you plan to buy a fall mat, be sure the seller participates in Medicare.

Most medical alert systems are not covered under Medicare Parts A and B because they are not considered durable medical equipment. However, some Medicare Advantage plans may cover certain alert systems.

VA Coverage

The U.S. Department of Veterans Affairs (VA) provides free LiveLife Mobile Alarm and MedEquip Alert medical alert systems for qualifying veterans. To find out if you are eligible, you or your caregiver must meet with a VA doctor, who will determine if you need a medical alert system to live safely. If you qualify, you may submit a durable medical equipment request to the VA for approval.

Sometimes, the VA will partially cover the cost of advanced systems with features like fall alarms and spouse monitoring. However, you would be responsible for at least some of the monthly fees.

Emergencies and Safety

Emergency plans are an important part of home safety for older adults. There are a couple factors to consider when making these plans.

  • Preexisting conditions: Make emergency contacts aware of preexisting conditions, such as diabetes, high blood pressure, or allergies to food or medication. Provide information about medication dosages, necessary devices, and doctors' phone numbers. Wear a medical alert bracelet listing health conditions in case of an emergency.
  • Phone access: Landlines and mobile phones should be easy to access at all times. Keep landline phones close to the bed, or place a phone in every room if possible. Consider a smartwatch for individuals who frequently misplace or forget their cellphones.

Medical Coverage

Medicare typically covers preexisting conditions at no additional cost, without imposing a waiting period. However, some conditions may make it harder to get supplemental coverage through private insurance companies.

Medicare offers Special Needs Plans for individuals with certain chronic conditions, including:

  • Autoimmune disorders
  • End-stage liver and kidney diseases
  • Cancer
  • Cardiovascular disorders
  • Chronic heart failure
  • Dementia
  • Human immunodeficiency virus (HIV)
  • Diabetes
  • Stroke and other neurological conditions
  • Disabling mental health disorders

Mattresses

You may need to replace your mattress every 7 to 10 years, or as soon as your current mattress shows signs of damage or significant wear that causes discomfort. You may also consider getting a new mattress, a pressure-relieving mattress topper, or an adjustable bed if you are diagnosed with a health condition that limits mobility or you struggle to get in and out of your current bed.

Choosing an accessible mattress or bed frame is important, especially if you use a mobility aid. Measure the height of any bed you consider to ensure that you can safely transition between your wheelchair or walker and the bed.

If you or a loved one is facing a temporary condition or recovery period, consider renting a hospital bed. Hospital beds can be beneficial for individuals who need round-the-clock care. They are also covered under Medicare, while some adjustable beds and mattresses are not.

Other Hazards

Poor lighting in the bedroom is associated with an increased risk of falling, and adequate light is an important part of maintaining home safety. Be sure that walkways are well lit and highly visible. People with vision problems may benefit from additional lights and a nightlight.

Windows and floors should also be in good working condition. Broken windows and uneven flooring can lead to injuries and falls. They may also let in cold air, moisture, and insects. This makes it important to repair damaged windows or floorboards as soon as possible and monitor the environment for signs of mold, mildew, or pests.

Additional Considerations

There are other important safety factors to consider.

  • Air quality: Regularly test the bedroom air for mold and allergens, which can worsen some health conditions and cause breathing problems. Treat dry air with a humidifier and overly moist air with a dehumidifier.
  • Bedroom location: The bedroom should be located as close to the bathroom as possible to help reduce falls.
  • Smart home devices: There are a variety of useful smart home systems, from security monitors to all-in-one controls that connect with smoke alarms, detect water leaks, and give medication reminders. Hands-free setups work well for those with limited mobility.

Grants and Financial Aid

Working with a health insurance provider, through Medicare or a private insurer, is one way to potentially secure funding for bedroom safety equipment. The following programs may also offer financial assistance options for out-of-pocket expenses and products not covered by insurance.

Program What it May Cover Eligibility
Disability Housing Grants for Veterans Home modifications or purchasing a premodified house Veterans with certain service-related disabilities
Home Improvements and Structural Alterations (HISA) Home modifications Veterans with disabilities that are not service-related
Here for a Reason Durable medical equipment (DME) not covered by insurance Anyone who cannot afford the cost of required DME

 

Many resources that help with locating and paying for safety equipment operate locally. Search the databases below to locate programs near you. Then contact those programs directly to find out if they can help with paying for the products you need.

Program Description
2-1-1 Over 200 programs across the country offering referrals to local assistance programs, including financial aid
Eldercare Locator Connects older adults with government and community-based resources that can help address health and disability issues
Salvation Army A national charity with locations throughout the U.S. that may be able to provide safety products at free or low cost
Catholic Charities A charity network that addresses unmet needs, regardless of a person’s faith background

Frequently Asked Questions About Sleep and Bedroom Safety for Seniors

What Is the Best Bed Height for Seniors?

According to the Disability Rights Education & Defense Fund, the best bed height for seniors is 20 to 23 inches from the floor to accommodate wheelchairs. However, some individuals may prefer a lower or higher bed, depending on their needs.

What Are Common Safety Hazards in the Bedroom?

Common bedroom safety hazards include poor lighting, cluttered floors, damaged flooring, and unstable furniture.

How Should an Older Adult Set up Their Bedroom?

Older adults should arrange their bedrooms with safety in mind, storing crucial items like mobility aids close to the bed and keeping floors clear for easy navigation.

Resources for Seniors and Caregivers

  • AARP Home Safety Checklist: Use this printable checklist from the American Association of Retired Persons (AARP), the nation's largest nonprofit seniors' organization, to ensure that every room in your house is safe and secure.
  • The Brain-Sleep Connection: Working in conjunction with the AARP, the Global Council on Brain Health developed this series of guidelines to help people over 50 get better sleep and stay mentally sharp.
  • Check For Safety: This safety checklist from the Centers for Disease Control covers common hazards in each room, along with tips for staying mobile and preventing falls.
  • Medicare Policies for Sleep Medicine: The American Academy of Sleep Medicine details which sleep-related procedures and health aids are covered under Medicare.
  • Instructional Videos for Home Caregivers: This video series offers advice on caring for people who are bedbound. Topics include safe mobility, bathing, and avoiding falls.

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