Senior woman in hospital bed looking at doctor, listening to recommendations

When To Consider Bed Rails For Seniors At Home

Helping an older adult stay safe and comfortable at home sometimes involves changing their environment. Bed rails are one option to consider when individuals have trouble moving or are at risk of falling out of bed. Bed rails can offer support for shifting positions, getting in and out of bed, or preventing nighttime falls.

In this article, we’ll cover:

  • What are bed rails?
  • When to consider bed rails
  • Alternatives to bed rails
  • Approaching the conversation of bed safety

Want to learn more about bed rails, fall prevention, or other caregiving tips? Check if you have free access to Trualta’s learning library and community of caregivers.

What Are Bed Rails?

Bed rails, also known as bedside rails or safety rails, are support bars that attach to the side of a bed to help with mobility and safety. They’re often used by older adults who need assistance repositioning, getting in and out of bed, or preventing falls during the night.

There are two main types: 

  • Adjustable bed rails: Can be added to most beds and are easy to install and remove.
  • Hospital bed rails: Are built into or designed for hospital and medical beds.

If you don’t own or rent a hospital bed, adjustable bed rails are the type you’ll likely use. These come in various types and sizes depending on your needs: 

  • Length: Some run along the full side of the bed, while others are shorter and placed only where support is needed. 
  • Attachment: Most attach to the bed frame or slide under the mattress and can be installed on one or both sides. 
  • Features: Many models also include features like adjustable height, safety straps for added stability, or ergonomic grips for those with hand pain or arthritis. 

Bed rails can be helpful for many older adults, but they aren’t a one-size-fits-all solution. While bed rails can be helpful, they’re not always recommended. Using bed rails for seniors is a debated topic within the healthcare system. Systematic research reviews have shown that serious injuries from bedrails can happen, but they’re usually related to outdated designs or incorrect assembly. 

A bed with a metal headboard and a raised bed rail on the side, shown in natural lighting from a nearby window.

When Are Bed Rails Appropriate?

History Of Rolling & Falling Out Of Bed

If your loved one has rolled or fallen out of bed while sleeping or turning, a bed rail may help reduce injury and offer a sense of security. Full-length rails can act as a barrier, stopping a loved one from falling if rolling while asleep. 

Trouble Repositioning In Bed

Some seniors have trouble readjusting in bed due to physical limitations, weakness, or pain. A bed rail offers added stability and allows them to use their upper extremities to help them when turning or sitting up. 

Consider a quarter-length versus full-length bed rail if you mainly want to help with bed mobility. This will provide support and assistance for entering or exiting the bed without completely restricting access.

Support For Getting In & Out Of Bed

Bed rails can act like a grab bar, offering added support when moving from sitting to standing. This can be especially helpful for those with balance issues or limited lower body strength. Additionally, this can be useful if your loved one’s mattress is very soft or the bed is low. If your loved one has weakness on one side of their body, such as after a stroke, a single rail on that side may be enough. 

Good Awareness & Confidence With Rails

It’s important to note that bed rails are best suited for mentally alert seniors who can understand the benefits of a bed rail. The use of a bedrail can offer more comfort and independence. Understanding why the rail is there can help it feel like a support, not a barrier.

When Are Bed Rails Not Appropriate?

Cognitive Impairment Or Confusion

Full-length bed rails can be perceived as a form of restraint, especially if both sides are raised and the person cannot get out of bed independently. This may lead to stress, agitation, or confusion. Seniors with dementia, delirium, or other conditions affecting thinking may not understand the purpose of the rail and could view it as something limiting their freedom. In some cases, they may try to climb over it, increasing the risk of injury.

Independent Mobility

If your loved one can move and get out of bed on their own, a bed rail may not be needed. Similarly, it could become an obstacle. Climbing over or around the rail, especially at night, can actually raise the risk of falling or getting hurt.

Alternatives To Bed Rails

If bed rails don’t feel like the right fit for your loved one, there are other ways to promote safety and support independence at night. Some caregivers choose to combine these alternatives with bed rails for added safety.

Here are a few alternative strategies to consider:

  • Reduce the risk of injury if a fall occurs: Lowering the bed, if possible, can reduce the chance of serious injury if a fall occurs. Placing a fall mat or cushioned surface beside the bed provides additional protection. Using an adjustable bed can also help by improving positioning and reducing the risk of rolling out of bed during the night.
  • Use simple strategies to lower nighttime risks: Install a night light to improve visibility and reduce confusion during bathroom trips. If support is needed, consider using a grab bar or transfer pole instead of a bed rail to help with mobility. A bell or monitor can also allow your loved one to call for help. For those at higher risk of falling or getting up alone, consider scheduled checks or overnight supervision.
  • Support better movement in bed: Ask a healthcare provider about exercises or strategies to improve strength, balance, and ease of movement.

Approaching The Topic Of Bed Safety

It’s important to include your loved one in the decision-making process whenever possible. Ask how they feel about using a bed rail and whether they think it would help. Share information about the potential benefits and show them the different types and sizes available. Focus on what matters most to them, whether it’s feeling safe, staying independent, or getting better sleep. If they’re unsure, suggest trying a temporary rail and seeing how it works. Adjustable bed rails are easy to install and remove if needed.

Conclusion

Using bed rails for seniors can be helpful, but like any safety device, they work best when chosen carefully and used correctly. They may be worth considering if your loved one has difficulty with bed mobility or is at risk of falling. However, it’s important to consider how well they understand the purpose of the rail and how it may affect their ability to move freely. Whenever possible, the decision to use bed rails should be made together, based on your loved one’s needs, preferences, and overall safety.

Don’t forget: Do you want to learn more about caregiving tips and tricks? Check if you have free access to Trualta.

References 

  1. Frances Healey, David Oliver, Alisoun Milne, James B. Connelly, The effect of bedrails on falls and injury: a systematic review of clinical studies, Age and Ageing, Volume 37, Issue 4, July 2008, Pages 368–378, https://doi.org/10.1093/ageing/afn112
  2. How To Pick The Best Bed Rails For Seniors. (2021, August 20). Forbes Health. https://www.forbes.com/health/healthy-aging/best-bed-rails/
  3. Huynh D, Lee ON, An PM, Ens TA, Mannion CA. Bedrails and Falls in Nursing Homes: A Systematic Review. Clin Nurs Res. 2021 Jan;30(1):5-11. doi: 10.1177/1054773820907805. Epub 2020 Feb 22. PMID: 32088988.
  4. What Are the Types of Bed Rails? | AssistedLiving.org. (2022, July 17). AssistedLiving.org. https://www.assistedliving.org/best-bed-rails-for-seniors/what-are-the-types-of-bed-rails/

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