The public’s focus on safety for everyday activities such as driving, medications and even walking has grown significantly over the past three decades. Keeping people safe has become a slogan for companies who do business in most markets or industries. We see daily public service announcements about seatbelt safety, texting and driving—even ads about eating your vegetables. Very rarely is anything communicated about sleeping safety. After all, sleeping is part of our nature. It’s instinctual. Getting to sleep is difficult for some, and sleeping disorders like sleep apnea affect millions. Sleep is not always an easy activity for the majority of Americans. How can you parlay safety into sleeping? First, we need to understand that the average 65-year-old spends almost nine hours a day in bed (Bureau of Labor Statistics, 2011). This number rises depending on medical conditions and activity levels. It is the most time spent on one activity in the average 65-year-old’s daily routine. Bed safety starts with comparison to the national average. The more time a person spends doing something, the greater the risk of an accident or injury.
We then address the kind of bed a user is sleeping in. Most seniors are sleeping in traditional beds with box springs and a pillow-top mattress. Many have found solace sleeping in adjustable beds, while some have been provided with medical or hospital beds due to an illness or positioning needs. The different style beds present different challenges. Compounding those challenges are personal traits and capabilities, medical diagnosis, strength and cognitive ability. Deciding which bed is best for you can be simple and should ultimately be discussed with your doctor. Contact a local HME provider for other options. Whichever bed you use, it should be a benefit to your life, not just a fixture in your life. The top of your mattress should be at a height that allows you to comfortably get in and out. If you are at risk of falling out of your bed, keep in mind that a lower bed helps reduce the severity of injuries, but can be very difficult to get out of when transferring. Beds that you or your caregiver can simply adjust in height to make transfers easy. Pay particular attention to the mattress you are using, especially if your medical condition is one that results in fragile skin or poor circulation. Long periods of time resting on a basic mattress can lead to skin breakdown and pressure ulcers. If you are using a hospital bed, consult with your provider about different options for your mattress. There are a multitude of optional accessories for a bed that, when used properly, can make your bed experience more comfortable and more practical. The most prominent of accessories, and one that is typically used with a hospital bed, is a set of side rails. The most basic and common use of the rails is to keep you from rolling out of the bed and falling. Rails come in all shapes and sizes and perform different functions. It is imperative to understand this simple fact—if accidentally rolling out of the bed is not a concern, then you may not need rails on your bed. Again consult your doctor and your HME provider to decide if rails are right for you. The US Food and Drug Administration and the Consumer Product Safety Commission issued warning as early as 1995 and as recent as 2012 about the risks associated with bed rails. In 2006, the FDA published voluntary guidelines that detail different measurements of the rails. These measurements only pertain to entire bed systems which include the bed, rails, and mattress. If you have a hospital type bed, it is critical to research where your bed system is from and if it meets these guidelines. The components of the bed system should all come from the same manufacturer. Rails that are marketed as universal and for use with any type of bed may be harmful if not mounted properly. Carefully follow the installation instructions and read all warnings in the owner’s manual. More information on bed rail entrapment can be found at fda.gov or invacare.com/bedsafety. Bed wedges have grown in popularity as an alternative to using a hospital bed. These foam wedges are easy to slide behind your torso, so the wedge elevates your head. These wedge pillows can be used in any type of bed, and, by propping up your head and torso, you can breathe easier, simplify eating in bed, and comfortably watch television. Bed wedges also alleviate fatigue while sitting up to talk with others in the room. Fall mats have traditionally only been found in places like nursing homes and hospitals. Today, designer mats for home use can be placed next your bed as a mode of decor. These mats provide functionality, cushioning from a fall while adding style to the room. A low height bed used in conjunction with a fall mat may reduce the need for side rails. Look to your local HME provider for other accessories such as over-bed tables. These tables have a base that rolls under your bed, while the top makes it easier to grab a bite to eat, hold the telephone and television remote, as well as your favorite book or computer tablet. Keeping these items within reach reduces fidgeting and unnecessary transfers. If you need help with transfers or repositioning, trapezes can be installed to offer the user a convenient handle bar within reach. Positioning with a trapeze employs the assistance of your upper body strength. Using the proper bed, the proper mattress and the proper accessories can help minimize the risk of injury, but there are a few other best practices to form safe habits in your life. Know if you need help transferring in and out of bed. If you cannot transfer on your own, build schedules around toileting, bathing and eating so someone can be there when you have to get out of bed. Look for obstacles on the floor. Power cords, telephone wires, shoes, even side tables or over bed tables. The walkway to the kitchen, bathroom or front door should be clear to prevent falls. If you need a mobility device such as a walker or cane, keep it close to the bed so you can use it as a transfer aid. If you are still independent, build a network of caregivers, friends and family who can develop a monitoring program that includes daily visits and frequent phone calls. Finally, if your condition should change at any time, consult your doctor about your sleeping habits and the bed system you may need to use. If your bed is electric—which includes most beds that have adjustable heights—have someone periodically assess the condition of the power cord. Frayed or damaged cords—mostly from vacuum cleaners or patient lifters—can lead to risk of shock or fire. If you are using a hospital or adjustable bed, contact your home HME medical equipment provider for any missing, damaged or non-functioning parts. Refer to the owner manual instructions, warnings and cleaning tips. While it’s unlikely that we will ever see a Super Bowl commercial concerning bed safety, we all have a responsibility to acknowledge the dangers, understand the causes and do our best to minimize the risks. Awareness begins with the individual user, who knows the best possible environment surrounding their own bed and bed safety practices. Consult your doctor, physical therapist, caregiver or your medical equipment provider for the proper solutions. Select the right type of bed to fit your individual needs and diagnosis. If you are using a hospital type bed system, confirm that it meets FDA guidelines. Look to simple accessories to enhance your experience, and be cognizant of falls. All of these components can help create a pleasant and functional bedtime experience where users can be capable of enjoying their rest.
