THE RISKS OF BED RAILS
By: Patrece Banks

Bed rails have been the standard for bed mobility, bed safety, and fall prevention; however current research has proven this standard has known risks. The Food and Drug Administration (FDA) recently released new bed safety guidelines for all care settings including the home. These guidelines are intended to change current thinking and practice of traditional bed rail use for safer and more effective alternatives.

A compliant hospital bed system with bed rails can be safe if used on a patient that has been properly assessed for a medical condition. Additionally, the assessment must be ongoing as medical necessity can change. There are some hospital bed systems that are not compliant and there are known risks that cannot be ignored. Many of these non-compliant hospital beds are now in homes as well.

Even more worrisome is the use of bed rails on traditional home beds. Bed rails sold without telling buyers of the risks leads people to believe they are providing a safe bed environment, when in fact they may be placing their loved one at risk. These products come in many shapes and sizes. Even small bed rails pose a risk of entrapment which occurs when a person gets trapped between the rails or between the bed rails and the mattress. This can cause injury or death. Cognitive impairment can increase the entrapment hazard. Rails are often recommended indiscriminately by healthcare providers and suppliers that are unaware of the risks themselves.

It is also important to understand what a restraint is, the risks and whether restraints are necessary. A restraint is something you cannot easily remove or restricts freedom of movement. For example a chair or sheet can restrain some people. Most people who need assistance with bed mobility do not need added barriers in or around their bed. The goal is to remove barriers and obstacles. Even a small bed rail can restrict freedom of movement and increase the risk of a bed fall.

Bed rails can increase the risk of injury from falling when a person attempts to climb over the rails. This can cause agitated behavior when bed rails are used as a restraint, thereby bruising, cutting or scraping the skin. Healthcare providers who work with patients in any setting, including the home, are there to provide a hazard-free environment and promote quality care. However, the lack of knowledge of appropriate safety issues can lead to unnecessary injuries and even death.

Other common misconceptions are “falling out of bed” versus a “bed fall”. Few people fall out of bed, i.e. roll out of bed. Most people fall while getting into or out of bed due to a loss of balance. To fully understand bed safety, bed mobility, and bed fall prevention the following statistics about falls and older adults are important:

• Falls are the leading cause of injury or death for those 65 and older.
• Falls from bed are the 2 nd leading cause of fall deaths.
• 95% of hip fractures are caused by falls.
• Of those who fall, 20% to 30% suffer moderate to severe injuries such as hip fractures or head traumas that reduce mobility and independence, and increase the risk of premature death.

Restraints should only be used when other, less severe alternatives fail to address a resident’s medical needs and the benefits outweigh the potential risks.

There are alternatives to typical bed rails that can be used with patients or family members. The goal is to reduce and eliminate restraints as well as entrapment hazards. There are various products and new tools that are sturdier and have safety or restraint free features built into the design. Understanding safety in and around beds and the alternatives available will help promote safe environments, quality of care and knowledgeable consumers and providers.

For more information about the different assistive devices and the resources available in Orange County, call the County of Orange Office on Aging at (800) 510-2020 or (714) 567-7500. Their friendly and knowledgeable Specialists also have resource information on meals, in-home care, healthcare, transportation, legal, caregiving assistance, prescription insurance, exercise classes and much more!