Bed Rail Safety

Last updated: November 29, 2012

Worried about a loved one falling out of bed? Don't rely on bed rails to keep him or her safe, says a new report in Biomedical Safety & Standards, a newsletter for medical-device safety professionals.

Though portable bed rails are often marketed as safe, they can increase the risk of injury and death.

That's not news in eldercare. After almost 1,000 cases of entrapment of frail seniors, and 484 deaths, were reported to the FDA between 1985 and 2010, long-term care facilities have been phasing out use of bed rails. But many caregivers rent them from hospital-supply stores for use at home.

Some stay-safe guidelines:

  • Don't believe everything you hear.
    The BS&S report specifically calls out products advertised as being able to make "any bed a safer bed" because it's an unproven claim. Safety standards exist for bed rails for children, but not adults.

  • Be sure of the big picture of why bed rails seem needed.
    Correctible incontinence often keeps getting people up at night, for example. Or poor balance and dizziness may be adding to unsteadiness.

  • Consider all the alternatives.
    The challenge is that while bed rails are often unsafe, the alternatives can be, too. Those who fall out of bed risk breaking bones, for example. Lower mattresses can help, such as a hospital bed on its lowest setting or a platform bed, which doesn't require box springs. Or consider a mattress on the floor (to cushion falls) or a motion alarm system (to notify a caregiver help is needed getting up).

  • Choose newer hospital-bed and bed-rail systems, if you feel you must use them.
    Snug-fitting mattresses can help avoid a gap that traps a frail adult.

  • Get professional advice. senior medical editor Leslie Kernisan, a geriatrician, suggests consulting with a geriatric care manager or geriatrician about the best bed set-up for your loved one's particular situation.

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7 Comments So Far. Add Your Wisdom.

10 months ago

They would not give my husband bed rails during his stay at a care facility. It was against the rules. He fell out of bed 3 times that we knew of. One times he bruised and cut his knee. Then they put him on the floor in a pc pipe bed. I'm sure it was cold and drafty. I had enough and brought him home with Hospice care. The best thing I did. They gave me a bed with rails and a bumper pad all the way around on the inside. You should use your own best judgement for your type of situation and you can do this with Hospice.

Anonymous said almost 2 years ago

It would seem to me that some <a href="">safety rails</a> would be safer than others. Those wide rails pictured aren't nearly as safe as those solid plastic "sides" that are on some medical beds.

almost 2 years ago

As an epileptic (complex partial seizures) a bed rail became imperative as, according to my husband, when I have a seizure in the night for some reason my brain tells my body to get up (same as it does if I go to sleep in a chair). If I hadn't the time to put both arms round me then I was out of the bed and collapsed on the floor! One time due to a shoulder operation my husband and I swapped sides. The next seizure I had resulted in me falling out of bad and gashing my head on the handle of his bedside cabinet resulting in having to call out the paramedics (we have to here in GB with head injuries). In the end we bought a bed rail (from the Stroke Association) that is about half the length of the bed so it enables easy enough access in and out of bed, but prevents me falling out of bed. It also fits flush against the bed and is easily removed for bed making etc. There is absolutely no room between rail and bed and is a God send!!

almost 2 years ago

Thank you...that was extremely helpful to get a sense of the problems with bed rails. Muchly appreciated. John, again.

almost 2 years ago

A main danger is that the person --often someone with dementia, apparently -- gets awkwardly wedged in the space between the rail and mattress and either can't breathe or hurts an arm or leg. This is especially true when there's a gap between the mattress and the rail. It's known as entrapment and is the reason for many of the deaths. People sometimes lose balance and fall trying to climb over them too.

almost 2 years ago

I agree with jrselser, in addition, the problem might be that the caregiver was too confident. In my ten years of caregiving experience, the only danger I saw was when caregivers don't care enough about the patient. In fact, bed rail is a big help because it can prevent an immediate accident when the caregiver happens to be busy. Patients make noise when they need something, and when help is not given or their demand is neglected the stronger ones will find their ways by climbing the rail.

almost 2 years ago

Sorry, but the article never said why bed rails were unsafe. It made reference to a gap, but please explain what you mean. thank you. John

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