Did you know that a senior has to be taken to the ER every 11 seconds for fall related injuries?
Well, I learnt about this when my mom found herself out of bed and on the floor as she woke up in the morning. Thankfully, she walked away with a few bruises, but my research revealed that many seniors are not so lucky.
Nearly one half of all such falls result in serious injuries and many even cause death. Unsurprisingly, a lot of these falls occur in the bathroom.
This is understandable given the wet, slippery floor; the low bath tub and all those faucets around which can spell trouble for someone who does not enjoy the same physically mobility that he/she did in the past.
Shockingly, the area around the bed in the second most common spot for falls among seniors.
Instances of the elderly falling out of bed as they sleep and taking a tumble as they try to get out of bed are both scarily common. And that discovery is what led me to learn more about how to prevent seniors from falling out of bed.
If you have an older adult at home, continue reading to know what causes seniors to fall and how you can make things safer for them.
Why do seniors have a higher risk of falling out of bed?
In almost all cases, it’s a combination of causes that eventually lead to the fall. However, at the crux of every tumble is either the loss of balance or the loss of strength. A healthy young person is just as likely to fall if his/her foot gets stuck in the rug.
The difference is that when you are young, you have better coordination and reflexes. So, when you trip, you either try to regain your balance by quickly grasping onto something that will stop you from going all the way to the ground or if the fall seems inevitable, you try to break the fall with your hands or another body part.
But, things are different for the elderly: As you get older, your muscle strength, sense of coordination and your reflexes all take a hit. So, when a senior tries to grab on to something to stop the fall, his/her muscles may not offer the strong clasping needed for the job. He may also lack the rapid reflex needed to quickly reach out to a support structure.
Moreover, seniors often don’t have the coordination needed to break the fall. This is evident from the fact that wrist fractures are the most common type of fall-related injury in seniors below the age of 65 but hip fractures become the most common form of injury for seniors headed towards their 70th birthday and beyond.
The loss of strength means a greater risk of injury: Loss of strength not only increases the risk of falling down but also greatly impacts the extent of injury that seniors suffer due to a fall. In seniors above the age of 70 years, a fall can result in life altering and dangerous injuries such as hip or femur fractures, head trauma, facial bruising, jaw fractures and deep lacerations.
But that’s not the worst of it: The problem is also exacerbated by the slow healing that is inevitable as you age. I will give this to you in my grandma’s words, “Ye ol’ bod don’t mend as well as it used to”.
So, what you have with seniors is a high risk of suffering from falls, a serious reduction in the ability to prevent and break the fall and muscles and bones that hurt easily but don’t heal as easily.
This should explain why many youngsters easily tide over hip fractures but more than 40% of the seniors who suffer from such an injury end up losing their lives to it within 6 months.
Why do the elderly fall out of bed: The high-risk factors!
1. Problem with balance:
Imagine trying to get up to use the bathroom or even to grab a glass of water from the night table when you are not steady on your feet!
As it is you are groggy when you wake up in the middle of the night and when balance and gait problems are added to a half-awake, half-asleep state, it can be nothing but a recipe for a fall. Is it any wonder then that often the elderly get up for a drink of water and find themselves on the floor?
A condition called benign paroxysmal positional vertigo is very common in older adults and results in dizziness when the head is moved. For a senior with this health problem, the simple act of sitting up from a supine position or standing up from a sitting position can cause instant dizziness and lead to a fall.
3. Physical incapacitation:
A recent stroke or surgery greatly increases the risk of falling from the bed because it impacts physical strength and abilities.
From aspirin to certain antibiotics and from blood pressure to diabetes medication, all of these drugs can cause loss of balance and light headedness that can result in a fall as soon as a senior tries to get out of bed.
5. Health issues:
A lot of health conditions can also cause sudden dizziness in response to a change in position. For instance, those who suffer from cervical spondylitis, ear infections, Meniere’s disease, blood pressure problems, migraine, anxiety disorders, anemia, hypoglycemia, dehydration and neurological issues like Parkinson’s disease and multiple sclerosis have a significantly higher risk of falling when getting out of bed.
6. Vision problems:
Eyesight issues such as glaucoma, cataracts, macular degeneration and even new corrective eyewear can make it hard for a senior to spot the objects in his environment or to properly perceive their distance, which can lead to inevitable stumbling.
Whether it’s linked to the use of diuretics or attributed to a medical condition that causes the loss of bladder control, a strong and uncontrollable urge to urinate can cause an older individual to rush out of bed haphazardly, raising the risk of stumbling and slipping.
8. Dementia and disorientation:
Any medication or ailment that causes disorientation and confusion can turn into a fall-risk. For example, many seniors with dementia experience end of day fatigue and confusion known as sundowners. It can be hard for them to take stock of the surrounding environment as they try to get out of bed.
In addition to these, several environmental factors that don’t matter as much to younger individuals can turn into a risk for older adults. For instance:
- New furniture and bedding that a senior is not used to.
- A higher than required bed or a new mattress that is too soft.
- Bedclothes that are too slick or stick to the bedding.
- Bedding that is too slick.
- Poor lighting in the bedroom.
- Throw rugs right next to the bed and in the way to the bathroom.
- Sleeping on a different side of the bed.
- Hard to reach light switches.
In other words, anything that gets in the way of physical movement or catches a senior unawares has the potential to turn into a fall-hazard.
What about seniors falling out of bed while sleeping?
Sometimes an elderly parent will wake up in the middle of the night on the floor with no idea of how he/she fell out of bed. Seniors falling out of bed while sleeping is attributed to three reasons:
- Restless sleep: Often, falls occur while seniors are sleeping deeply and in the dream phase of their sleep cycle. A nightmare or a vivid dream can make them jump out of bed suddenly. Because they are still groggy or almost asleep, a fall is inevitable as they try to get out of bed.
- Sleepwalking: Don’t be surprised if a senior in your household has suddenly developed the habit of sleepwalking. Because this action occurs when a person is not conscious, the risk of a dangerous fall is very high.
- Rolling off the bed: I know this one is hard to believe but like children, older adults will often simply roll out of bed with no memory of having done so till they wake up on the floor and in pain. The rolling off may be a result of disturbed sleep that leads to a lot of tossing and turning through the night or simply be caused because your elderly parent sleeps too close to the edge of the bed.
How serious are falls from the bed for seniors?
The risk of fracture is extremely high, depending on the height of the bed and the environment around. Which body part gets impacted has more to do with the age of the senior and any underlying medical conditions that he/she may have.
- Major bones often get affected: As I discussed above, in those who are below the age of 65, hand and leg fractures often result from taking a tumble out of bed. But those headed towards their 8th decade have the highest risk because in their case, major bones tend to break, such as the hips, the femur (thigh bone), humerus (upper arm bone) and the shoulder joint. A fall from the bed can also lead to serious head injuries.
- Full recovery may not happen: Unfortunately, recovery from fractures is extremely complicated for seniors and in more than half the cases, older adults never recover completely. In the US, nearly 125,000 seniors suffer from hip fractures that cause permanent partial or total disability. The loss of independence takes both a physical and psychological toll on such seniors.
- The psychological issues: Even when the fall does not cause serious bodily harm, it does create a significant dent, mentally. Most adults who have fallen out of bed or have a risk of falling suffer from chronic fear and anxiety. In fact, their fear of falling is so great that it limits their physical movement and activity. In turn, this adds to their anguish and can trigger or worsen age-related deterioration in mental acuity.
How to stop the elderly from falling out of bed? Products that actually work!
Although it isn’t possible to address every risk factor completely, you sure can stop some of the most common issues from turning into a problem. Here are 6 products/techniques that will help you to do just that:
1- Protect in case of a fall:
Thick, non-slip floor mats placed on the side of the bed can help immensely to lower the risk of fractures and head injuries in case of a fall. Ensure that your elderly parent is comfortable walking on it.
I have found that is best to tuck the mat a few inches under the frame of the bed. This way, there is no risk of your parent getting his/her foot stuck in the rug and stumbling.
2- Prevent falls due to jumping out of bed:
Bed rails work exceptionally well for most seniors, but not all. Let me explain this further. For some older adults, the rails work as an effective barrier that keeps them from rolling off.
But, it may not work for those who are suffering from cognitive deficits. I have heard of instances of seniors hurting themselves while trying to slide past the bed rail to the end of the bed or getting their arm or leg caught in the rail while trying to climb over it.
Having said that, bed rails come in three varieties and often choosing the right kind for the needs of your elderly parent can lead to them working well. Personally I had much success with them for my mom. So, you may want to consider these options:
- Assist bed rails: Think of these as the “starter” bed rails that are fairly small and not very intrusive. They were designed to make transfer in and out of bed easy for the senior and the caregiver. But they are also very effective in preventing roll overs in low-risk, older adults, who are cognitively aware of their environment. Also known as transfer bed rails, these also happen to be the most affordable of the 3 options.
- Standard rails: They are longer and higher than the assist bed rails, but don’t fit the entire length of the bed. While hospital beds have these as a part of their design, you can also get versions that can be attached to the existing bed in your parent’s room. They can be folded to the side when not in use. However, if your parent swings his/her legs over to the side of the bed, there is the risk of bruising because the rails invariably stick out of the frame of the bed.
- Full-length rails: As the name suggests, these cover the entire length of the bed and can be perceived as intrusive by some seniors. But, they do offer the maximum amount of protection. However, these may not be the right option for seniors who suffer from incontinence or are on diuretics that require them to go to the bathroom several times through the night. These can be installed on your existing bed. However, you have to make absolutely sure that you explain to your elderly parents that they should not attempt to get out of bed on their own while the safety rail is up.
3- Stop them from rolling off the bed:
Your parents probably used bed side bolsters and/or wedges to keep you from rolling off the bed as you graduated from your crib to a proper bed. Well, these products also work for seniors, who simply need a small physical reminder to stop the rolling.
Even when a person is asleep, encountering a barrier sends a signal to the brain to stop the movement of the body in the direction of the barrier, and that is how the raised bed perimeter works.
A concave mattress works particularly well to stop the roll before it turns into a sudden fall. However, buying a new mattress with a raised perimeter can be expensive.
A more affordable option is to use a safety mattress cover, which has the same features as a concave mattress but costs a mere 10% of the later. Having said that, it is important to know that the raised perimeter will make it harder for the older adult to get out of bed.
If your parent has a problem with balance or gait and a higher risk of falling while getting out of bed, you may want to consider bed side rolls or wedges that can be fastened to the side of the mattress and removed when required.
4- Sometimes a small reminder is all that’s needed:
For seniors who suffer no cognitive deficits, you may want to use pool noodles. Yes, I am talking about the buoyant tubes that kids and people use in pools. You can tape them together to form a raised perimeter around the mattress that will stop your parent from rolling off the bed and will also serve as a reminder to not attempt to get out of bed without assistance.
You will need ribbons and tape to connect the polyethylene cylinders together and to keep them stuck to the sides of the bed. Once you have attached the noodles to the side of the bed or the mattress, place a fitted sheet over them, so that they work just like bed side rolls do.
5- An alarm that alerts you to the possibility of a fall:
These are inexpensive, but they work like a charm. In fact, they are often used in hospitals and senior care homes. The technology is simple. A pressure-sensitive pad is placed under the sheets in a position that puts them directly below the shoulder blades of the person sleeping on the bed.
As soon as this individual sits up, the pressure is taken off the pad, which triggers the alarm, alerting you to the fact that your parent is trying to or wants to get out of bed. Unfortunately, the alarm does not come with a speaker that can be kept in your room. So, use it with a baby monitor to get timely alerts on the movement of your elderly parent.
6- For high fall-risk seniors:
This product is known as a Posey bed and it is the most intrusive of all options because it pretty much covers the bed from all sides. Think of it as a tent-like structure that covers the bed from the front and the back, from both sides and from the top.
Although it is too restrictive for seniors who enjoy full cognitive capacity, it is the safest option for older adults who suffer from dementia, Alzheimer’s and REM behavior disorders.
20 tips to remove environmental risk factors!
Even if you use one or more of the products listed above, unless you secure the environment around the bed, the risk of falling will continue to be high. So, here are a few simple yet effective tips to deal with the environmental factors that can turn into a problem.
- Install proper and adequate lighting in the room.
- Make sure the light switches are easy to operate or if possible install clapping lights.
- Remove clutter from the area around the bed and from the way to the bathroom.
- Remove the rugs from around the bed or tape them down to prevent stumbling.
- Don’t use bedding items that reach the floor and can cause the feet to get tangled in them.
- Before retiring for the night remove clothes and pillows that may have fallen off the bed and on the floor around it.
- Install sturdy bed side tables that will support your elderly parent’s weight should he/she need it.
- Explain to your parents that before getting off the bed, they must make sure that both their feet are flat on the ground and that they should sit for a minute to make sure there is no dizziness.
- If your parent suffers from balance/gait problems, keep a walking stick or the walker such that it can be easily accessed.
- Tuck back all electrical cords to prevent tripping over them.
- Keep night lights on in the bedroom and the bathroom, which offer enough illumination for your parent to avoid bumps and trips.
- Get your parent a pair of supportive, non-skid slippers for use in the bedroom and around the house.
- Keep a sturdy chair along the way from the bed to the bathroom. It should not be in the way but placed on the side so that it can be used for support or to sit down in case your mom/dad experience vertigo while coming out of the bathroom.
- Don’t allow pets into the room of a senior as they may get underfoot.
- Minimalistic is the word to remember when designing/redesigning your parent’s rooms. The idea is to minimize clutter and offer ample of room for movement.
- Grab bars installed at the side of the bed and along the walls can greatly help to avoid falls due to loss of balance.
- Install a bed side lamp in the room, so that your parents don’t have to fumble about in the dark to get to the light switch on the other side of the room.
- For seniors who suffer from incontinence and mobility problems, a bedroom portable toilet can come in handy.
- Keep items that your parent frequently uses within easy reach.
- Keep water in a cup with a lid, which will prevent spills.
Best bed, bed height and mattress for the elderly
The bed: A platform or low bed is certainly a safe choice for seniors who have the tendency to roll off the mattress. However, they may not be the most comfortable option for tall individuals who may find it hard to get off of them.
If you have an elderly parent living with you, I strongly suggest investing in an adjustable bed, which can be set up to suit the height and the changing health requirements of older adults.
The bed height: Ideally, the bed should just be high enough to allow a person to sit back on the edge and still have his/her feet flat on the ground. Usually, about 20-25 inches from the floor to the top of the mattress is what you should go for.
The mattress: A firm mattress offers better support when trying to get off the bed and it does not constrict breathing by allowing the spine to bend and it does not put pressure on the joints.
Of course, you don’t want the mattress to be hard to the point of being uncomfortable. My recommendation here would be a pocket sprung mattress with a memory foam topper.
There you have it – That’s everything you need to know to stop your elderly parent from falling off the bed.
One last recommendation – Start by making a list of all the risk factors that apply to your parent and then look for products and solutions to minimize/eliminate those risks. This way, you will have a personalized fall prevention plan that is just right for your mom/dad.
And on that note, here is wishing all seniors out there many, many fall-free and pain-free years to come!