Mobility issues in general are misunderstood and lack appropriate solutions to address the problem. One issue is why, do people fall out of bed and why is it such a healthcare mystery. You may wonder how beds and bed rails equal a mobility issue until you understand a century old misconception.
Many bed falls are mobility related. The most common solutions were to confine the person or restrain them with bed rails, sometimes both. Today’s focus is on individual needs and keeping people mobile without confining or restraining them.
One myth is that the elderly fall out of bed because the bed rails are not raised. Yet we never hear what caused them to “fall out of bed” so informed decisions are rare. Exploring the reasons why the elderly and others fall out of bed will help us make better mobility decisions now, and in the future. Bed fall examples:
1. Accidental, rolled off the bed while reaching for a TV remote or glass of water on a night stand, usually an accident. Is this a balance or mobility issue, both or just an accident?
2. Fell off the edge of the bed. If the person was properly placed in bed they may not fall off the edge. This person could have a mobility issue and needs various mobility aids or more assistance. Proper in-bed placement could be important.
3. Rolled off the edge of the bed attempting to roll on ones side and got too much momentum. Could proper in-bed placement alleviate the issue or would a restraint free mobility tool be beneficial.
4. Another type of bed fall is transferring out of bed or getting into bed. Common mistakes and mobility gaps are the improper use of walkers and canes. Often people need a helping hand to complete a task but lack the additional mobility aid needed to complete it safely and with less stress.
Rolling into bed rails is painful and an entrapment risk. They are confining and restrictive causing the user to constantly bump into the rails creating bruising and possibly skins tear issues. The user often blames themselves for injuries not understanding it’s the confining and restrictive device causing the problem not them. This is an example of using or recommending the wrong tool.
We are also realizing many mobility aids like walkers and canes are poorly designed creating risks and that bed rails are not mobility aids. We cannot address needs without understanding the cause and circumstances prior to recommending a solution. We should also understand mobility aids and the effects they have on the user.
This is a new way of thinking about the mobility needs of seniors, the disabled, and the elderly. We cannot continue to throw inappropriate mobility aids and partial solutions at the problem and expect positive outcomes. Each person has individual needs based on their own set of conditions that we need to understand before we make life changing choices. We are just beginning to understand mobility issues and falls. New ideas, new knowledge and new actions can have positive outcomes.
References (partial list): National Safety Council, Consumer Product Safety Commission (CPSC) National Electronic Injury Surveillance System (NEISS), FDA Hospital Bed Safety Workgroup (HBSW), Hospital Reporting Of Deaths Related To Restraint And Seclusion (September 2006: HHS Office of Inspector General), Older Consumer Safety: Phase I (CPSC December 2005), Preventing Falls and Injuries While Reducing Siderail Use: E. Capezuti, Aim to Reduce Bed Falls: A. Bezaitis (Fall Prevention Center of Excellence, August 2006)