A mattress at the appropriate degree of firmness will be comfortable for the person to sleep on. It will also help the individual to easily push off from when getting out of bed. Consider a medium-firm mattress – a mattress that is too hard may intensify any aches and pain; a mattress that is too soft may make it difficult to get out of.
In general, when the person sits at the edge of the bed, his/her feet should be flat on the floor and knees should be in a straight line with the hips. This allows the person to shift his/her weight forward over the feet, making it easier for the leg muscles to help lift the person to the standing position.
For many people, the most suitable bed height is 18 inches (same height as a chair seat). If the person is quite short or tall, the bed height should be adjusted accordingly.
If the Bed is Too High
In general, if the person’s feet do not touch the floor when sitting at the edge of the bed, the bed is too high. This can lead to the person sliding forward off the bed. Depending on how many inches the bed needs to be lowered, consider one or several of the following:
- Remove the castors or just the wheels.
- Cut down wooden bed posts.
- Buy a low profile (three-inch) metal bed frame (standard is seven inches).
- Buy a low profile (five-inch) box spring (standard is nine inches).
- Buy a shorter height mattress (lowest is about nine inches).
If you’ve exhausted all options, you may need to use a footstool, but be careful that the person doesn’t slip when using it or trips over it when walking in the bedroom, especially at night. Make sure the night lighting is adequate.
If the Bed is Too Low
If the person’s knees are above the hips when sitting at the edge of the bed, the bed is too low. This makes getting out of bed difficult, as well as making both you and your care receiver work harder then needed. One way to raise the bed is to place special plastic or wood bed blocks (available in home stores) under the bed legs; these blocks can be stacked for different bed heights.
Although it may be hard to imagine, people with dementia sometimes forget how to get out of a bed and reminders can be helpful. Coaching a person so he/she can transfer with minimal assistance is helpful if the person still has adequate physical ability to rise safely. They also need language comprehension to understand your instructions. And the bed should not be too high, too low, or too soft for the safest and easiest transfers.
Before attempting to help a person out of bed, give them a good reason to get up – a warm, gentle voice can really do wonders. Once you have the person’s buy-in, give step-by-step verbal, visual, and, if needed, tactile instructions.
A bed handle can help a person stand and get out of bed – it offers a stable surface to hold onto and push off from and it can also help with balance. To use safely, the person still needs good upper body strength and the ability to stand and & bear weight. Couple of questions to ask when installing bed handles:
- Does the bed handle securely attached to the bed frame? The type of bed handle you choose is important, as certain types are safer than others. Some models clamp on or bolt to a metal bed frame. Others attach to a wooden board that is sandwiched between the mattress and box spring and strapped to the bed frame. We do not recommend this type as it relies solely on the person’s weight to keep the handle in place and could pull away or be pulled out by the care receiver if agitated.
- Can the handle support your care receiver’s weight? Many are rated for a maximum weight of 150 to 250 pounds, but they’re not designed to support the full weight of an individual.
- Does the person enters or exit the bed from either side? For safety, consider installing two handles, one for each side of the bed.
- Are any openings big enough for a person to mistakenly put his/her head through? If so, do not purchase, as entrapment can be serious.
- Is there someone to monitor the bed handle on an ongoing basis? The handle should be against the side of the mattress, without any gaps. Regularly check to see that the mattress hasn’t shifted during usage because the person could become wedged in between the mattress and the handle. The handle should be securely attached to the bed. Regularly check to make sure it hasn’t loosened or, if it was temporarily removed for some reason, that it has been securely put back on.