A hospital bed is useful if the person is recovering from surgery or needs relief from certain health conditions. It’s also vital during the late stages of dementia when your loved one has difficulty walking.
Being able to adjust the bed’s positions makes caregiving easier and the person more comfortable when in bed. Not all hospital beds are the same, however. For insurance purposes, we’ll also provide the classification names Medicare uses for each type of hospital bed, along with coverage guidelines.
Beds for Couples
For most situations, Medicare only pays for twin size beds. If you’re used to sleeping in the same bed, here are three things you can do to make it seem as you’re still sharing the same bed:
- Obtain an extra long (80 inches) twin bed for yourself and place it next to your loved one’s hospital bed (standard size is 88 inches). Although the two beds have a slight difference in length, at least you’ll be “together.” But this arrangement will only work if your bedroom is large enough so you can still move comfortably around.
- Use separate twin bottom sheets.
- Use one king size sheet for the top sheet, blanket, and comforter.
If you have the financial means, keep in mind that adjustable “hospital beds” are available in various sizes (twin, full, queen) and lengths (75 inches – 88 inches) for private purchase.
If you’re afraid your care receiver will react unfavorably to a hospital bed, try a colorful new bedspread and add decorative pillows for a fresh, new look. The person may not even realize that it is a hospital bed.
As most hospital mattresses are 80-inches long, you’ll need to buy extra long twin-size sheets for a good fit (otherwise the bottom sheet will keep slipping off).
A standard hospital bed mattress may be too hard and too hot to sleep on – the vinyl covering can cause a person to sweat more. Consider adding a mattress overlay to increase your loved one’s comfort and to prevent pressure sores, especially if the person is spending a lot of time in bed. Medicare may pay for the overlay if the person meets the eligibility guidelines.
Some persons who are used to sleeping in a larger bed may not take kindly to the smaller, twin size bed that Medicare funds. If you have the financial means, keep in mind that “hospital beds” are available in full, queen, and even king size for private purchase. You’ll also be able to specify a shorter length than the 88-inch Medicare-funded hospital bed.
Medicare Reimbursement
‘Fixed Height’ Bed
Not all hospital beds rise in height. Some hospital beds only allow for adjusting the head and leg sections; Medicare classifies these as “Fixed-Height” beds. You cannot raise or lower the bed for wheelchair transfers and caregiving activities, such as giving your loved one a sponge bath in bed. A fixed height bed is only available with a manual hand crank. For a standard, fixed-height, manually operated hospital bed, one of the two conditions must be met:
1) Your care receiver’s condition (e.g., cardiac disease, chronic obstructive pulmonary disease, aspiration problems) requires positioning of the body in ways not feasible in an ordinary bed (i.e., the head/upper body needs to be elevated more than 30°). or
2) Your care receiver requires special attachments (e.g., traction equipment) that cannot be fixed and used on an ordinary bed. To look up your state’s up-to-date Medicare guidelines, go to http://www.medicare.gov/coverage/Home.asp.
‘Variable Height’ Bed
If the hospital bed requires manual adjustments for the head, foot, and height, Medicare classifies this as a “variable height” bed; there are no electric controls. Keep in mind though, that even though this bed is classified as a “variable height” bed, the foot and head sections also adjust.
‘Semi-Electric’ Bed
A semi-electric bed allows you to adjust the head and foot sections with a push of a button. As the bed is equipped with a small motor, you’ll need a standard three-prong electric outlet in which to plug the cord. However, you still need to manually adjust the bed’s height by turning the bed crank.
Fully Electric Bed
A fully electric bed allows you to adjust all sections with a push of a button. Medicare usually doesn’t cover the cost of a fully electric bed. However, if your care receiver meets the requirements for a semi-electric bed, Medicare will pay for that amount and then you (or your care receiver) pay the difference. Check with your health care provider for more information as certain hospice benefits cover a fully electric bed.
A fully adjustable electric bed may be necessary for you – the caregiver – if you have a physical limitation. For example, turning the crank can be difficult or impossible if you have a bad back or arthritic hands. Make sure to talk to the person’s doctor about any limitations you yourself may have.
High-Low Beds, Falls, & Bed Rails
Many individuals at are the risk for falls either from rolling out of bed or getting up and walking unaided when it’s no longer safe to do so. Bedrails are sometimes used to help keep the person safe in bed, but studies in hospitals and nursing homes have shown that people with dementia are at an increased risk for serious falls if they attempt to get out of bed by climbing over the bed rails. Others may become agitated if they feel restrained, and, sadly, some become entrapped in the rail or in the space between the mattress and the rail. Our review of the best bed handles can be found here.
The FDA has issued recommendations to help you make the right decision for keeping your loved one safe while in and getting out of bed. It recommends using only partial rails when needed, and special high-low hospital beds. These beds can be raised for transferring and caregiving tasks and lowered close to the floor for sleeping.
It’s believed that even if a person would attempt to rise independently, he or she would be unable to do so. If the person were to roll out of bed, the risk of injury is less because the bed is close to the floor – some bed frames are as low as seven inches (without the mattress) above the floor.
The FDA also recommends using a special safety floor mat to cushion the impact should a person fall. Be sure to choose a mat with a beveled edge and to use nightlights to reduce possible tripping if you or your loved one is walking in the room at night. Keep in mind that a fully electric high-low bed is the easiest to operate.
Specialty Mattress Toppers/Overlays
A standard hospital bed mattress may be uncomfortable for the person, especially if he or she spends a lot of time in bed. For example, he or she may find the mattress too firm and uncomfortable. Or the vinyl mattress cover may make the individual hot and sweaty. Both pressure and moisture contribute to the development of pressure sores, especially with high-risk individuals.
Many caregivers place a special pressure relieving mattress topper or overlay on top of the existing mattress. Or the person’s health care provider may prescribe one to treat a pressure sore. Although many types of mattress overlay materials are available, no single type is effective in all situations.
Hospital Bed Tables
A hospital bed table offers a handy surface for activities for persons who spend a lot of time in bed. Most hospital tables are height adjustable and can be easily moved as they have wheels (castors). However, rolling furniture can be dangerous if, for example, it gets used for support. For safety’s sake, choose a bed table that has two locking castors, which may increase the table’s safety. We don’t know of any bed tables on which all four castors lock.
