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My mother is in the late stages of Alzheimer's. She has recently been switched to a twin-size hospital bed that lowers up and down because she keeps falling/slipping/rolling out of bed at night.


The bed is pushed up against a wall on one side, a fall mat is being utilized, and a mattress cover with foam sides has recently been implemented, but nothing seems to keep her in bed. Not sure how much of this is accidentally slipping out, and how much is her trying to get out. She has always slept in a full or queen-size bed, so a twin bed is new to her.


Mom used to be aggressive, but we have finally gotten her meds right (or as good as they can be, thank heaven), so she is no longer having outbursts at night, but still wakes up often.


Does anyone have any suggestions about what else might work to keep her from falling out of bed? I have been told that bed rails are not allowed in memory care.

It took a long time for my son to be approved for a proper medical bed. he had a similar problem. There was a risk for him falling out of the bed rolling over etc.
We put mattress on the floor next to his bed for soft landing if so . Also, there is a medical equipment prescribed type medical bed that can be lowered to almost ground level so if they fall, they won’t fall very far.
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Reply to BrandGo
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Can you give her 400 mg of magnesium glycinate at dinner? That will help her sleep through the night. The glycinate version won't cause loose stools.
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Reply to brandee
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Staff has a controller to raise the bed up to care for the client. (So they don't hurt their back.)
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Reply to brandee
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Make sure she has the bed that drops to the ground using the controller and she sleeps in the bed at ground level. Fall mat is on floor next to bed.

Bed rails have been illegal in care homes in Florida for years. They cause a serious choking hazard and cause deaths for seniors that roll into the bed rail.
The seniors asphyxiate and can't roll back to safety.

In some areas bed rails are still legal but understand they can cause deaths and serious injuries.
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Reply to brandee
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Your mom does not need side rails or any obstacle to "rollover" since it only means a greater height from the ground. Since she is going to try to get out of bed at night, the staff are utilizing methods to prevent injury: lowest bed possible, no side tables, thick mat on the ground... She has previously been hostile at night so her meds that make her more biddable are a Godsend. You could talk with her doctor about medication to help her sleep through the night since it appears she wakes up frequently to try to get out of bed.
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Reply to Taarna
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I’m in aged care, but not in dementia. My past life 12 months ago, I had a queen bed with a few falls, slips off the side. To keep it short, I had a hand rail before Aged care which was a terrific thing for me. On arrival here, I was told that I couldn’t have bed rails which frightened me and I had a few panic attacks. I signed a waiver and got two rails either side, one shoulder and head. The other pair knees down. It will stop me falling but if I really wanted to, I could wriggle my way out. Good luck
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Reply to missjj
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Is she in memory care? Or at home?

Is her falling (getting) out of bed your biggest concern?

You have a fall mat, and foam sides. She is probably trying to climb out over the sides.

My husband was doing that. The method to resolve it was a bed that lowers to just inches above the floor, and a mat next to the bed.

It sounds like you already have that in place.

Do you want to keep her from trying to climb out of the bed? Even with bed rails, believe me, this is possible.

She is not in her right mind, and she is doing what feels right to her. It doesn't sound like she's in any danger, if her bed is lowered and there is a fall mat.

What, exactly, is your concern?
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Reply to CaringWifeAZ
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Lee188: Perhaps her physician can prescribe medications.
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Reply to Llamalover47
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Mother sounds like she could use meds at night for agitation. It may be adjusting as you say to new bed arrangements. I wonder if you sign legal responsibility if the centre will retract on the bed rails. They dont go up high anyway and if she rolls - it just keeps her in. I can understand it could create more issues if she were to climb on it - but surely if she rolls out of bed then it is the most logical answer. Failing that surely the centre can offer some solutions -
mattress on the floor? Night lights - alarms to indicate if person is getting out of bed - bolster pillow for her to cuddle up to or at the sides
Maybe make an appointment to see the head there to discuss alternative safety measures and speak to her doctor as her anxiety increases at night which must be disturbing for her.
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Reply to Jenny10
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Try a bed roll belt
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Reply to Eliseduffy
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MidwestOT Feb 22, 2025
Eliseduffy, If that’s what I think it is, it would be considered a restraint and not allowed in a facility.
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My dad had the same issue. Even with aides day and night (and he hated them), he would manage it when they went to the bathroom or turned their back for a minute. He hurt his head pretty bad the last time he fell.

His last few days on earth were in a hospice respite facility. They told us that bed railings were associated with injuries because they can try to climb over them. Instead, they lowered my dad’s air mattress to the floor and put big bolsters on either side and gym mats beyond them. And the whole thing had alarms in case he tried to exit. To get out of bed, the only way would be to crawl and he could not get from crawling to standing on his own, so no more falling. It does make it more difficult to turn, change, and clean the person though because you have to get down nearly to the ground, or raise the bed back up temporarily.

good luck!
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Reply to Suzy23
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I experienced this with my companion / friend.
I purchased a full body pillow and put next to him near the railing. He never fell out of bed again. It may not be fool or full proof, but it will help immensely.
Or use two, together. Make is very difficult for her to get 'beyond' the pillows (if possible)

If your mother is struggling, trying to get out of bed, ask MD for medication to calm her down ... at nights.

Gena / Touch Matters
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Reply to TouchMatters
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https://a.co/d/cz6wgte

this inexpensive and quite easy to install and use rail works wonders for my husband. He was constantly falling out of bed before I purchased this.
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Reply to Conniepam
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I would make sure someone else is not responsible. It is likely that she is the cause of her own slips, but there are many care workers that have been prosecuted for elder abuse. My grandmother- in-law, was handcuffed to the bed rails, which caused enormous distress. When she was brought home, there were no more issues.
The elderly sometimes become extremely restless and filled with anxiety, because they may realize their health is getting worse and their lives are ending very soon.
Best of luck to your family.
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Reply to Tiger8
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SusanM56 Feb 25, 2025
Holy cow! Staff hndcuffed her to the bed?! How is that better than bedrails??
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Our memory care only allows Halo rails that attach to the bed. Expensive and not covered by insurance
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Reply to Arkh64
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Use bed rails. I have them on my Dad's side here at home and during his 1 awful week at a nursing home it took 3 days but they finally put rails on. Ohio does by request and pressure lol.
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Reply to MonicaG54
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My mother's hospice nurse brought in a bolster mattress cover to place on top of the hospital bed mattress to cup her body in and cut down on the falls. It makes it harder to get out of bed, whether she's doing so willingly or by accident. My mother was the queen of falls that she called "slips" amounting to 95 of them. This bolster cover cut the falls out of bed down by 80%, miraculously. Had they found one for the slips out of the wheelchair in Memory Care, we all would've been a lot happier.

Im linking you to a bolster on Amazon that's similar to the one hospice used for mom so they can have an idea of what you're talking about:

https://www.amazon.com/Prevention-Bolster-Mattress-Defined-Perimeter/dp/B07X5F5P54/ref=sr_1_7?crid=13YSOEQZMEBHI&dib=eyJ2IjoiMSJ9.4fypNbBpoRoNKH1ajhJwx_TmgGMv7yk6QKORSEnDOpuB5ZjnlNHVhkyR91tHXCJGsAO59Cv2TcMIlYbjThMtmL5tbf0MgQajD8MTTYkaK_g1QFKrFNleZ8CQeaba6IU6scJI5fCqPecjmn965YDDr3IqhI92gepD-1SsioU7axV67kf78H7qA8xSOA5xL2ojyETUPu8CQgVXKtvFEgPdHX-9X187wnuQ7CKTZ9ajC-Y_Vyb_ty2B4KqnSQJ4eMYFuY56qalKnBNXiBxlMYmWXPWO1GHpzYiK3yb_tM8PooyWKEBL7rHCAA2HZZLNvt0bwhLzL6LI4-fYq84RC3RMsiAdOTEL11IGrRH4MVAWZG23bTd55166EtQAboF0j1dogVSHJtkKbwljvT30xte8a8G63JfwAn7ksBKt_wqtQUEmQ3mFhbT0ZcgdCrQVUeR8.IaFjMZo9IUood1Y4RLUkbvdTGTgjDNT2k2WxLVaznI0&dib_tag=se&keywords=Bolster%2Bkeep%2Badult%2Bfrom%2Bfalling%2Bout%2Bof%2Bbed&qid=1739903028&sprefix=bolsterkeep%2Badult%2Bfrom%2Bfalling%2Bout%2Bof%2Bbed%2Caps%2C1021&sr=8-7&th=1

Is this the type you already have on moms bed, OP?

Good luck with a difficult situation.
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Reply to lealonnie1
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MikeinTexas Feb 22, 2025
1) For a child we jut put pool noodles on the sides under the bottom fitted sheet. May be too simple, but it is a low cost option. 2) If it is a hospital bed, doesn't it have rails? 3)When my wife was in hospital for her stroke, they had an alarm that went off if she tried to get out.
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At some point Geaton's advice about mattress on the ground is about all that works, unfortunately. The unfortunate part is that it makes all care almost impossible, and attempts to get up may result in further falls. The brain gets exceptionally wonky with spatial things and with balance; it is an almost insurmountable problem as anyone who worked in health care can assure you. We used to try beds with a netting and zipper things, but even those eventually became dangerous for one and another reason. I sure wish you good luck and you sure are trying all the things we could first and most easily recommend. If you find something hope you will let us know.
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Reply to AlvaDeer
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Either lower the bed as low as it can go, or put the mattress directly on the ground.

My guess is she's trying to get out of bed at night. That's how my 100-yr old Aunt with advanced dementia broke her hip, even though we had her bed very barricaded, the caregiver didn't want to put the mattress on the ground for various reasons. Even after my Aunt was in the rehab facility with her broken hip she was still trying to get out of bed or climb out the window. She wasn't very mobile on her own. You can't underestimate what someone with a broken brain will decide to do.
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Reply to Geaton777
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Lee188 Feb 18, 2025
Thanks for your insight. Unfortunately, the facility said they are not allowed to place the mattress directly on the ground due to the difficulty of staff getting her up and out of the bed, which could cause staff injuries to their backs, etc.

The hospital bed is lowered to its lowest setting every night, but Mom has rolled out of it and been found face-down on the fall mat. She was unhurt (may have never even awakened when she rolled out), but I was told if she didn't have the strength to move her head, she could suffocate. I think she has the strength to turn her head, but who knows?
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