Unaware of hospital bed dangers, many elderly patients are injured or killed

Too far to fall

When you think of nursing home dangers, you probably think about drug overdosing or getting the wrong medication, maybe higher risk of infections.

But it turns out one of the most dangerous things in a nursing home can be the bed.

You know the kind…a classic type of hospital bed with retractable rails on both sides.

This type of bed is so common, we never question the need for the rails. In fact, we would probably be surprised if they weren’t there.

But when those rails are affixed to beds in a nursing home or a rehab facility, there’s a danger lurking that you might never expect.

Bad at geometry

Since 1985, the FDA has received more than 800 reports of patients trapped or entangled by hospital bed rails. Patients died in 480 of those cases. Almost all of the victims were described as “frail, elderly, or confused.”

And you can be sure those numbers only represent a portion of the totals because this is a type of incident that often goes unreported.

Dr. Steven Miles, a geriatrician, has reviewed many of these cases. He told the New York Times that bed rails generally do more harm than good. The rails decrease falling by only 10 to 15 percent. But they increase risk of injury by about 20 percent.

Miles says the rails are more dangerous because they “change the geometry of the fall.”

When a patient who’s confused or disoriented tries to climb over the rails, he falls further than he would from a bed without rails. And after climbing over the rail, he’s more likely to strike his head if he falls.

Even worse, most hospital bed injuries and deaths are caused by entrapment of elderly patients between rails and mattresses.

Commonly, a patient weakened by illness or age may roll against a rail in such a way that the mattress moves toward the rail on the opposite side of the bed. This enlarges the gap between the mattress and the rail, making entrapment of the head and chest more likely. Breathing is reduced or cut off, causing asphyxiation.

In 2006, the FDA issued guidelines to reduce bed rail hazards, identifying seven potential “zones of entrapment” in a typical hospital bed.

Five years later, Dr. Miles estimates that probably fewer than 10 percent of nursing home beds have rails. Still, that means there are thousands of dangerous beds out there because nearly 1.5 million elderly people live in rehabilitation or assisted living facilities.

If you have an elderly or incapacitated family member who lives in a nursing home, insist that they’re given a bed without rails. If the facility says that isn’t an option, look for a facility that doesn’t use them.

Sources:
“Practice Hospital Bed Safety” FDA Consumer Update, 1/11/11, fda.gov
“Safe in Bed?” Paula Span, New York Times, 3/10/10, nytimes.com