Two thirds of falls causing an injury occur inside the home. Recent research has also found that more than one third of adults over the age of 65 years fall each year. As we spend a significant amount of time in the bedroom, safety in this room is an important issue to address.
One of the most important things to consider in the bedroom is appropriate lighting. A light or switch should be easily accessible from the bed. In addition, a night light will help to ensure the pathway to the bathroom is clearly lit and tripping hazards (such as the cat) avoided.
Look around the room for clutter or obstacles. Are electrical cords crossing the floor? Does the bed skirt, sheets or blanket drag on the ground when the bed is made? Do any of these items end up on the floor at night? These items should be taken away or modified to remove potentially dangerous situations where someone slips or gets their feet tangled up.
If getting in and out of bed is difficult, bed blocks that raise the height of the bed may be helpful. Where bed partners are different heights, it is important to check that the height of the bed works for both people. A grab bar or pole located beside the bed will likely provide the stability needed to transfer out of bed. Some half bed rails have also been designed with the intention that they can be used as grab bars. When considering bed rails, caution should be used because these devices often do not “keep” the person in bed, but rather become an obstacle to climb over. If the bed is on wheels, these should be locked or removed to ensure the bed remains stable for the transfer.
An adjustable bed may also help more frail adults to transfer out of bed. Raising the head of the bed first may make it easier to shift into a position of sitting at the side of the bed. These beds have the added advantage of providing a variety of comfortable positions to make sleeping easier.
If an ambulation aid (e.g. cane, walker or rollator) is used, ensure there is a safe location—easily reachable from the bed—for parking/storage. If a single-point cane is used, consider an umbrella stand or similar device so the cane can stand beside the bed. If it falls on the floor, the cane will be much harder to grab and use and could turn into a tripping hazard itself in the morning or during the night.
Keep a pair of slippers at the bedside. Slippers with a closed toe and heel are the best option to help prevent injury to the feet. Slippers should have a non-skid sole and support the foot.
Having an emergency response system or a telephone that is easily reached from the bed will ensure that help can be called if needed during the night. If a telephone is by the bed, a large-print list of important telephone numbers can be helpful. Consider a phone with large numbers and pre-programmable speed dial buttons.
An adequately sized night stand that can house a light, telephone, glasses and other important items that may be needed during the night is also a necessity. Dropping things or reaching too far to access thing is dangerous.
It may also be time to consider relocating the bedroom. If stairs are difficult, a bedroom on the main floor may be appropriate if there is a toilet close by. Depending on the frequency of rising during the night, choosing a bedroom that is closer to the washroom can be a smart move.
Some seniors have a decreased ability to sense temperature. As a result, it is more likely that an older adult will experience burns from a heating pad or electric blanket. Falling asleep with a heating pad should certainly be avoided. If heat is needed or preferred, consider the use of a hot water bottle if it can be safely filled. If an electric blanket is used at any time, ensure that it is on top of other bedding. It should not be tucked in because this may damage the blanket. It is also important to follow the manufacturer’s instructions.
If a supplemental heater is used in the bedroom, again ensure that the manufacturer’s instructions are followed. Heaters should always be located away from flammable material and where they will not get in the way, especially if the resident needs to get up during the night.
Smoke detectors should be located outside each bedroom door and be in good working order. If the smoke detector runs on batteries, it is important to remember to change the battery every six months. Usually there is an advertising campaign to remind us to do this when we change the clocks. (If you cannot reach the smoke detector to change the battery, ask someone to do it for you.) When thinking about smoke detectors, it is also a good idea to consider and discuss an emergency exit plan.
Decreasing the clutter in the closets and drawers will make dressing easier. It will be faster and less confusing for seniors to find clothes to wear, and hanging or properly folding clothes will help to ensure they do not get as wrinkled. Storing the clothes that are most often worn in waist-level drawers or a closet decreases the amount of bending and reaching required. If your loved one has dementia, encourage their partner to put their clothing in another room and just lay out what is needed each day. This may decrease confusion.
A sturdy chair with arms in the bedroom may provide a safe environment for dressing. Armrests make it easier to stand up. In addition, arms will reduce the likelihood of slipping out of the chair compared to the shifting of weight needed to dress on the bed.
Assistive devices, such as a reacher may be helpful for activities such as making the bed. Ask or arrange for assistance with more strenuous activities such as changing the bed or flipping or rotating the mattress.
Doing an annual safety check is one way to ensure that the bedroom and other areas of your home remain safe. With a little bit of extra attention, the bedroom can remain a safe, comfortable place where independence in personal care can be fostered and maintained for as long as possible.
Linda Norton, MSCH, BSc, OT, OT Reg (Ont), is the Rehabilitation Education Co-ordinator with Shoppers Home Health Care.