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Reduced risk of bed falls and injuries

 

little boy Paul

Mary’s story

Mary is 72 years old and has been diagnosed with Parkinson’s disease and associated dementia. The Parkinson’s has resulted in very rigid movements which greatly affect her mobility and transfers. Due to poor understanding of her functional levels and poor risk awareness, Mary regularly attempts to transfer from the bed, resulting in frequent bed falls and associated injuries. Mary lives with family members, who advised their occupational therapist that they were very anxious and under significant strain due to her frequent bed falls that occur when

sleeping on a low bed with a mattress next to the bed. Mary’s son advised that paramedics are sometimes required on a daily basis, and on one particular day, they were called on ten occasions to assist with transferring Mary from the floor back into bed.

Results

A FloorBed™ was put into place for a trial and Mary was hoisted into the bed at an appropriate height. When left unattended at night, the family lowered the bed to the floor to reduce the risk of fall injury. With the FloorBed™TM in use, the falls have ceased. The family reports that Mary will sometimes bring her legs out of the bed; rather than a fall occurring, her feet rest on the floor and Mary will either bring her legs back into bed or leave them resting on the floor before sliding them back into bed when unassisted. The FloorBed™ provided benefits to all:

  • User – Mary has stopped falling out of bed, therefore reducing the risk of injuries associated with bed falls.
  • Carers – The mattress platform height of 640mm enables the carers to carry out care tasks safely at an appropriate height.
  • Family – The family reports that they are more relaxed and experience less disrupted sleep as they feel reassured that Mary is not at risk of bed falls and injuries. • Paramedics – Mary no longer requires paramedic intervention as she remains safely in bed.

Testimonial:

“I am used to the bed and feel safer near to the floor.” 

Click here to download the full case study.

ETHEL

Ethel’s story

Ethel is a 93 year old lady who was diagnosed with Dementia approximately 6 years ago. Her cognitive and physical functions have deteriorated and she is now unable to mobilise and weight bear safely. Ethel is not orientated to time, place or people and struggles to follow instructions. She has very poor awareness both of personal risk and her own limited physical abilities. 

Although Ethel has minimal strength and is unable to push herself to stand, she has what the care staff describe as ‘fidgety movements’. This means that she can reposition herself and, consequently, is at risk of falling from both bed and chair. When unsupervised, she frequently attempts to get out of a standard low bed. Several bed falls have resulted in damage such as bruising, head and internal bruising and, consequently, hospital admission.

The care staff carried out a risk assessment and determined that the risk of injury from a chair fall was greater than from a bed fall. As a result, Ethel was cared for in bed nearly all the time and was moved to a central location enabling the staff to monitor her frequently. However, there was still the high risk of bed falls. A trial of the FloorBed™™ was offered and the nursing home was keen to test the concept.

Results

The FloorBed™ was provided and although Ethel continued to fall out of bed, this was now a roll rather than a fall, substantially reducing the impact and risk of injury. It was decided to create an extension of the bed by placing a crash mat of bed-height next to the FloorBed™. This reduced the likelihood of injury even further.

The three main benefits of using a crash mat in conjunction with the FloorBed™ were:

• When Ethel fell out of bed she rolled onto an equally soft and padded surface.

• If Ethel fell asleep and was safe and comfortable after she had rolled out of bed, the staff could safely leave her sleeping on the crash mat.

• The transfer back into bed was very quick and easy as the carers could use slide sheets to transfer Ethel back to bed, eliminating the need for a hoist or other lifting system.

Click here to download the full case study.

 

TOM

 

Tom’s story

Tom is a 92 year old gentleman who was diagnosed with Vascular Dementia in 2011. He also has poor vision as a result of Macular Degeneration. Tom previously lived in his own home with his wife. In November 2013 he required more care than his wife could provide at home; he was moved into a care home where he was provided with a low rise bed of 350mm height (including the mattress).

 

 

Tom is not orientated to time, place, or people (other than his wife). He struggles to follow instructions and is not aware of the difference between night and day; he has very poor insight into his level of function and poor risk awareness. He is hoisted for transfers between the shower chair and bed as he is unable to weight bear. Tom experiences frequent and vivid hallucinations and becomes fearful of falling, even to the extent of imagining he is falling from an aeroplane or boat. Tom grips the edges of the bed whilst experiencing these hallucinations and appears agitated and anxious.

On one occasion Tom displayed these distressed and agitated behaviours for an extended period of time, thus making his care difficult. He had refused to sit out of bed for several months, and so was confined to bed. In spite of this, he would still attempt to get out of bed at inappropriate times. When the carers asked him to stay in bed, he would become agitated and raise his voice, telling them to leave him and go away.

Tom was identified as an appropriate candidate for the trial, as he was frequently attempting to get of bed alone, resulting in bed falls. Even with the use of a crash mat, these falls caused bruising, head injuries and other damage. Medical intervention was often required and incident reports were being completed on a regular basis.

Results

The FloorBed™ was provided for Tom and set very low when he was left alone. The carers and Tom’s wife report that since having the bed, Tom has not attempted to get out of bed at all and so has not had any bed falls. They also report that Tom appears safe and comfortable in the bed and is happy to be left there alone.
In addition, it is reported that Tom has been a lot calmer throughout the day and night. Since using the FloorBed™, he appears more alert, more responsive and better able to follow instructions.

Another observation is that Tom has fewer and less intense hallucinations; Tom’s wife believes that Tom feels a lot safer and more secure when left alone which has led to him being more relaxed and calm.

The carers report that the FloorBed™ has not only improved Tom’s overall quality of life, but has also had a very positive impact on them. Relationships between the carers and Tom have greatly improved as they no longer have to cause him distress by repeated requests to stay in bed. The carers no longer have to fill out incident reports or provide such frequent supervision. The need for medical intervention has been significantly reduced, decreasing the carers’ workload.

Statement from Carer:
“Best thing I’ve seen anywhere for people at risk, no risk of tripping on the crash mats. This helps the carers a lot – makes the residents much happier, no calling doctors, no incident form, not having to monitor him as much.”

Statement from Tom’s wife:
“He is much calmer in this bed, maybe he feels safer and the hallucinations have become much better.”

Click here to download the full case study.

DOROTHY

 

Dorothy’s story

Dorothy is a 93-year-old lady who lives alone and is supported by her family, who visit frequently, and carers that assist four times a day with personal care tasks, domestic tasks and mobility.

Dorothy has dementia, which has resulted in poor safety awareness and poor orientation to time and place. In addition, a recent stroke caused significant weakness throughout the left side of her body. Dorothy requires the support of one carer and a Zimmer frame for all mobility. Unfortunately, there are times that

Dorothy will attempt to get out of bed when unattended, and since she is unable to mobilise alone, this often results in a fall.

Dorothy’s family reported that they had significant concerns regarding Dorothy at night and requested that bed rails were provided. However, the OT service were aware of the increased risk due to Dorothy’s confusion and did not feel this was appropriate. They provided a low bed with a mattress platform height of 200 mm and a crash mat. The family monitored Dorothy’s night-time behaviour over a four-week period and reported their findings, which they gathered each morning. On five occasions Dorothy was found on the crash mat, on five occasions half of Dorothy’s body was in the bed and half out, on six occasions she had been found in bed on their arrival and the rest of the time the family found Dorothy sat up sitting on the edge of the bed. The family were very concerned about the risk of injury and wished to explore further interventions.

Results

A FloorBed™ was put into place for a trial and was set at the lowest point of 70 mm from the ground when Dorothy was assisted into bed each night. Since the FloorBed™ has been in place, Dorothy has not fallen out of the bed. Each morning, the family find Dorothy lying safely on her bed.

The family have also reported that they are aware that Dorothy’s behaviours can be inconsistent, however they feel reassured that should Dorothy roll out of bed at any time, the risk of injury is minimal as the low height reduces the impact significantly.

Click here to download the full case study.

little boy Paul

Phillip’s story

Phillip has a diagnosis of dementia which results in poor risk awareness and confusion. Phillip is dependent on a hoist for all transfers due to difficulty weight bearing. He would frequently attempt to get out of bed, unaware of the associated risks. This was resulting in him falling1-2 times per week, and unfortunately the consequences of these falls was skin tears caused by the impact against the side of the bed, the bedside cabinet or the floor. On one occasion, Philip sustained a head injury, despite there being a crashmat in place.

Results

A FloorBed™, with a mattress platform height of 7cm from the ground, was put into place for a trial. The outcome far superseded expectations as not only has the FloorBed™ eliminated bed fall injuries, it has eliminated the falls completely. The carers have reported that they have observed Phillip reach out and place his hand on the floor, then turn over in the bed and go back to sleep rather than attempt to get up and out of bed.

Phillip has not had any bed falls since the provision of the FloorBed™.

In addition to reducing the risk of bed falls and injuries:

• The FloorBed™ provided reassurance to the care staff as the risk of bed falls and injuries was significantly reduced.
• The FloorBed™ provided a safe and appropriate working height for the carers when assisting with care tasks.

Testimonials

‘It is really comfortable and it’s funny how this bed works; it goes up and down like being at the funfair.’ – resident

‘If we could give a FloorBed™ to each resident, we could reduce the amount of night checks required and therefore reduce staff levels.’ – Home Manager, Barnfield

Click here to download the full case study.

little boy Paul

Susan’s story

Forty-nine year old Susan experiences involuntary movements in all four limbs as a result of Huntington’s disease. These movements can be very expansive and cause Susan to become off balance when mobilising and transferring; they have also resulted in several bed falls, as the movements continue whilst Susan is asleep. Susan lives with her husband, Jim, and was sharing a double bed until the large movements began to disturb Jim and he had to sleep in another room.

Unfortunately, Susan was falling out of bed whilst asleep each night, often more than once. Susan frequently required paramedic and hospital intervention due to significant injuries, including injuries to her eye and shoulder. On one occasion she required stitches to her head.

Susan is able to mobilise independently and requires support from a riser recliner and toilet frame to enable her to retain her independence with her transfers. Susan required an intervention to reduce the risk of bed fall associated injuries without impacting on her independence with bed transfers.

Provision of side rails would have prevented Susan from being able to transfer in and out of bed independently, and a crash mat is likely to have increased the risk of falls as it would have been a trip hazard when attempting to stand and mobilise.

Results

A FloorBed™ was put in place to reduce the risk of bed fall injuries. Once Susan has transferred into the FloorBed™, she lowers it to the ground and the ultra-low mattress platform height of seven centimetres turns the fall into a roll, which reduces the impact and therefore the likelihood of injury.

This has been very successful in reducing the occurrence of injury for Susan. The uncontrolled movements are still causing Susan to come out of the bed whilst asleep; however, since provision of the FloorBed™TM, Susan has not sustained any injuries as she is no longer falling but rolling out of the bed.

Susan also benefits greatly from the hi-lo function, as she is able to use the controls independently to raise the bed, which enables her to retain her independence with bed transfers.

An intercom system has been put in place to alert Jim when Susan falls, and he is then able to assist Susan back to bed safely. Since provision of the FloorBed™, Susan has not required paramedic intervention or further hospital admission.

~The family has advised the OT that they are less anxious as they do not worry about Susan hurting herself as a result of a bed fall. Susan has also reportedly advised that she is very grateful for the FloorBed™ as it has reduced the occurrence of injuries.~

Click here to download the full case study.

Floorbed™

Andrew’s story

Andrew is a 42-year-old man with severe generalised dystonia, he experiences frequent spasms as a result. His spasms have been so severe on occasion that they have caused him to experience bed falls and have also frequently resulted in him hitting his head and arms on the wooden headboard, leading to a much disrupted sleep pattern and, as a result, exhaustion.

A standard profiling bed with side rails was considered to prevent him falling out of bed, however, this provision was not deemed suitable due to the risk of injury and entrapment. The provision and fitting of side rail bumpers was not deemed strong enough to prevent the risk of injury and entrapment due to his very strong, uncontrolled spasms.

During a recent hospital admission, Andrew had been provided with an ultra-low bed that has a minimum height of 9 cm. This reduced the risks to Andrew and so the OT looked at providing this in the community, however the cost exceeded £3,500.

Results

The FloorBed™ with a mattress platform height of just 7cm was significantly more cost effective and so a trial was arranged. Following the successful trial it was agreed that Andrew would benefit from provision of the FloorBed™ with head and foot board bumpers and side rails. A compatible safety mat was also provided – this mat matches the height of the bed and mattress at the lowest point.

The benefits of the FloorBed™:

  • The bed lowers almost flat to the floor for sleeping at night with a safety mat of the same height as the mattress for extra security.
  • The bed can be used at normal height for rest periods during the day with the soft, but firm, side rails raised for security, which cannot cause injury to the user.
  • The bed has profiling bed functions to adjust the back rest and knee break for change of position whether the bed is raised or lowered.
  • The bed has fitted smooth padded panels that completely cover the head and foot boards.

Feedback from Andrew:
Andrew states that he has been able to relax because he has no anxiety about falling out of bed and no fear of injuring himself during spasms. Andrew reports that he has been able to sleep for long periods of time (up to 5 hours), which he has been unable to do for the last 2 years. This has resulted in him being less exhausted during the day.