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Aging in Place at Home: The Definitive Guide Part 4


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Getting In and Out of Bed

Getting In and Out of Bed Section Banner

Getting in and out of bed requires the coordination of a few key body functions that can be challenging for older adults. Trunk strength is necessary to rise up from and lower into a lying position. Adequate hip range of motion is essential for lifting and twisting legs onto and off of the bed. Accurate proprioception is key to understanding where the bed and floor are in relation to one’s body and hedge against falls.

Unfortunately, these faculties naturally degenerate with age; the once simple act of getting in and out of bed becomes an intimidating and risky task.

This portion of the guide details the helpful options that are available for making getting in and out of bed easier and safer.


Leg Lifter


Purpose

A leg lifter makes getting into bed easier by utilizing upper body strength to help lift up and swing a user’s legs onto the bed. Leg lifters also help with safely lowering legs off of the bed. Those recovering from knee surgery, hip surgery, stroke, or some other condition affecting the ability to move the lower body can benefit from a leg lifter.

Additionally, leg lifters can also help anyone with limited lower body flexibility and mobility. Users must have enough hand-eye coordination to loop the stirrup around their feet and maneuver onto the bed. Many users will need both hands to properly lift their legs. Every user has different capabilities, though, so some may be able to operate the leg lifter with only one hand.


Must-have Features

Leg lifter with wide mouth stirrupAdjustable, wide-mouthed stirrup – The stirrup should have a large opening that can accommodate the user’s feet while wearing shoes. Furthermore, the stirrup should be adjustable so that users can customize its shape to more easily loop around their feet. Once the shape is set, the stirrup should keep that shape until the user modifies it again.

The best option is a stirrup with bendable metal wiring sewn into the nylon webbing.


Rigid metal body – The body of the leg lifter should contain a rigid metal rod that holds its shape during use. This metal rod is essentially an extension of the user’s arm, so it must have a high resistance to bending.

Leg lifter with rigid metal body

Click here to see the highest recommended leg lifter.


Features to avoid

Leg lifter cinchCinch-style stirrup – Some leg lifters have a stirrup that cinches tight around the user’s foot. While this helps with holding onto the foot, it can make releasing the foot from the stirrup very difficult. Avoid cinch-style stirrups and choose a leg lifter that boasts a more user-friendly foot stirrup.


What to know before buying

Verify that the leg lifter is long enough for the user. The leg lifter should be at least as long as the distance from the middle of the user’s palm to the bottom of their feet. Take this measurement while the user is standing up straight or lying down flat and facing up. Ensure arms, legs, and back are all fully extended to guarantee accuracy.


It is important that the leg lifter is always handy when mounting and dismounting the bed, so designate a specific spot to keep it that is easily accessible. Consider keeping a spare leg lifter or a grabber tool nearby in the event the leg lifter falls out of reach.


Recommended supplementary products and home modifications


Bed Pull Up Strap


Purpose

Bed pull up straps help users rise from a lying position to a seated position to assist with getting out of bed. Users simply grab hold of the pull up strap hand grips and hoist themselves up.

Bed pull up straps are especially beneficial to those with limited core strength or anyone recovering from abdominal surgery. Of course, the bed pull up strap is also an aid to weaker and frailer persons in general who may not be using the device to address a specific health condition.

Keep in mind, though, that users must have enough upper body strength and coordination to properly pull themselves up with the strap.


Must-have Features

Bed pull up strap fastening systemSecure fastening system – Make sure the bed pull up strap utilizes a strong attachment method for securing the strap to the bed frame.

Look for pull up straps with buckles and clips that lock or snap together. Avoid straps that merely thread around a hook or tie into a knot because the straps may unexpectedly release or unravel over time.

Click here to see the highest recommended bed pull up strap.


Bed pull up strap hand gripsHand grips – Choose a bed pull up strap with hand grips along the length of the strap.

The hand grips should be positioned so that users can grab hold of the strap without bending their wrists. Using a bed pull up strap requires users to pull a significant amount of body weight, so it is important that the wrists stay straight to avoid injury.


Features to avoid

Bed rope ladderGangly construction – Steer clear of bed pull up straps made of a loose, stringy material because the strap can get twisted up or snagged on a part of the bed frame.

Instead, find a pull up strap that is more compact in nature and made with thick webbing that is less prone to bunching.


What to know before buying

Find a secure part of the bed frame where the pull up strap can attach. Users who have adjustable beds with moving parts must be careful to fasten the strap to a fixed, non-moving part of the frame.


While laying down flat on the bed with each arm resting straight on either side, measure the distance from the user’s elbow to the intended spot where the strap will fasten to the bed frame. When shopping for a pull up strap, make sure its length when attached to the bed frame is at least as long as the above measurement.

Note well that some manufacturers only list the length of the portion of the strap that users can grab and do not include the bottom part of the strap that fastens to the bed. Put in a call to the retailer or manufacturer if the overall length cannot be found.


Verify that the bed pull up strap has a high enough weight capacity rating. Bariatric pull up straps do not exist, so users who need a greater weight rating may consider utilizing two pull up straps, one for each hand.

Those who intend to use two pull up straps absolutely must pull on the straps simultaneously and with equal strength to avoid potentially placing too much weight on a single strap. Following this methodology can be difficult, so only pursue this solution if the user is capable and mindful enough to maintain protocol.


It is important to have a retrieval system set up in the event the pull up strap falls off the bed or gets kicked out of reach.

Purchase a separate adjustable-length strap with buckles and use it to attach the top hand grip of the pull up strap to the head of the bed frame. Typically, it is best to attach the retrieval strap at the top corner of the bed; this helps keep the pull up strap to stay on only that particular side of the bed. Users who find the pull up strap getting in the way while sleeping can adjust the length of the retrieval strap so that the bed pull up strap is suspending at the side of the bed rather than resting on top.

Always be mindful of the bed pull up strap when transferring onto and off of the bed. Depending on how tightly the retrieval strap is attached, the bed pull up strap may be on the bed or hanging to the side, so users must understand that there may be instances in which they must sit on the bed pull up strap or maneuver their feet around the strap during transfers.


Recommended supplementary products and home modifications


Bed transfer assist rails


Purpose

Bed transfer assist railBed transfer assist rails give support to users as they are lowering onto and lifting up off of a bed.

There are two parts of a bed rail. First, bed rails have a horizontal portion that slides between the mattress and box spring to wedge the rail in place. Second, bed rails have a vertical section that extends up and creates a handle for users to grab. Some grab rails have legs that rest on the ground while others do not.

Most anyone can benefit from the extra help that bed transfer assist rails offer, but those with weak core strength, poor balance, and chronic fatigue are particularly ideal candidates.


Must-have Features

Bed transfer assist rail with cushioned handleCushioned, non-slip handle – Users place a lot of weight on bed rails, so the handle should be padded for comfort and boast a non-slip surface to prevent falls that could happen as a result of hands sliding off the handle.


Features to consider

Adjustable-height – It is very important that users find bed rails that match their preferred height for maximum comfort and function.

Bed transfer assist rail - adjustable heightInstructions for determining a user’s ideal bed rail height is below. But even with a bed rail of the correct height, it is highly recommended that the bed rail have an adjustable-height feature.

The mattress and bedding can affect the seated height of the user, so having a bed rail that can accommodate any fluctuation is wise. For example, mattresses can sink when users sit on them and thick bedding can add height to the bed.

Try to find a bed rail that adjusts in height.


Bariatric – Standard bed transfer assist rails can typically accommodate up to 300 pounds. Those who need a bed rail that can support a higher weight capacity should opt for one of the bariatric models available; these usually max out around 400 pounds. Bariatric bed rails function the same as standard models, but are made with stronger, heavier materials.

One thing to note: the bariatric bed transfer assist rails that are compatible with standard beds and bed frames are not available with the adjustable-height feature. Therefore, be certain to verify that the height of the bariatric bed rail is appropriate for the user.


Bed transfer assist rail with storage pouchStorage pouch – Some bed rails include a built-in storage pouch that can hold television remotes, phones, and other small items.

As long as the bed rail is easily within the user’s reach while lying in bed, then a storage pouch can be a very convenient feature.


Features to avoid

Bed transfer assist rails without a security strap – Bed transfer assist rails should always have a security strap that fastens the bed rail to the bed frame.

Bed transfer assist rail with fastening straps

A security strap helps keep the bed rail from shifting around and changing position. Most importantly, a security strap prevents the bed rail from unexpectedly sliding out from under the mattress if the user pulls on the bed rail or bumps into the rail with a lot of body weight.

Not every bed transfer assist rail includes a security strap, but a simple webbed strap with a buckle clip found at a local hardware store can be used to fasten the bottom of the rail to the bed frame.

Never use a bed transfer assist rail without a security strap.

Click here to see the highest recommended bed transfer assist rails.


What to know before buying

To determine the ideal bed rail height, have the user sit in a chair with a table directly on one side. Place both hands on the table and try pushing off while rising into a standing position.

If the table is too tall for the user to adequately push off of then try again with the same chair placed next to a shorter table. In the event there is no shorter table available, try using a taller chair at the original table. And if that isn’t an option, then try raising the height of the chair by placing something flat on the seat top or propping up the chair with something stable like a sheet of plywood. After changing the height, test to see how easy it is to push off from a seated position, and continue to adjust as needed until finding the right height.

If the table is too short for the user to adequately push off of then try again with a shorter chair placed next to the same table. In the event there is no shorter chair available, try placing the original chair next to a taller table. And if that isn’t an option, then try raising the height of the table by placing something flat on the tabletop that is secure enough to hold its position when being pushed off of. After changing the height, test to see how easy it is to push off from a seated position, and continue to adjust as needed until finding the right height.

Once the height is comfortable for the user, measure the distance from the chair’s seat top to the tabletop. Add this measurement to the height of the top of the bed to determine the installed height of the bed rail.

Next, measure the distance from the floor to the top of the box spring or platform where the bottom of the bed rail rests and subtract this from the installed height.

Finally, beds can sink down when users are seated, so it is wise to have the user sit on top of the bed and see if the bed height lowers significantly. If so, measure the height difference and subtract this figure from the current bed rail height. This final measurement is the ideal bed transfer assist rail height; find a bed rail that matches or comes very close to this height.


Think about the width of the bed transfer assist rail because the user must be able to easily maneuver around it to get into a lying position and to stand back up. Those who find it difficult to scoot forwards and backwards on the bed should opt for a smaller, less obtrusive transfer rail that doesn’t require any effort to maneuver around.

In addition to using a narrow bed rail, consider installing the rail closer to the head of the bed as this places it further out of the user’s way. When the bed rail is at the head of the bottom the user can also more easily grab hold of the rail to assist with sitting up from a lying position.


Users with King and California King size mattresses may have to purchase a separate security strap at a local hardware store that is long enough to wrap around the bed frame for fastening down the bed transfer assist rail.


In some instances, bed transfer assist rails can also function as bed guard rails to help keep users from rolling off the bed. Those who intend to use the bed rail for both purposes should find a rail that is wide enough to effectively prevent the user from falling off the bed.

The rail should be about as wide as the user’s torso is long. Also, the rail should be placed around where the user’s torso is when lying down so that it can most effectively guard against falls.


Recommended supplementary products and home modifications


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