When the solution becomes a bigger problem than the problem


Some time toward the end of last year I confessed that I had been about to write a column on bed rails when I became derailed by something else that seemed more important, so I didn’t; I did, however, threaten you with making good on that threat at a later date.

Some of you thought I was kidding: “Bed rails?!” was the response I received from more than a couple of you; actually, it went something like, “… We’re all leap-frogging from one crisis to the next on an hour-to-hour basis, and you want to talk about bed rails?!”

Well, yeah, I do and here’s why: Bed rails can (and, sometimes, do) kill — or come close, or injure or just make a bad situation worse. Let’s back up a bit.

Another thing that kills, injures or sets folks on a permanent downward spiral on a pretty regular basis is falls. It sounds kind of silly — almost funny, in a funny sort of way — but the truth is, it’s true: Falling over puts many thousands of us on a glide path to permanent disability and/or death every year. Along with falling over, another way someone can fall is to fall “out of,” like a bed.

There can be any number of reasons why a person could fall out of bed, but the one that most of us can get to the quickest is the scenario where a person has dementia (think, Alzheimer’s). They don’t know where they are or why they’re there, they’re “somewhere else” in their minds or they’re scared or they need or want something or … So, they try to get out of bed, and BOOM! It’s scary, dangerous, can be life-threatening or injure the person to the point where a tough situation just got a whole lot tougher.

And if you’ve ever been a caregiver in that situation (or are now), you know what I’m talking about.

So, a rational, caring person thinks, “Prevent the fall!” Good! So, what do we do? We install bed rails to keep the person “safe.” Not good.

Bed rails look pretty benign and seem intuitive. You (caregiver) can still see “in,” they (person being cared for) can still see out and don’t feel like they’re reclining in a casket, and CLICK! One less thing to have to worry about.

We usually see bed rails in facilities (nursing homes, what-not) or hospitals, but more and more of us, as we’ve become “caregivers,” have had them installed at home, because that’s the only place where we can afford to take care of somebody who needs to be taken care of. They are, after all, commercially available and we caregiver-types are all about “SAFE” (especially since we can’t hover over our person 24/7, although we try), so it’s one less thing to have to worry about.

I certainly support the sentiment and the line of thought, but the research says (you know, “evidenced-based,” and all that) the rate of falls is actually higher with rails and more likely to cause injuries, in addition to a significant risk of asphyxiation, or strangulation, or … yeah, it’s actually worse. If you’re around these things, look at them from this perspective:

Bed rails don’t stop folks from trying to get out of (escape from?) bed, so they try; they try to get through (injuries, broken bones, asphyxiation, strangulation), under (same things) or over — BOOM! “Wow! I never thought…” Of course you didn’t! But here we are.

Now, can bed rails (particularly those with advanced designs) ever be a good thing, like in hospitals? Sure! It all depends upon the person and what’s going on with them and where they are. But, if the scenario is one of long-term care (they’re not going to get better and go home and live happily ever after), these things get real scary, real quick.

I could quote all kinds of national studies and research and statistics and blah blah, but I like you better than that, so I won’t; the fact is, it’s a fact. Does it happen to everybody? Of course not! But here’s the deal: We only have to be wrong once.

So, let’s go back to the original problem, because it’s still the problem. I mentioned “facilities” earlier, but if you walk through them, you’ll see that, generally speaking, these folks have come up with some pretty ingenious ways of getting around it, like putting the bed on the floor, or with one side against a wall with thick pads on the floor or both.

If you’re a caregiver — at home — you just immediately saw some obvious problems with either or both of those above. I know; so, talk to some pros, do some homework, look into it. Remember, it only takes once for the “solution” to become a bigger problem than the “problem.”

And if you’re the family of a person (particularly in a facility!) who has fallen out of bed (it happens — I know — I’ve been there), don’t be too quick to holler, “Get some bed rails on here!” Yes, the problem needs to be solved, or the threat needs to be reduced (which sounds more like life-on-Earth to me), but setting up a potentially fatal obstacle course might not be the smartest thing we could possibly do.

I’m sorry. I know that, for some of us, this just means another thing to do — another thing to figure out — another thing to worry about, and most of us didn’t need that, but here we are.

Yes, you can.

Mark Harvey is the director of Senior Information and Assistance for Olympic Area Agency on Aging. He can be reached at harvemb@dshs.wa.gov or 532-0520 in Aberdeen, (360) 942-2177 in Raymond or (360) 642-3634. FACEBOOK: Olympic Area Agency on Aging-Information & Assistance.