Condition:
- Dementia
Challenges:
- Unable to mobilise safely
- Unable to weight bear safely
- Disorientation
- Poor risk awareness
- High risk of falls
Functional benefits:
- Hi-lo function
- Even-plane safety mat
- Easier transfers back into bed
Description of case:
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.
Main issues:
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 the bed and her chair. When unsupervised, she frequently attempts to get out of a standard low bed. Several bed falls have resulted in harm such as bruising, head and internal bruising, and consequently hospital admission.
Intervention:
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 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.
Outcomes:
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, reducing 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
