A Comprehensive Guide to Prescribing Homecare Beds

Selecting the right homecare bed is a critical process that involves understanding the patient’s clinical needs, their living environment, and the practicalities of equipment trials. This guide aims to assist occupational therapists and physiotherapists in making informed decisions when prescribing electrically adjustable homecare beds, ensuring optimal care and support for patients.

The Role of Adjustable Beds in the Homecare Environment

Electrically adjustable homecare beds are essential in managing and improving the quality of life for patients with limited mobility or specific care requirements. They offer significant benefits in terms of comfort, safety, and independence, while also addressing the needs of carers.

• Facilitating Safe Transfers: Adjustable height and backrest positions enable safer patient transfers, minimising the risk of injury to both patients and caregivers. The use of bed sticks can provide additional support and stability during these transfers.

Tips: Some users benefit from a taller height to transfer off the bed and a slightly lower height to transfer into bed. Don’t be afraid to experiment with height settings for transfers.

• Improved Independence: Electrically adjustable beds can allow users to reposition in bed without (or with less) assistance, allowing them to remain independent at home for longer. Users can adjust their position using the electric backrest, leg rest, and Trendelenburg (tilt) functions. Users can use these functions for comfort, pressure care management, oedema management, and bed mobilization.

Mobility in bed can be supplemented with a range of accessories, such as bed sticks or self-help over-bed poles (monkey bars). Consider mattress selection carefully if mobility concerns exist, as a soft mattress might affect mobility in bed. Consider using special sheets (such as the SlipperySally Sheet) to improve mobility in bed.

Tips: If a self-help over-bed pole is required, be sure to check whether there is a compatible unit that can be affixed to the bed. Freestanding poles won’t move with the bed and can be hard to reach if the bed is in a low position. Educate the user on where to stow their remote. Bedside table drawers can be pulled out with the remote hooked on the front, or bed accessories can be utilised to ensure the remote is always in reach.

• Addressing Manual Handling Risks: Setting the bed to an appropriate height is crucial for reducing the physical strain on caregivers. The right bed width is also essential, especially when using slings for transfers, to ensure the process is safe and efficient.

Tip: If your patient receives care from a variety of carers, make sure the maximum height of the bed can accommodate their tallest carer. Use caution when specifying wide beds for users who transfer using lifting equipment, as this can make life for carers difficult. Single or King Single beds are the best choice where the patient is receiving care in bed.

• Preventing Falls: In the past, fold-down side rails have been the primary mechanism for preventing falls where patients experience unwanted movement or behaviours during the night. This method for reducing fall risk is becoming less popular due to both restrictive practices and entrapment concerns. For patients at risk of falling, options like floor line beds that can be lowered to ground level offer a safer alternative, reducing the impact of falls without the risks associated with folding bed rails.

Tips: Floor line beds are best paired with a lower-profile mattress to reduce the overall height of the system.

Key Considerations and Tips for Prescription Homecare Beds

• Assessing the Bed Size: It’s crucial to consider the size of the room where the bed will be located. Adequate circulation space is necessary for the patient’s mobility aids and for carers to assist comfortably. Larger beds can be more difficult to make and harder to manage for the elderly. Don’t get us wrong, a larger bed provides more room and can be more comfortable for many people. We just recommend that patients consider all the pros and cons before committing to a large bed.

Tips:

• Unfortunately, we have encountered many instances where our patients’ new beds simply won’t fit in the room provided. This turns out to be a costly exercise, often incurring extra fees and extending wait times for essential equipment. Be sure to ask plenty of questions and use extra caution where the new bed configuration is larger than the old. We would highly recommend picking up a laser distance measure for quick and accurate room measurements (handy for home mods drawings too!).
• Use caution when prescribing both split queen and partner-style beds. It can be challenging to apply fitted sheets, especially on split queen beds that are inseparable. Ensure that the patient is aware of these issues and has a strategy in place for making up the bed. Split queen beds require special size fitted sheets. These are available from GMobility.

• Choosing Between an In-Home Trial and a Showroom Visit: While visiting a showroom allows for the comparison of a wide variety of equipment, in-home trials provide a realistic sense of how the bed will fit into the patient’s daily life. However, logistical limitations mean in-home trials might not offer the same range of options to try. It’s essential to weigh these factors based on the patient’s ability to travel and their specific needs.
• Avoid funding pitfalls: Increasingly, many funding bodies are restricting funding for some bed accessories. The rationale used when deciding if an item can be funded can broadly be summarised as “does the product deliver clinical benefit without causing undue risk to the patient?”. This seems to be particularly prevalent with homecare packages, and the application of these rules varies from provider to provider. In practice, this means we are seeing funding declined on items such as head and foot boards, bed linen, and pillows.

GMobility can assist you in making a strong clinical case for each of these items for the right patient (i.e., the headboard helps prevent the pillow from falling on the floor; many users with reduced mobility are unable to pick up items from the floor, and this practice may contribute to an increased fall risk). It’s best to ask in advance if there are specific restrictions or justifications the provider requires to ensure the patient gets the equipment they need.

Tips: Some beds include a headboard in the base price avoiding the need for additional justification on this item. Contact the team for assistance with product selection.

How GMobility Can Help

Hopefully you found the information and tips in this guide useful. If you have any questions, please don’t hesitate to reach out!

GMobility has a wide variety of beds, mattresses, and accessories available for trial both in our showrooms or in your patient’s home. Our team is well positioned to provide product advice and out Assistive Technology Specialists can assist you to problem solve solutions for those tricky clients. Get in touch, we are here to help!