The addition of a simple bed rail on or around your bed can help make it safer and easier to get in and out of bed. Bed rails are available in a multitude of different types and styles. Some even come with trays to hold your morning coffee or pockets to stash away your favorite book or the TV remote.
The best type of bed rail for you will depend on a number of factors: your physical skills, height, weight, mattress size, type of mobility aid you use, your budget, and your aesthetic preferences. Below, you’ll find a summary of the different bed rail types along with helpful tips to aid you in choosing a model best suited to your needs.
What is a Bed Rail?
A bed rail (also know as a bed assist rail or bed safety rail) is a supportive structure that is installed on or around the bed to provide added stability when sitting down on or standing up from the bed. They are also used to assist with moving, rolling, or repositioning in bed, for support when transferring from a wheelchair to and from the bed, and as an assistive aid to prevent someone from rolling out of bed.
Bed support rails differ in where they are designed to be attached: the bed itself, the wall, floor, ceiling, or as part of a free standing frame. Most bed safety rail models do not require any formal installation. They are simply held in place by the weight of the mattress or by tension exerted between two surfaces. Some models are designed to be securely screwed in place.
Bed Rail Types
To determine which type of bed rail is right for you, it is helpful to first understand what your options are. A list of the different types of bed support rails can be found below, along with some helpful tips to aid you in selecting the type best suited to your needs.
1. BED RAILS WITH LEGS
Bed Rails with Legs are stabilized in two ways: two vertical legs stand on the floor and the horizontal rail is stabilized by the weight of the mattress. When a user stands up and exerts pressure on the bedrail, the weight is transferred down through the legs to the floor. This type is a good consideration if you are able to walk and just need some extra “oomph” to get up. If you use a wheelchair and you have a small bedroom, be aware that the legs on this type of bedrail could create an obstacle for your wheelchair’s footrests, impeding your ability to move around in the room. In this case, a legless bed rail model, or model that attaches to the bed frame, wall, or ceiling is usually a better consideration.
2. LEGLESS BEDRAILS
No surprise here, a legless bedrail is just a bedrail with no legs. It has an L-shaped design: the longer side of the rail slips in between the mattresses and the shorter side extends vertically upwards, providing a supportive surface to hold onto. Because the rail is stabilized by the weight of your mattress, this type generally works best when it is being stabilized by a heavy, queen or king-sized mattress. If you have a lightweight, single or twin-sized mattress, be aware that when you exert pressure on a legless-style bed rail, it could cause the mattress to lift up and the rail to tilt forwards. Not ideal! If you DO have a lighter weight mattress, a bed rail model with legs that extend to the floor, or a model that gets screwed securely in place is usually a better consideration.
3. BED RAIL HANDLES
Bed Rail Handles are narrower, take up less space, and usually have a sleeker more low profile appearance. They provide an added handhold you can use for stability when sitting down and a place to push up from when standing up. Due to their narrow design and the fact that many models are secured by only a single fixed point, they may wobble a bit when being used for support, making this a less ideal solution for persons who are heavier or who anticipate needing to exert a lot of force down through the handle in order to stand up. In these cases, the bed rail models with two legs that extend down to the floor or models that attach securely to the bed frame or other nearby surfaces are usually better considerations.
4. BED RAILS WITH CROSS BARS
Bed rails with multiple horizontal cross bars can provide three helpful benefits: extra handholds for use when rolling in bed, different height rails to select from to aid in pushing yourself up to standing, and can assist to prevent entrapment or suffocation from occurring. The latter is a concern for persons who are unable to independently physically readjust themselves in the bed. (Learn more about entrapment prevention at the end of this guide.)
5. FOLD DOWN BED RAILS
This type of bed rail (aka Swing Down Bed Rail) easily folds down out of the way to allow for easy, unimpeded access to the bed. Heads up! These rails swing ‘outwards’ and down, so for this type of bed rail to work, there must be adequate free space beside your bed to swing the rail down and up. This type is a good consideration if a second person will be present to assist. If your intent is to use it independently, keep in mind: You must have the skills to be able to reach down and swing the rail back up after you are on the bed. Two notable benefits: It makes it possible to sit down closer to the top of the bed (preventing the need to wiggle yourself up the bed further after you lie down) and makes it easier to position a wheel tray table by the bed, if you eat meals in bed. Drawbacks: Moving parts can break or catch fingers.
6. ADJUSTABLE HEIGHT BED RAILS
Bed Rail models equipped with an adjustable height handle are more versatile and will allow you to experiment with different heights to determine which grip height works best for you. They can be found in both legless styles and models with legs that extend to the floor.
7. ADJUSTABLE LENGTH BED RAILS
Some bed rails have a telescoping rail that slides back and forth horizontally, providing you with the option to lengthen it when you are in bed and to shorten it when you are ready to transition into and out of the bed. This type is a good consideration if you have a tall bed and want a physical cue to help prevent yourself from rolling unexpectedly out of bed and/or you would benefit from an extra hand hold for some “oomph” when you are standing up. If you habitually find yourself rolling out of the bed or you weigh more, it would probably be good to consider a bedrail that provides an even greater degree of support. Examples include: bed rails designed to be screwed to the bed frame and many of the dual sided bed rails.
8. DUAL BED RAILS
As the name implies, a Dual Bed Rail is simply 2 bed rails (aka Double Sided Bed Rail). One rail gets installed on either side of the bed. Cross bars resting underneath the mattress join the two rails together, assisting to hold the rails more firmly and securely in place. Dual Bed Rails come in both half and full-length styles and can be found in different sizes to suit different mattress widths. The half-length models are a good consideration if you share the bed with a spouse and both of you would benefit from a bedrail for support. Full-length models are a good consideration if you are prone to rolling out of bed and have someone who can assist you to raise and lower the rail. How do you get out of the bed when a full-length bed rail is in place? Most full-length models have a spring-loaded knob on each side, allowing the entire rail to slide vertically up and down, so a person can easily transition into and out of the bed.
9. BED RAIL WITH PIVOTING HANDLE
These types of bed rails provide Two-in-One functionality. They function as a normal bed rail to assist you to transition into and out of your bed. They also offer a swing out mobility arm that locks in a position perpendicular with the bed. The mobility arm functions like a cane, offering a little extra support to assist in transferring from the bed to a wheelchair or to more easily stand up to use a walker. Some people love this feature; others report they never use it because they say they are too lazy to adjust it each time they enter and exit the bed, hence they simply leave it fixed in one position. You’ll have to be the determiner of whether this added feature makes sense for your needs or not.
10. TRAVEL FRIENDLY BED RAILS
Collapsible, travel friendly bed rails are designed to fold flat for easy transport, making it possible to use both at home and when spending time away.
11. FLOOR-TO-CEILING POLE
Clever persons have put the old-school concept of “floor joists” to use to create the Floor-to-Ceiling support pole (aka Super Pole). It doesn’t require any screws. You just turn a screw-like mechanism inside the pole until enough tension is exerted between the floor and ceiling to stabilize the pole. Ideally, it should be installed between the floor and a cross beam in the ceiling. The Superpole provides assist with standing up and/or with transferring to a wheelchair or bedside commode. It also provides a nice stable surface to lean against when managing pants after using a bedside commode or when getting dressed. They come in bariatric versions and angled versions (for use with angled ceilings). Extenders are available to accommodate ceilings up to 10′ in height. Models with a no-slip surface where your hands are likely to grab to prevent hands from slipping down the pole.
12. BEDSIDE SUPPORT RAILS THAT REST ON OR ATTACH TO FLOOR
Some bed support rails can be positioned between the floor and bed frame and rely on the tension exerted between the two to hold it in place. Others models are designed to be screwed into the floor, offering a more stable support surface than a portable piece of equipment. If you anticipate relying heavily on the bed rail for support; you transfer yourself independently from a bed to a wheelchair, or wish to have a handhold in one specific spot, a model that screws into a fixed place on the floor is a consideration. Confirm the model selected is designed to accommodate the weight capacity you require and have a reputable handyman or contractor install it. A drawback is that you cannot move a floor-mounted bedrail model out of the way, or easily relocate it to a new location, if you need to. If your ceiling height permits, a Floor-to-Ceiling model is usually a better consideration because it does not require formal installation.
13. WALL MOUNTED BED SUPPORT RAILS
This type of bed support rail extends out perpendicular from the wall, providing a place to hold onto when you are getting in and out of bed. A positive benefit for this type of rail is that it can easily be moved aside to position a bedside table by the bed or to allow you to slide over to a bedside commode. Models that flip-up versus swing sideways usually work best if you have furniture situated close to the bed. The presence and size of a headboard will affect how close the rail can be positioned to the bed. Careful attention needs to be paid when selecting the installation height to ensure it is low enough to be used as a handle to bear weight down on when standing up. Models with a leg that extends down to meet the floor are typically the most sturdy.
14. WALL TO FLOOR BED SUPPORT RAILS
As the name implies, this type of grab bar attaches to both the wall and the floor. It is L-shaped, extends outwards from the wall, and bends 90 degrees to meet the floor below. It can be used for support with sitting down and standing up from the bed or to transfer to a wheelchair. Models may have a simple L shape only or may include a small support leg (like a kickstand) that aids to further stabilize it. Most models are designed to be fixed securely in one place. This comes with a drawback: it cannot be moved aside to position a tray table by the bed or to slide over to a commode. Some models have a pivoting handle, providing the option to swing it the side if the furniture located nearby permits.
16. TRAPEZE BED RAILS
A trapeze can be installed over the bed to use for assist with sitting up or repositioning yourself in the bed. The trapeze can be attached to the ceiling, or purchased as a unit with a Floor-to-Ceiling pole or a free-standing frame that rests behind and under the bed. This is a consideration for persons who spend a lot of time in bed and have difficulty moving around or repositioning themselves in the bed. Bed and mattress heights vary, so make sure to take into account the height of your mattress when selecting a specific option to ensure the trapeze will hang at a height that works for your needs.
18. BED LADDER
Provides a handhold to use to pull yourself up to a seated position in bed. Bed ladders are flexible and can twist and move around, so they should not be considered as a stable, secure handhold, but simply as an additional supportive aid, to assist in pulling oneself upright to a seated position or repositioning oneself in the bed. An added benefit is that they are easy to pack up and take along when traveling.
OK! Are you dizzy yet from scanning through all the options? As you can see there are many different types and styles of bed support rails to choose from. Hopefully, an inventor out there has created one that exactly fits your needs. Before you make a final determination on a specific type or model, make sure to take the following considerations in mind.
- Weight Capacity: Confirm the bed rail’s weight capacity is suitable for your needs.
- Bed Type: Be Aware! Not all bed rails work on motorized beds with height adjustable head and foot. Conversely not all rails that work on motorized or hospital-style bed frames will work on residential beds. So, it is important to confirm the bed rail you have selected is suitable for your type of bed.
- Mattress Width: Verify that it is designed to work with your mattress size: Twin, Full, Queen, or King.
- Bed Rail Handle Height: Some bed rail handles are height adjustable, while others come with one fixed height. Either way it is important to confirm that it achieves the height you need. (See tips at end for choosing the bed rail height.)
- Horizontal Cross Bar Height: Are you considering a bed rail model with two legs and a horizontal rail that slips between the mattresses? If so, measure from the floor up to the gap present between your mattress and the box springs. Confirm the bedrail’s leg length (distance from the horizontal bar to the bottom of the bed rail’s feet) will work with your bed.
- Full Length vs. Half Length Bed Rails: A full length rail is best for someone who has a tendency to roll out of bed, or for people who have an alternating pressure air mattress that assists with turning them from side to side. A half length bed rail attaches to the head of the bed and allows someone who is independent to swing their legs over the edge and use the rail to push themselves up to standing.
- Strapping Mechanism: Many portable-style bedrail models include a strap that attaches to the rail and then gets secured to the bed frame. This is beneficial to help hold the bedrail more securely in place.
- Bed Rail Covers: Some models come equipped with a cover that includes pockets, providing a nice place to store your phone, remote control etc. Slipcovers with pockets can also be purchased separately and added to an existing bed rail.
What’s the Best Bedrail Height?
The answer to this will vary based on the height of your mattress and on your own height and physical characteristics. Each person varies in the height of their legs, torsos and arms, as well as in the degree of flexibility in different joints (due to arthritis, torn rotator cuffs, old sports injuries etc.)
We have provided some general tips for selecting the best bed rail height for three different scenarios below.
- Do you plan to use the bed rail for assistance with standing?
If so, keep in mind: Higher is not always better! If the bedrail handle is too high, it will be hard for you to bear weight down on it to push yourself up. One trick you can use to figure out the best bedrail height for you is to stack a few books on either side of yourself on the bed and practice pushing off of them, adding or subtracting books until you find the height that gives you the greatest degree of “oomph” when you are pushing yourself upwards. Then choose a bedrail that provides this height. As a precautionary measure, it would be good to have someone stand by you while you are performing the book test, so if you do feel unstable they can provide you with some support for balance.
- Do you need a bedrail to help prevent you from rolling out of the bed?
If so, measure from the floor to the top of your mattress. Then, choose a bedrail with a handle height that will safely rest above the height of your mattress. There is no specific formula for number of inches a bedrail should be over the height of the mattress, but if it the rail is only a few inches over the top of your mattress height it is conceivable you could still roll out, so in general: the higher the rail is the better.
- Do you need the rail both to “assist with standing up” and to “prevent rolling out of bed”?
If so, you may want to consider a rail with multiple cross bars. The topmost rail can be used to prevent you from rolling out of bed, and you can use lower rails to push up from when you are standing up.
Bed Rail Entrapment: How to Prevent It
Bedrail entrapment is a concern for persons who are physically unable to readjust themselves in the bed. Many people have suffocated due to being trapped between a bedrail and the mattress, or due to a head slipping between the rails. To prevent entrapment, the bed frame, bed side rail and mattress should leave no gap wide enough to entrap a person’s head or body. The FDA recommends the following safe guidelines for bed rails:
- Open space between rails should be less than 4 ¾ inches.
- Bottom rail to the mattress should be less than 4 ¾ inches.
- Space between outer edge of mattress to rail should be less than 4 ¾ inches.
Many bed rails on the market do not meet these guidelines or only meet parts of them. If the bedrail you like does not meet all the guidelines above, and you are concerned entrapment could be an issue, you can adapt the bedrail to make it safer by using a bedrail slip cover over the rail to prevent the head or arms from being trapped between the rails; adding a long narrow pad that can be slipped between the rail and the mattress, or inserting a long wedge pillow between the rail and the mattress to help prevent entrapment and suffocation.
The Homeability Advice™
A bed rail can be extremely helpful if you have difficulty rolling over in bed, or standing up from the bed. Adding a rail to your bed is an easy way to increase stability and enhance your confidence when getting in and out of bed.
Of the portable-style bed rail types available, the models with legs that extend down to meet the floor are usually the sturdiest, but they do not work well for everyone! If your bedroom is small and you use a wheelchair, the legless bedrail models and models that attach to the bed frame, floor, or ceiling are usually better options.
If you anticipate needing to rely heavily on the bed rail for balance and support or you have bariatric needs, then a model that gets permanently attached to the bed frame, wall, floor, or ceiling is usually a better consideration. Make sure to confirm the bed rail’s weight capacity is adequate for your needs and to have the rail installed by a reputable handyman!
If you are unable to move around easily in the bed and/or are fearful entrapment might be an issue, you may want to consider a motorized, hospital-style bed that comes pre-equipped with bed rails. Medicare and/or other insurances will often assist in paying for a motorized-height adjustable hospital bed, if it is deemed to be medically necessary. Typically you will be required to rent the bed for a period of time, and eventually you’ll own it at the end. If you feel this is what you need, ask your doctor for a referral to get a hospital bed.
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