Adjustable Beds Are a Boon for Both Patient and Caregiver

by Christina Medvescek on Mon, 2012-10-01 09:45

In the journey with ALS, the right equipment can make life so much better

SleepSafe’s Assured Comfort adjustable bed offers electric head and foot elevation, and solid hardwood headboards and footboards. It’s available in four sizes.
Article Highlights:
  • There are two parts to consider when getting a hospital bed (also called an adjustable bed): the frame and the mattress. This article focuses only on adjustable bed frames, not on mattresses or overlays.
  • The article discusses when to consider a hospital bed, advantages, types of bed frames, paying for it and other considerations when transitioning to a hospital bed.
Editor's note: Please be sure to check with your local clinic team, particularly the occupational therapist, for recommendations on hospital beds and other assistive sleep equipment. The local clinic team also may be able to help with questions about insurance and other funding options.

A hospital bed can be tilted up or down at the head and foot, and the entire mattress can be raised or lowered. True hospital beds are considered “medical devices” and are regulated by the U.S. Food and Drug Administration (FDA). They’re sold or rented through durable medical equipment dealers, both in retail locations and on the Internet.

However, some mainstream retailers offer adjustable beds with many of the features of hospital beds, but without FDA oversight of the bed’s specifications. (These beds fall under the jurisdiction of the U.S. Consumer Product Safety Commission.) Although they may offer more options in size, look and features, a non-FDA-approved bed may not qualify for insurance coverage.

There are two parts to consider when getting an adjustable bed: the frame and the mattress. Often these are sold separately, allowing greater flexibility and comfort. (This article focuses only on adjustable bed frames, not on mattresses or overlays.)

When is it time to get a hospital bed?

Do an assessment: Is the person able to walk or transfer independently? Can he or she independently perform activities of daily living? Is it possible for him or her to re-position in bed without any outside support? Can caregivers assist the person in bed without hurting their backs? If all the answers are “yes,” a hospital bed may not be needed.

What are the advantages of a hospital bed?

For people with ALS who are experiencing respiratory weakness, breathing is easier when the head of the bed is raised. Raising the foot of the bed helps with swollen feet and legs, a common problem in ALS. And being able to self-adjust the bed at the touch of a button provides not only comfort but greater independence — something caregivers appreciate as well.

For caregivers, the height adjustment feature allows greater ease in transferring and in providing care in bed, such as bathing, dressing and toileting.

Low-tech bed adjustments

Bed risers (which go under the bed legs to make the bed higher), combined with the right mattress and pillows, can provide a comfortable and functional bed. The upside is that it’s less expensive than buying an adjustable bed frame. The downside: The person using the bed can’t change the positioning without great effort or help from a caregiver.

For slightly more money (between $130 and $200, depending on the size) the Mattress Genie can raise and lower the head of the bed with a touch of a remote control. This heavy-duty inflatable wedge goes under the head of a standard mattress and an attached pump adjusts the air volume, raising the head up to 40 degrees and 26 inches) in about a minute. To lower, gravity and body weight help with deflation, which takes up to three minutes. Most mattresses are flexible enough to bend with the Genie, which comes in sizes from twin to king. But both sides of the mattress must be raised at the same time — something to consider with a shared bed.

Adjustable bed frames

Stylish headboard and footboard sets can disguise the "hospital" in a hospital bed. Pictured is a set from TenderCare Beds that comes in five finishes with an available matching nightstand.

Basically, a fully adjustable hospital bed frame comes in three models:

  • manual, in which all adjustments are done by hand;
  • semi-electric, in which the head and foot adjustments are done by pushing a button, but the height of the bed is adjusted by hand (this is the one most insurances pay for); and
  • fully electric, in which all adjustments are electronic.

Many models offer “bedroom-look” headboards and foot panels, which help take away the hospital-room feel.

Most hospital beds are slightly narrower than standard twin-size beds. But full, queen and even king-sized adjustable beds can be found, sometimes with dual controls for the separate sides (check out Ultramatic, Assured Comfort by SleepSafe Beds, Joerns, Golden Technologies, Volker and others). Bigger adjustable beds with mattresses generally cost several thousand dollars.

It’s often possible to extend the bed length by 4 inches. Larger people also may benefit from a “bariatric” frame, which is basically a super-sized, heavy-duty twin. The bigger the bed, the more expensive, of course, and the less likely it is to be covered by insurance.

Some commercially available adjustable beds offer head and foot adjustments but not height adjustment — a key feature for comfortable and safe caregiving. (“Hi-Lo” beds go extremely low to the floor, and usually are recommended for people with Alzheimer’s disease who are prone to wander and might climb over bed rails and fall.)

Side rails come in half and full lengths, or none at all. Although falling out of bed isn’t a huge hazard in ALS, many caregivers recommend getting a half side rail because it can provide leverage for someone trying to turn over or stand up, and offers a handy place to hang things like remote controls. One warning: Smaller individuals can become trapped between the side rail and the mattress, so assess the bed carefully for entrapment risks.

For a final shot of comfort, some beds also offer a vibrating massage option — with no need to drop in a quarter first!

Paying for it

Check with your insurance company to see what sorts of adjustable beds are covered and what documentation is required for coverage.

Contact a local durable medical equipment dealer to learn about available beds. Most dealers either rent or sell beds and mattresses. Usually Medicare, Medicaid and private insurance policies cover semi-electric twin beds with either a spring or foam mattress. (Special mattresses and overlays are a separate matter and may require additional documentation for coverage.)

Medicare pays for hospital bed rental only, not purchase, and requires a monthly co-pay of 20 percent of the monthly rental amount. After 13 months, the item is considered “purchased” for the beneficiary and no additional co-pay is required.

SpinLife says on its website that some Medicare consumers choose to buy rather than rent when the purchase price is comparable to the 20 percent co-pay they will end up paying over the 13-month Medicare rental period. For about the same price, they may be able to get a new bed with exactly the options they want.

SleepSafe Beds offers examples of insurance letters of necessity and steps to follow if your insurance claim is denied.

Additionally, the MDA national equipment program may be able to help you locate a gently used hospital bed and mattress — check with your local MDA office to learn more.

Accessories and other considerations

A rolling bed table, such as the kind used in hospitals, is really handy and often is available used.

An added trapeze above the bed can help with self-turning and positioning.

Keep the bedroom setup open and flexible, to accommodate more equipment down the line. Some individuals turn a downstairs den or dining room into their bedroom space because of the extra room and proximity to daily life.

Christina Medvescek
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