Sleep and Bedroom Safety for Seniors

Covered in this guide:

• Fall Safety in the Bedroom
• Safety Getting Into and Out of Bed
• Safety Sitting Up in Bed
• Navigating the Bedroom Safely
• Mattress Safety and Comfort
• Additional Considerations for Bedroom Safety
• Financial Assistance for Improving Bedroom and Home Safety

Updated: July 29, 2023 | Reviewed by: Marc Levesque

Home is where the heart is, but it's also the site of many accidents involving older adults. As they age, people are more likely to experience vision changes, balance problems, cognitive decline, muscle weakness and other problems that leave them unsteady on their feet, increasing the risk for falls.

Medication usage and environmental factors also contribute to a senior's risk of fall-related injuries. Almost 90% of older adults take at least one prescription medication regularly; some of these medications cause dizziness, drowsiness and other side effects that can impair balance and coordination. Seniors may also live in older homes that have loose floorboards, uneven floor tiles and other hazards, further increasing the risk of falls.

In the United States, an older adult falls once every second, making falls one of the leading causes of injury among seniors. Falls are responsible for about 95% of hip fractures and can cause broken bones, traumatic brain injuries and even death. As a result, falls account for more than $50.75 billion in medical costs per year.

The good news is that falls are preventable, especially if you spend some time addressing common hazards in your home. This guide focuses specifically on the bedroom, namely what you can do to reduce the risk of falls caused by poor lighting, damaged flooring and other safety issues.

Fall Safety in the Bedroom

Falls can happen anywhere, but the bedroom is one of the most common accident sites due to how often it's used. According to the American Academy of Family Physicians, seniors need seven to eight hours of sleep each night to feel well-rested. That's at least 2,555 hours spent in the bedroom over the course of a year. Many people also use their bedrooms for reading, folding laundry and other activities, increasing the amount of time spent in this part of the home.

Seniors with en suite bathrooms have an even greater risk of falls, as they're more likely to slip on wet floors, stumble when moving from a tiled bathroom to a carpeted bedroom or have difficulty getting into and out of the shower or bathtub.

Common Bedroom Hazards

Inadequate Lighting

Our visual system uses sensory input to determine the position of other people and objects. This makes it possible to navigate from room to room without tripping or bumping into things. Unfortunately, many seniors have vision problems that make it difficult to perceive objects, increasing the risk of falls in the bedroom.

Some of these vision problems make it difficult to see in poor lighting conditions, making inadequate lighting one of the most serious hazards in a senior's home. If a bedroom doesn't have an overhead light, the occupant may have to rely on bedside lamps or floor lamps that aren't bright enough to illuminate walkways and furniture. Depending on the location of the home, a bedroom may not receive much natural light during the day or light from nearby buildings at night, making it even more difficult to use the room safely.

Damaged Flooring

Many seniors also have problems with balance and coordination, leading to unsteadiness and difficulty moving from one area of the bedroom to another. Some balance problems are due to changes in the vestibular system, which gives the brain information about the body's position. Seniors may also develop balance problems due to low blood pressure, head injuries, medication usage and some diseases of the circulatory system.

No matter what caused it, poor balance can lead to serious injuries, especially when a bedroom has worn or damaged flooring. If a bedroom has wall-to-wall carpeting, a tear in the carpet is a major hazard, as the occupant's foot may get caught underneath a piece of material. A large tear may even expose the hard surface underneath, causing a senior to slip and fall.

Area rugs are also a potential hazard, especially for seniors who use canes, walkers and other mobility aids. If a rug bunches up, it's easy for a senior to trip over the uneven surface or get a mobility aid caught in the gap between the rug and the floor. Some seniors shuffle when they walk, making it difficult to make a smooth transition from the area rug to another type of flooring.

Even bedrooms without carpeting and area rugs can be hazardous for older adults. For rooms with hardwood floors, loose or missing floorboards increase the risk of trip-and-fall accidents. Other surfaces may have cracks or pits, making it difficult for a senior to navigate across an uneven surface. 

Human factors also play a role in determining the risk of falls on a hard flooring surface. For example, a senior's choice of footwear can affect their ability to maintain their balance. Some homeowners use wax to polish their floors, which leaves a slippery residue that can increase the risk of falls.

High Beds

High beds increase the risk for two types of accidents. The first is falls that occur when an older adult attempts to get into bed. Seniors with balance issues and muscle weakness may struggle to lift their legs high enough to climb onto the top of a high mattress. Older adults with upper-body weakness may also find it difficult to get themselves onto a high bed. The second type of accident occurs when a senior falls out of bed, which may occur while they're sleeping or during an attempt to sit or stand upon waking.

Preparing for Safety Emergencies

Because bedrooms contain so many potential hazards, it's wise to plan ahead for a safety-related emergency. You can do this by keeping the phone close to your bed, creating detailed health records and purchasing some type of personal emergency response system for your home.

Keep the Phone Close

If you trip on an area rug, fall out of bed or get in some other type of accident, you need to be able to call for help immediately. That's why it's so important to keep your cell phone on you at all times or have a landline available in every room.

If you prefer to use a cell phone, put the phone in your pocket every time you move from one room to another. If your hands are full and your outfit lacks pockets, you can also purchase a small pouch with a wrist strap to make it easier to carry your phone. It's a good idea to keep a corded phone nearby on your nightstand or end table. When you're not using the phone, keep it on the charger to ensure it doesn't die when you need it most.

Create Detailed Records

Emergency medical personnel can do a better job treating you if they know your medical history. If a fall knocks you unconscious, however, you won't be able to give an EMT or paramedic a list of your health conditions and current medications. That's why you should create detailed health records and make them easy to find in case of an emergency.

Your health record should contain an overview of your medical history, a list of your current medications and information about any implantable medical devices in your body. The medication list should contain the name of each medication you take, how much you take and how often you take it. If you take aspirin to prevent blood clots, for example, the entry would look something like this: "Aspirin - 81 milligrams daily."

If you've had surgery, list the name of each procedure, the date it was performed, the surgeon's name and the hospital where the procedure took place. "Laminectomy to repair tethered spinal cord, 2019, Dr. Michael Shaw, University of Pittsburgh Medical Center" is an example of what this should look like. Implantable devices include things like arterial stents, artificial joints and pacemakers. Be sure to provide the name of each device, the reason it was implanted and the date it was implanted.

Once you create your health record, make it easy for people to find. Keep copies on your bedside table, in the entryway and/or on a desk with other important papers. If you feel comfortable doing so, email a copy of the record to your attorney or a trusted family member.

Consider an Alert System

Several companies offer alert systems to give seniors and their loved ones extra peace of mind. If you don't want to install any equipment in your home, you can get a pendant that hangs around your neck. These personal emergency response systems typically have a button that gives you immediate access to the monitoring center, making it easy to summon first responders even if you've fallen and can't get to your phone. Some devices can detect falls and contact the monitoring center automatically, giving you an extra layer of protection.

A smart home system is another option. Depending on which system you choose, you may get a base station, multiple sensors and other system components, all of which protect you against a variety of threats. Smart home systems are typically used for deterring burglars, but seniors can benefit from smoke detection and other features. A smart home system may even alert you if water seeps into your home during a storm, giving you a chance to clean up the mess before you slip and fall.

Safety Getting Into and Out of Bed

If you're concerned about falling out of bed, bed bumpers and bed rails can protect you during the night. Manufacturers also make personal transfer devices that make it easier to get out of bed in the morning. If you need assistance getting out of bed, transfer aids reduce the risk of injury for you and the person providing your care.

In the United States, falling out of bed is one of the leading causes of the 1.5 million fall-related injuries requiring emergency treatment each year. Using these products can help you reduce your risk of serious falls.

Bed Rails

Bed rails prevent older adults from rolling out of bed while they're sleeping, which can help prevent broken bones and other injuries. They also provide extra support for seniors who struggle to sit up or move from a seated position to a standing position. If you install a bed rail, you can grasp it while you're sitting up or use it to support your upper body when you rise from the bed.

Although bed rails are designed to keep seniors safe, they aren't appropriate for every individual. Seniors with cognitive impairments or muscle weakness shouldn't use bed rails due to the small risk of bed rail entrapment, which occurs when someone gets caught in a rail or is wedged between the rail and the bed.

Bed Bumpers

Bed bumpers, also called bed rail pads, are usually made of foam and covered with vinyl to protect them from spills. They reduce the risk of bed rail entrapment by creating a barrier between the user's body and the hard rail surface. Bed bumpers also make it more comfortable for an older person to sleep in a bed with a rail attached.

Personal Transfer Devices

If you have trouble repositioning yourself or getting into and out of bed, you may benefit from one of these personal transfer devices:

• Leg lifters: Manual and power leg lifters do exactly what they promise — lift your legs so that you can get out of bed safely. Manual leg lifters usually consist of a sturdy strap with a loop on the end. Power leg lifters are ideal for users with limited arm strength, as they do the work of lifting the legs. All you have to do is push a button to operate the device.
• Lifting poles: If you still have much of your upper-body strength, you may benefit from lifting poles, which provide extra support for sitting up or getting out of bed. Tension-mounted poles are locked in place with pressure from the floor and ceiling, eliminating the need to install unsightly hardware. Using a tension-based system also makes it easy to move a lifting pole from your bedroom to another room if you have to sleep elsewhere in your home.
• Pivot discs: A pivot disc can make it easier to transfer from your bed to a wheelchair, especially if you have a limited range of motion due to an illness or injury. You step on the pivot disc while holding your bed rails for extra support when you get out of bed. Once your feet are firmly in place, the disc pivots, allowing you to sit down in a wheelchair without having to twist your lower body.
• Bed pulls: A bed pull is a device that wraps around your mattress, giving you something to hold on to when you're repositioning yourself in bed. You can also use this device to pull yourself into a seated position.

Transfer Aids Designed for Caregivers

If you receive care from a loved one or a paid personal care aide, there are several transfer aids that can make it easier and safer for you to get out of bed with assistance.

• Gait belts: A gait belt goes around your waist, giving your caregiver something to hold when they're helping you get out of bed.
• Sliding boards: If you have trouble putting weight on your legs, a sliding board makes it easier for caregivers to shift your weight as you transfer from your bed to a wheelchair.
• Glide sheets: A glide sheet attaches to a transfer board, making it easier to slide your body across the board while your caregiver helps you.
• Lifting slings: To reduce the risk of injury, some caregivers use lifting slings to help seniors get out of bed. These slings can be used to lift the legs and other body parts, reducing the amount of weight a caregiver must bear during a transfer.

Safety Sitting Up in Bed

For seniors with mobility problems, simply sitting up in bed is as difficult as standing up or transferring from the bed to a chair. Fortunately, there are several products available to make it easier to move into a sitting position, reducing your risk of bed-related injuries. You can also consider some lifestyle adjustments to make your bedroom a more secure environment.

Adjustable Beds and Bed Frames

With an adjustable bed, it's possible to raise the foot or head of the bed, making it easier for seniors to sit up even if they have muscle weakness in their arms or legs. An added benefit of having an adjustable bed is that you can raise the head to make it more comfortable to read, watch television and do other activities before you go to sleep at night. If you need to spend a lot of time in bed following an injury or surgical procedure, you can also prop yourself up to eat, receive assistance with grooming activities or take your medications.

Depending on which model you choose, an adjustable bed may have additional features to keep you safe and comfortable. For example, some models feature under bed lighting to make it easier to see if you have to get up to use the bathroom during the night. Adjustable beds may also have massage functions or zero-gravity settings to relieve pressure on your back.

Medicare coverage for adjustable beds depends on the type of bed you buy and where you buy it from. If you buy a hospital bed from a Medicare-approved supplier, then Medicare Part B may cover the cost under its durable medical equipment (DME) benefits. Medicare won't cover adjustable beds made for the general consumer market (non-hospital beds), and it won't pay for a hospital bed purchased from an unapproved supplier.

Furniture Placement

Many seniors fall out of bed when reaching for books, medications or other items stored on a bedside table or other piece of furniture. To reduce your risk for bed-related falls, consider moving your furniture closer to your bed to reduce the amount of reaching you have to do. Putting a nightstand right next to the bed, for example, makes it easier to access dentures, glasses, bottles of lotion and other items you typically use before bed or first thing in the morning.

If your bedroom is configured in a way that makes it difficult to move the furniture around, consider buying an adjustable tray table to keep next to your bed. A tray table usually has wheels, making it easy to slide it under the bed frame when you need it and move it out of the way when you don't. If you purchase a tray table, you'll also be able to keep your cell phone at your fingertips, ensuring you can call for help if needed. Medicare doesn't pay for tray tables because they're not considered medically necessary for preventing, diagnosing or treating a health condition.

Bed Caddies

A bed caddy keeps everything you need right at the side of the bed, eliminating the need to reach toward a nightstand, dresser or other piece of furniture. Each caddy typically has a flap that goes between the box spring and the mattress, preventing it from sliding around. You can use a bed caddy to store your glasses, cell phone, tablet, remote control and other small items. Bed caddies aren't covered by Medicare, but they're fairly inexpensive.

Navigating the Bedroom Safely

Slipping, tripping and stumbling can lead to serious injuries, including fractures, sprains, joint dislocations and concussions. It is essential to make lifestyle and design changes to navigate your bedroom more easily. Eliminating common hazards reduces your risk of falls and may prevent serious accidents.

Habits and Routine Changes

Lifestyle changes cost nothing, but they can make your bedroom much safer. To reduce your risk of falls, consider doing the following:

• Keep a flashlight near your bed. If your bedroom doesn't have good overhead lighting, a flashlight can help you see better if you have to walk around in the evening or get up in the middle of the night.
• Use smart devices in your bedroom. Voice-activated smart devices allow you to perform a variety of tasks, such as ordering items from your favorite store, scheduling appointments or checking the weather, all without having to get up from your chair or bed. Using one of these devices can help reduce your risk of falls by limiting the number of times you have to get into and out of bed each day.
• Store mobility aids near your bed. Mobility aids are only useful if you can access them when you need them. Keep canes, walkers and other mobility aids as close to your bed as possible so it's easy to use them when you're ready to get out of bed and start your day.
• Plan your schedule carefully. If possible, plan to perform as many tasks as possible during the day so that you don't have to get in and out of bed several times at night. For tasks that must be completed at bedtime, such as taking medications or checking your blood sugar, keep everything you need on your tray table or nightstand. If you have to take medicine, for example, put your medication organizer and a fresh bottle of water next to the bed.
• Wear non-slip socks or shoes with rubber soles. Appropriate footwear can help you avoid slipping on wood or laminate floors.

Room Design

• Eliminate excess furniture and decorative items. It's important to have clear walkways in every room of your house, especially if you have balance problems that make it difficult to navigate. You're more likely to trip over or bump into things if your room is cluttered with furniture and other objects. Ask a loved one to help you move some of the furniture to another room or eliminate decorative items that create tripping hazards.
• Move lamps, televisions and other items with electrical cords. If you have an electrical cord stretching across the bedroom floor, there's a good chance you'll trip over it at some point. To reduce the risk of falling, move electrical items so that their cords aren't in your walking paths.

Mattress Safety and Comfort

A good mattress reduces pressure on your spine, keeps you comfortable while you sleep, and helps prevent pressure ulcers caused by lying in bed for long periods of time. To make your mattress even safer and more comfortable, follow these tips:

• Replace old mattresses with sagging coils or other signs of wear and tear. Medicare only pays for mattresses if they're medically necessary, so you may have to pay out of pocket if you don't have a condition that would justify the use of an air-fluidized bed or other type of support surface.
• Upgrade to a hospital bed or an adjustable bed frame. Remember that Medicare Part B may cover the cost of a hospital bed if you buy from a Medicare-approved supplier.
• Check the height of your bed. Many companies promote thick mattresses as the most comfortable option, but a high level of thickness may make the bed too high for you to get into and out of it comfortably. By switching from a mattress with a 16-inch thickness to one with a 12-inch thickness, you can reduce the overall height of your bed by four inches, which may help you avoid falling in your bedroom.
• Take steps to make the bed more comfortable. Mattress toppers, throw pillows, body pillows and lumbar support cushions can all make your bed more comfortable. Joint pain often gets worse at night, so anything you can do to reduce discomfort can also help you reduce your risk of falls when you're ready to get out of bed.

Additional Considerations for Bedroom Safety

A few additional changes can make your bedroom much safer and reduce your risk of fall-related injuries. To increase your safety, consider changing the location of your bedroom, installing new flooring or using products designed to improve air quality.

Bedroom Location

Balance problems, joint pain and other medical conditions can make it difficult to get up and down the stairs several times per day. For some seniors, creating a first-floor bedroom is a great way to reduce the risk of injury. If there are no bedrooms on the first floor of your home, consider moving a bed and a few other pieces of bedroom furniture to your living room or dining room.

If you ever decide to move to a smaller home, keep bedroom safety in mind when deciding which house to buy or rent. Choosing a home with a first-floor bedroom can help you avoid stairs and eliminate the need to move your bedroom furniture downstairs if your medical condition gets worse.

Flooring Selection

Removing hazardous flooring can help you reduce your risk of accidents caused by tripping or stumbling. Manufacturers are responding to the need for safer flooring options, so carpeting, laminate and hardwood aren't your only options. Some companies offer flooring made of rubber and cork, which are safer than harder options. Rubber isn't slippery when it's wet, and it absorbs shock well, making it less painful if you fall at some point. Because it's softer than many other materials, cork also absorbs shock and provides extra cushioning in the event of a fall.

Air Quality

Air quality impacts sleep quality, so it's an important consideration when looking for ways to improve sleep and bedroom safety. If you live in a damp environment, you may want to purchase a dehumidifier to pull excess moisture from the air and reduce the risk of mold and mildew growth.

Humidifiers are ideal for dry environments, as they add moisture to the air, preventing dry skin, chapped lips and irritated sinus cavities. If you decide to get a humidifier, be sure to change the filter regularly to prevent mildew from growing.

Air purifiers have filters capable of removing certain particles from the air, improving air quality and helping users avoid the health effects of inhaling these particles into their lungs. Although they can't remove every pollutant from the air, air purifiers reduce indoor pollution levels. If you don't have room for an air purifier, consider changing the filter in your HVAC system.

Financial Assistance for Improving Bedroom and Home Safety

Some hazards can be mitigated easily, while others require help from a licensed contractor. Many seniors live on fixed incomes, making it difficult to afford to hire a professional for home modifications and repairs. Fortunately, there are several grant programs available to help eligible participants make safety-related changes to their homes. If you don't qualify for a grant, you may qualify for one of the home improvement loans guaranteed by the Federal Housing Administration.

Specially Adapted Housing Grant for Veterans

The Specially Adapted Housing Grant is available to veterans with certain service-related disabilities. Grant funds can be used to purchase, build or remodel a home, making it easier for disabled veterans to navigate their living spaces. You may qualify for the program if you have one of the following service-connected disabilities:

• Blindness in both eyes
• Loss of limb/loss of use of a limb
• Severe burns
• Loss of a foot or leg that makes it difficult to walk or maintain your balance without using a mobility aid; the injury must have occurred after September 11, 2001.

As of 2022, the funding limit is $101,754. To apply for the SAH grant, log in to your eBenefits account and complete the application. If you don't have an account or prefer to fill out a paper application, download the VA Form 26-4555 Application in Acquiring Specially Adapted Housing or Special Home Adaptation Grant. Mail the completed application to your regional loan center. You can find your designated loan center by using the directory on the VA website.

If you need help completing the application, contact a program staff member at (877) 827-3702.

Special Housing Adaptation Grant

The Special Housing Adaptation Grant is available to veterans with severe disabilities related to their military service. Qualifying disabilities include an amputation or losing use of more than one limb, certain respiratory injuries and certain types of burns. As of 2022, the SAH funding limit is $20,387; you don't have to use the entire amount at once, however. If you use a smaller amount now, you can apply to receive additional funds in the future. Grant funds can be used to build, purchase or modify an existing home.

To apply for the SAH grant, use your eBenefits account to complete the online application. You can also download VA Form 26-4555, fill it out and mail it to your designated regional loan center. The VA has eight loan centers in the United States, so it's important to send your application to the center assigned to your area. The VA has a directory of loan centers on its website.

If you have questions or need help filling out Form 26-4555, call (877) 827-3702 to speak with a staff member.

Rural Repair and Rehabilitation Grants

The Section 504 Home Repair Program offers grants and loans to help homeowners make needed repairs and/or modifications. Grants are available to seniors who are at least aged 62 and have incomes that place them in the very low income category established by the U.S. Department of Agriculture. The income limits vary by county, so check the USDA map to find out the limit for your area. If you're under age 62, you may qualify for a Section 504 loan.

You must also meet the following requirements to qualify for a Section 504 grant or loan:

• Own the home
• Use the home as your primary residence (live in the home)
• Live in an eligible rural area (enter your address on the USDA Eligibility website to find out if you qualify)

To apply for Section 504 funding, visit your local USDA Rural Development office.

FHA Title I Property Improvement Loans

Under Title I of the National Housing Act, the Federal Housing Administration guarantees loans issued by private lenders to consumers who want to make their homes more livable. You can't use Title I loan funds to install a swimming pool or pay for other luxury items, but the program requirements are fairly flexible, so you can use this type of loan to make your home safer or more accessible.

The maximum loan amount varies based on what type of home you own.

* Source: U.S. Department of Housing and Urban Development

To qualify, you must own or have a long-term lease on the property. You must also fill out an application, prove that you're a good credit risk and sign a note agreeing to the terms of the loan. If you receive a Title I loan, you can use it to pay contractor fees, appraisal fees, inspection fees, permit fees, title examination costs and fees charged by engineers or architects. 

You must apply for this type of loan by contacting an approved Title I lender directly. Contact the HUD Customer Service Center at (800)-767-7468 to get an approved list of lenders for your state.

Expert Reviewer

Marc Levesque

Marc Levesque is a Resource Coordinator who provides in-home assessments, connections to services and assists with long-range planning. Marc is committed to helping seniors and their families throughout the aging process. Marc is a team member at Hartford HealthCare Center for Healthy Aging and a trusted resource for families, many of whom he has worked with for nearly a decade.