A Safe Dementia Bed                                                                                                            ©   JR Nelis  12OCT20

My wife has Vascular Dementia.   This year her condition deteriorated to the point where I had to move her into an Assisted Living facility. 

There is something inherent within us that allow us to sense whenever we are at the edge of a bed while we are sleeping.  We will somehow sense that edge, stop rolling in that direction, and will remain in the bed.  However, that inherent ability to sense that edge is frequently lost whenever one has dementia.  My wife has rolled out of her bed more than once.  Fortunately, up until this last time, it just resulted in bruises.  But this last time it resulted in a fractured hip, requiring partial hip replacement surgery, rehabilitation, and some loss of mobilization.

After the first instance of the facility reporting that she had rolled out of bed, I suggested that it sounds like it is time for a partial bed rail to be installed so that this roll-out does not occur again (a partial bed rail is a half length rail that is just at the top half of the bed so there is still freedom to get in and out of the bed unassisted). I was told that they were not allowed to use any kind of a bed rail or any of the similar restrictive safety devices that I have seen advertised.  Researching this, I found that some people have somehow gotten themselves trapped in gaps between a bed rail and the mattress and were asphyxiated.  Others have climbed over a bed rail and have taken a much harder fall with an injury.  Based on a few instances of those unfortunate events occurring, thousands of people are now at risk of getting seriously hurt by falling out of rail-less beds. Including my wife.

However, while researching I found that there are things called ‘Roll Guards” that are still permitted.  But all of the Roll Guards that I found on-line were just soft cushions that could be overcome.   I fact, I was told that one of these soft Roll Guards was already being used on my wife’s bed whenever she did the roll-out that resulted in her hip fracture.  I concluded that what was needed was a more substantial Rigid Roll Guard.  Something that was rigid enough to be detected so that it is more likely to prevent any further rolling in that direction. 

So I created a ‘Safe Dementia Bed’ with a built-in permanent ‘Rigid Roll Guard’.

I am not going to go into a lot of step by step detail, because the bed frame that you start with will dictate the details of your construction.  I used a bed frame that I purchased from Wayfair.  It was an all wood frame, with a lot of slats so that it could be used with just a mattress.    Bed frames seem to come and go, so this link to what I used may no longer be valid:  https://www.wayfair.com/baby-kids/pdp/earle-twin-platform-bed-w004051137.html

In retrospect, if I had found a commercial wooden frame bed that had a solid headboard and a solid footboard, that would have saved me some work.  I would not have had to fill in the open areas where I felt that there could be some limb entrapment if I just left them open.  However, my search did not turn up a suitable one.

My Safe Dementia Bed design is based on using a Plush Pillow Top Mattress. A Plush Pillow Top mattress is necessary to provide the necessary compression.  You will see that below. I purchased my Plush Pillow Top Mattress from The Original Mattress Factory, a local Pittsburgh PA company.  However, that style of mattress is readily available in just about any brand.

The Plush Pillow Top Mattress is actually my Secret Sauce!!  You must use a Plush Pillow Top Mattress in order to obtain the compression that is necessary for the slightly lower Rigid Roll Guards to be detected whenever rolling towards them.  Using any other type of mattress that does not provide that degree of compression would not allow the Rigid Roll Guards to be an effective deterrent.   (If you used higher Rigid Roll Guards, then they would probably be viewed as being non-permissible ‘Bed Rails’)

( Click on any picture for a larger view )

Here is the commercial bed frame that I started with:




  To convert this to a “Safe Dementia Bed”, I did the following:





With the comfortable Plush Pillow Top mattress, the top of the mattress is now at 16” above the floor.  



Here is my modified bed.   The changes are more obvious in the images taken before I applied the finish:




I used Finish Grade Pine everywhere.   I used slots routed in the posts to minimize the need for fastening hardware. 



The hand-holes were an afterthought – was harder to move the bed around without the openings that I had closed off.



This modified bed should be considered as Early American Style.   It is sound and robust, however the finish is not quite factory perfect.  I could not get an exact match on the color.  And putting the finish on with a brush and not getting any runs is not one of my skills.  





The comfortable Plush Pillow Top mattress will compress enough for the Rigid Roll Guards to be detected by the sleeper’s body if the sleeper is rolling towards the edge of this bed.    While reaching a Rigid Roll Guard may wake the sleeper, that is better than letting the sleeper roll off the edge of the bed and fall to the floor.    Here is an example of the compression that you will get from a Plush Pillow Top mattress.   There will be body contact with the Rigid Roll Guard no matter how you approach it:



The Rigid Roll Guards do not restrict free entry and exit.   My feet are on the floor in this next picture:



With the top of the mattress at 16”, it is about the same height as a couch.   So getting up and out of this lowered bed should not be any more difficult that getting up and out of a couch.


Be mindful of the height of the Headboard.  I had to deliver the assembled bed to the front door of the facility. The bed would have to go into the facility and then into my wife’s apartment on its side in order to get through the doors.  To make that easy to accomplish, the headboard height needs to be less than the door width.  My headboard is 29.5” high.  So, I was OK for all 30” and wider doors.







Perhaps you know of someone who is in a similar situation.  If so, run with this idea and see what you can create for them in order to keep then safer.  You can’t buy it anywhere. You have to hack one yourself.   But remember to use my Secret Sauce.