Why are Bed Sticks Considered High Risk Assistive Technology? 

Going back 20+ years ago, the humble bed stick (or bed pole) was one of the most used pieces of equipment that I used as an occupational therapist. I used them to help people at who were struggling to get out of bed, finding it hard to roll in bed, or finding it difficult to find their balance when standing up. They were low cost, people could afford to buy them and could be bought at all equipment stores. 

Fast forward to 2024, and this is one piece of equipment that I would rather avoid using if possible. I use it a ‘last resort’ piece of assistive technology (AT) because of the inherent risks in using these. But there are probably people new to Occupational Therapy, or those looking to buy this low-cost piece of equipment to help them move around the bed, that may think they are harmless.   

What went wrong? 

A Coroner’s reports from 2012 investigated the death of a woman in a nursing home who dies from asphyxia from getting her head between the mattress and the bed stick. We call this entrapment. Unfortunately over the last 2 decades there are many people around the world who have died or been seriously injured from the use of a bed stick or bed rail.  

That’s why they are classified as high-risk piece of equipment. The risks for when things go wrong are significant and potentially tragic.  

What is a bed stick or bed pole? 

Bed sticks are used to help people to lean on to get in and out of bed, or move in bed safely by themself. They are a lightweight pole shaped with one end is held secure under the mattress while the other end is positioned to produce one or two posts on the sides of the bed.  

When would you use a bed stick? 

Occupational Therapists might consider a bed stick as an option when helping find assistive technology solutions to help someone get around their bed. It might be to help them to roll in bed, sit up from lying position, to swing your legs to the side of the bed when seated, or to help steady you when you’re standing up.  

You have to analyse your client’s functional limitations and goals before identifying solutions to help; there may be a lot of other options available to help that are lower risk when you know what you are trying to achieve in using assistive technology solutions.  

Can I still recommend the use of a bed stick? 

Absolutely you can use a bed stick. However it is considered the last line of intervention. Use these with caution, after completing a comprehensive risk assessment.  

Occupational Therapy Australia identifies that a comprehensive bed stick assessment should include assessment of someone’s cognition, perception, motor functioning, fluctuation in abilities, mobility, history of falls, bed stick positioning, context. It is recommended that once a bed stick is used, there should be regular reviews scheduled to ensure that it’s still safe and appropriate for use ongoing.  

Bed sticks should not be used in the following situations 

• If the person is confused or in delirium, including from impact of medications 

• To prevent someone falling out of bed; evidence shows they don’t work for this 

• For restraint or as restrictive practice  

• If there is a risk of entrapment between the bed, mattress and the bed stick 

• If there is no one to review and confirm that the bed stick is still safe for them to use 

• The KA524 model of bed stick (bed stick with two upright poles) is not to be used, as recommended in the Coroner’s Report and Department of Health and Ageing.  

There are comprehensive risk assessments available that you can use when considering using a bed stick to determine if this is the right piece of equipment for your client (see references below).  

However, in my practice I focus instead on the many other strategies and solutions we have in our “AT Toolkit” to help clients to get around in bed with lower risks associated. Not only does that lead to less paperwork (to complete risk assessments), but more importantly this generally leads to improved client outcomes by introducing strategies that might last for the long-term.  

Some options that could be considered: 

• Lean on a bedside table 

• Raise the bed height- helps with sit to stand transfers out of bed, but can make it hard to get into bed 

• Bed Ladder- pull yourself up from lying to sitting 

• Electric Back Bedrest or bed wedges- can assist from lying to sitting without replacing the bed 

• Self-Help Pole- these come with their own risks, particularly for anyone with heart or shoulder problems, and are often not weight rated for bariatric clients. But they are useful in some situations 

• Electric Profiling bed- although this is higher cost, an electric height adjustable bed with head raise, knee break and Trendelenburg can assist people to get in and out of bed as independently as possible, and reduces manual handing risks for carers.  

If you are new to working with assistive technology and want to learn more, if you want to grow your “AT Toolkit” to draw from a wide range of solutions and strategies, and want to be in a supportive community who can help you on your journey, the AT Roadmap is now available.  

Signing up to the AT Roadmap gives you access to over 30 hours of training, much of this is on demand for you to complete at a time that suits you. With 2 intakes per year, you also get access to our AT Tribe to connect with us for monthly calls and Q&A sessions.  

Occupational Therapy Templates and Resources 

SWEP : SWEP Bed Mattress and Bed Equipment assessment tool  

• https://swep.bhs.org.au/files/365/Bed_Stick_Clinical_Considerations_for_Prescribers.pdf  

South Australia Equipment Programme: Prescribing Equipment by Type: https://equipmentprogram.sa.gov.au/lists/dhs-equipment-program-documents/prescribing-equipment-by-equipment-type  

• Safe Use of Bed Rails 

• Bedsticks Clinical Considerations for Prescribers  

• Bedrails Clinical Considerations for Prescribers 

• Guide to assessing Entrapment Risk 

Want to learn more about bed sticks – Check out our most recent webinar

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