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Elderly man sleeping in bed

Using a Bed Lever - Ministry of Health Recommendations

A bed lever is designed to assist someone getting in and out of bed and moving from a lying position to a seated position and vice versa.  It is not designed as a restraint or to prevent falling out of bed.

It is extremely important to ensure a person has the correct bed lever for their specific needs and that the bed lever is installed correctly to avoid head entrapment (please see page 2 for recommendations on assessment, fitting and positioning). 

A report was released in mid February 2019 following the very sad deaths of three elderly people over a three year period. The report recommended that metal hoop bed levers  should have three bars and a gap between the vertical bars of no more than 60 mm to 100 mm, recommended 85 mm. In addition it is recommended that they all be fitted with a cord with cleat system to secure the lever safely under and hard up against the mattress leaving no gaps where a person could become trapped. The placement of the bed lever from the position of the pillow is also extremely important. 

These are recommendations we are following in New Zealand as we await  further clarification and advice from the Ministry of Health, ACC and NZ Standards to ascertain if existing standards will be changed.

A bed lever can be extremely helpful and suitable to a wide range of people with varying degrees of reduced function. However, we strongly recommend that you use the checklist below to help you decide if a bed lever is suitable, compatible with the bed and environment. The checklist can identify potential contraindications and risks but may not cover every situation. For this reason we recommend you consult with an occupational therapist or health professional. 


Risk Assessment Guidelines and Checklist

  1. Check the maximum user weight of the bed lever you are using, generally between 100 kg to 150 kg. Ensure this weight is not exceeded.
  2. The Bed lever will not carry the full weight of the user, it is only used for balance and support whilst moving from sitting, lying or standing.
  3. Bed lever will be positioned 318 mm away from wall/headboard/footboard so that any entrapment risk is reduced as gap is large enough to pass through.
  4. Must be fitted onto a suitable stable and firm mattress that will not squash excessively and create a gap between the bed lever and mattress.
  5. Cord and block must be securely fitted and regularly checked and refitted i.e. Each time the bed is made. This is to prevent a gap forming between the lever and mattress of more than 100 mm.
  6. The lever is not being used as a restraint to stop someone falling out of bed.
  7. The bed lever is not for a restless sleeper, or someone with erratic, repetitive or violent movements.
  8. Bed lever is not fitted to a powered profiling or hospital style bed.
  9. Person using the lever is deemed to be alert and orientated, even if getting up in the night to access the toilet.
  10. Person using the lever is deemed at low risk of being unbalanced or disorientated e.g. from medication or a pre-existing health condition.
  11. Pillows, sheets, or bed covers are suitable and not going to create an issue of entrapment.


Installation Instructions

  1. It is important to secure the bed lever and avoid any gap occurring that could cause entrapment.
  2. Please follow the manufacturer guidelines for the model you have purchased.
  3. Between the bed lever and bed ensure you always fit the cleat with cord and block, secure the cord tightly.
  4. Ensure the gap between the bed lever and the headboard is a minimum of 318 mm.
  5. Between edge of mattress and bed lever or pillow – use forearm to push down on edge of mattress, it should be firm enough so any gap created is less than 100 mm.

 Diagram of bed lever installation



Independent Living Charitable Trust cannot be liable for any harm or injury that may result from the improper use, suitability, incorrect installation, or neglect to follow through with ongoing safety assessments as the user’s situation changes.
If you have any concerns regarding these precautions, please get in touch.

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