Case study: Nursing beds in dementia care centers

Introduction: The Heart of Dementia Care Lies in the Details

Dementia care is about more than just medical management—it's about creating spaces that feel like home, where residents feel safe, seen, and comfortable. For many individuals living with dementia, the bedroom becomes a sanctuary, a place where confusion fades and familiarity takes hold. But not all bedroom setups are created equal. In particular, the nursing bed—a piece of furniture often overlooked—plays a pivotal role in shaping a resident's quality of life. From reducing falls to easing agitation, from simplifying caregiving to preserving dignity, the right nursing bed can be a game-changer.

In this case study, we'll step inside GreenHaven Dementia Care Center, a mid-sized facility in Portland, Oregon, that recently underwent a complete overhaul of its resident sleeping arrangements. What began as a mission to "ｕｐｄａｔｅ old beds" quickly evolved into a transformative project that reshaped how staff, residents, and families experience dementia care. We'll explore how GreenHaven moved from traditional, one-size-fits-all beds to electric nursing beds with customized multifunction features , and the remarkable impact this shift had on everyone involved.

The Starting Point: Challenges with Traditional Nursing Beds

Before the upgrade, GreenHaven relied on standard manual crank beds—sturdy, but far from ideal for dementia care. "Those beds were relics," laughs Sarah Lopez, GreenHaven's Director of Nursing, who's been with the center for 12 years. "You had to crank them up and down, which took time and strength. For residents with dementia, who often move unpredictably, that delay could mean the difference between a calm moment and a fall."

The issues weren't just physical. Traditional beds sat low to the ground, making it hard for residents to reposition themselves independently—a small loss of autonomy that, over time, chipped away at their confidence. "Mr. Gonzalez, one of our residents with early-stage Alzheimer's, used to try climbing out of bed to reach his water glass," Sarah recalls. "He'd get stuck halfway because the bed was too low, and then he'd panic. It broke my heart to see him so frustrated."

Staff also struggled with nursing bed management . Adjusting nursing bed positions manually meant disruptions during care routines. "If a resident needed to sit up for meals, we'd have to crank the bed, which made a loud noise," explains Maria Ortiz, a certified nursing assistant (CNA) at GreenHaven. "That noise would startle others in the room, sometimes triggering agitation. And if we needed to lower the bed for transfers, we'd have to stop what we were doing and spend 5 minutes cranking. It slowed everything down."

Family members noticed, too. "My mom, Eleanor, has vascular dementia, and she'd come home from visits complaining about how 'cold' and 'hard' her bed was," says Mark Thompson, whose mother lived at GreenHaven for two years before the upgrade. "I thought she was just confused, but when I visited, I saw the mattress was thin, and the bed didn't adjust. She couldn't even prop herself up to read. It made her feel like she was in a hospital, not a care home."

The Turning Point: Researching Solutions for Dementia-Friendly Beds

In 2023, GreenHaven's leadership team decided enough was enough. They allocated funds for a pilot program: replacing 10 traditional beds with newer models designed specifically for dementia and long-term care. "We didn't just want 'better beds'—we wanted beds that spoke to the unique needs of our residents," Sarah says. "Dementia affects memory, spatial awareness, and motor skills, so the beds had to address all of that."

The team started by researching options. They looked at home nursing bed manufacturers that specialized in elderly care, attended trade shows, and even visited other dementia centers to see what worked. "We quickly realized that electric nursing beds were the way to go," Sarah notes. "But not just any electric bed—we needed ones with features that prioritized safety, comfort, and ease of use for both residents and staff."

After months of deliberation, GreenHaven partnered with a manufacturer to trial two types of beds: a basic electric nursing bed with height and backrest adjustment, and a customized multifunction nursing bed with additional features like programmable positions, pressure-relief mattresses, and built-in sensor alarms.

The Case Study: Implementing New Beds at GreenHaven

Phase 1: Selecting the Pilot Group

GreenHaven chose 10 residents for the pilot, representing a range of dementia stages and physical abilities: from mild cognitive impairment to advanced Alzheimer's, and from ambulatory to wheelchair-bound. "We wanted a mix to see how the beds performed across different needs," Sarah explains. "Included were residents like Mrs. Henderson, who had frequent nighttime falls; Mr. Lee, who struggled with contractures due to limited mobility; and Ms. Patel, who became agitated during morning care routines."

Phase 2: The Beds in Action

The new beds arrived in January 2024, and staff spent a week training on their use. "The electric nursing bed s were intuitive, but we still practiced adjusting positions, setting alarms, and troubleshooting," Maria says. "The best part? They came with a user manual that was actually easy to follow—no medical jargon, just step-by-step instructions with pictures."

Here's how the two bed types performed:

1. Basic Electric Nursing Bed

This model offered height adjustment (from 16 inches to 24 inches), backrest elevation (up to 75 degrees), and knee rest adjustment. It had a simple remote control with large, color-coded buttons—red for "lower," green for "raise"—and a lockout feature to prevent residents from changing settings independently if needed.

2. Customized Multifunction Nursing Bed

The star of the pilot, this bed included all the features of the basic model plus extras tailored to dementia care: a pressure-relief mattress with alternating air cells, programmable "favorite" positions (e.g., "mealtime" or "bedtime"), under-bed lighting to reduce nighttime disorientation, and a weight-sensing alarm that alerts staff if a resident tries to exit unassisted.

"Mr. Lee has severe arthritis and contractures," Sarah explains. "With the multifunction bed, we can program a 'stretching' position that gently extends his legs for 10 minutes every hour. His physical therapist says his range of motion has improved by 30% in three months. And the under-bed light? A game-changer for nighttime. Ms. Patel used to wander because she'd wake up disoriented in the dark. Now the light comes on when she moves, and she stays in bed, calm."

Phase 3: Measuring Impact

Over six months, GreenHaven tracked key metrics: falls, resident agitation (measured via staff reports and the Cohen-Mansfield Agitation Inventory), staff time spent on bed-related tasks, and family satisfaction scores. The results were striking.

"The numbers speak for themselves," Sarah says. "But the real wins are the stories. Like when Mark Thompson visited his mom, Eleanor, and found her propped up in bed, reading a book—something she hadn't done in years. 'She looks like herself again,' he told me. That's the impact we're after."

Key Features That Made the Difference

What exactly about these beds transformed GreenHaven's care? Let's break down the features that had the biggest impact:

1. Electric Adjustability: Speed and Precision

Unlike manual beds, electric nursing beds adjust with the push of a button. "In an emergency, like if a resident is choking, we can raise the head in seconds," Maria says. "With manual beds, by the time you cranked it up, precious minutes had passed." For residents, this means less waiting and more control—many can adjust the bed themselves for comfort, which boosts their sense of independence.

2. Customizable Positions: Tailored to Individual Needs

The customized multifunction nursing bed allowed staff to program positions for specific residents. "Ms. Rivera, who has trouble swallowing, needs to sleep at a 30-degree angle to prevent aspiration," Sarah explains. "We saved that position as 'Ms. Rivera's bedtime'—one button press, and the bed adjusts perfectly. No more guessing."

3. Safety First: Lower Heights and Alarms

Lowering the bed to 16 inches reduced fall severity, while weight-sensing alarms gave staff time to assist residents before they attempted to stand alone. "We used to have 'bed checks' every hour, which interrupted sleep," Maria says. "Now the alarm alerts us only when someone is actually moving, so residents sleep better, and we're more efficient."

4. Comfort: Pressure Relief and Home-Like Design

The pressure-relief mattresses on the multifunction beds reduced the risk of bedsores—a common issue for immobile residents. "Mr. Carter had a stage 2 pressure ulcer before the upgrade," Sarah notes. "With the alternating air mattress, it healed in six weeks. And the beds look like regular home beds, not hospital beds—soft fabrics, neutral colors. That familiarity helps residents feel more at ease."

Challenges and Lessons Learned

Of course, the transition wasn't without hurdles. The biggest challenge? Cost. "Electric beds are pricier upfront," Sarah admits. "Our initial budget only covered 10 beds, so we had to phase the rollout. We also had to train staff on troubleshooting—once, a bed stopped working because a resident had unplugged it. We now have a 'tech cheat sheet' for CNAs to reference."

Another lesson: Involve residents and families in the process. "We should have asked residents what they wanted in a bed," Maria says. "Some prefer firmer mattresses; others like softer ones. Next time, we'll do resident surveys first."

The Future: Expanding the Program

Buoyed by the pilot's success, GreenHaven has secured funding to ｒｅｐｌａｃｅ all 45 beds in the facility with electric nursing beds by the end of 2024. "We're prioritizing the customized multifunction models for residents with higher needs and basic electric beds for others," Sarah says. "We're also working with the manufacturer to add even more dementia-specific features, like voice-activated controls for residents who can't use remotes."

Other dementia care centers have taken notice. "We've had three other facilities reach out to ask about our beds," Sarah adds. "It feels good to be leading the way—but really, we're just listening to what our residents need. At the end of the day, that's all that matters."