Do we need Mental Capacity assessment to get bed rails?

Hi All,

MIL’s mental capacity is diminishing by the day. Had Dr out again today as carers were concerned that she spent the day in bed yesterday (at her request) and when they called at lunchtime, they found her with her legs over the side of the bed trying to get up … she is fully hoisted as cannot weight bear at all.

I discussed with GP whether there was any benefit of getting a dementia assessment as we are concerned about her safety and welfare if she “forgets” she cannot walk. He replied that there is nothing to be gained, she is 87 and she is bound to have declining mental capacity.

I rang the care company after he left and explained that she had tried to get out of bed the previous day, and the Manager hadn’t been told even though it was in her daily record and the carer I saw at lunchtime told me she had found her trying to get up when she arrived yesterday.

Can we request bed rails for her without a formal MCA assessment? I used to work in care myself but I know it can be regarded as deprivation of liberty if the person is considered able to make choices for their welfare, but we fear MIL cannot at the moment.

GP also suspect MIL is severely anaemic which might be affecting her mental state and is prescribing iron tablets, but they take some time to actually kick in.

Her daily notes from yesterday mentioned she didn’t know what day it was and at tea time she mentioned how dark it was as she thought it was morning. Today she seems more with-it, but argued with me that she didn’t stay in bed yesterday, so there is definitely something going on … :frowning:

web search

Bed rails: management and safe use - GOV.UK(6,the%20use%20of%20bed%20rails.

Mental Capacity Act
The Mental Capacity Act (6) protects those who may not be able to make decisions about their own care and treatment. Those that lack capacity may or may not benefit from the use of bed rails. Whenever possible, the views of the patient should be accounted for when considering the use of bed rails.

All care professionals should understand their obligations under this act, and organisations should ensure that these requirements can be implemented effectively.

There’s everything to be gained from a dementia assessment. There’s a big difference between the sort of loss that happens to everyone during advanced age - a little slower to learn, as opposed to confusing day and night, and serious short term memory issues.

Getting out of bed may be dangerous but needs to be assessed against the risk of greater injury if she succeeds in getting out of bed when there are bars on the sides. Further to fall can mean serious injury. Difficult choice and it’s definitely safer to do a mental capacity test and a best interests decision where there are people able to help you to weigh the pros and cons.

It’s a good idea to contact the Helpline. They can probably put you in touch with the right people. You can email them at and they will respond to your enquiries within 10 working days, although it can often be sooner.

The telephone helpline providing information is open from Monday to Friday between 9am and 6pm - 0808 808 7777