Bed steps help with a mattress that sits too high, but the real fix is matching bed height so the person can sit on the edge with both feet flat and knees near 90 degrees.
A high mattress turns a simple act into a small climb, and that climb is where falls happen. The National Council on Aging’s bedroom safety guide notes most bed-related injuries happen during the transfer itself, not during sleep.
Take a tape measure from the floor to the top of the mattress. Somewhere between 20 and 23 inches is a common target, per Hill-Rom’s whitepaper on optimal bed height, but that’s a starting point, not a rule. Bodies differ, and the functional test below beats any single figure.
The Sit-And-Stand Test That Decides Everything
Sit on the edge of the bed with both feet flat on the floor. If the knees bend to roughly 90 degrees and the hips sit level with or slightly above the knees, the height is right. When the hips drop below the knees, standing takes real effort and balance, and stumble risk rises. When the feet dangle or the person slides forward to touch the floor, the bed is too high. Run the test in normal clothing and nighttime footwear, since slippers change the answer.
When the Bed Is Too High or Too Low
Lower a too-high bed before buying anything. Removing a box spring, switching to a lower-profile frame, or lowering an adjustable frame fixes the cause instead of working around it. For a bed too low, sturdy bed risers can raise the frame, but only if they fit securely and sit flat on the floor. A wobbly riser is worse than a low bed.
Bed steps give a stable platform for climbing into a genuinely high bed, like a tall adjustable frame or an antique bed with a thick mattress. They reduce the strain of that climb and give a solid place to plant a hand and foot. They do not fix balance problems, dizziness, leg weakness, or nighttime confusion—if any are in play, a step changes nothing and the underlying issue needs a doctor’s attention.
Any bedside step should have a wide, textured platform, a weight rating well above the user’s weight, and a handhold. Test it in daylight first, and place it so the top step lines up with the mattress edge. To compare models built for this, our roundup of the best bed steps for high beds covers weight ratings, step height, and handrail options side by side.
Assistive devices deserve caution too. A transfer pole or enabling side rail can make getting out of bed steadier, but both must match the person’s abilities and be installed per the manufacturer’s instructions. Bed systems guidance stresses removing fall and entrapment hazards and matching equipment to the individual.
Nighttime Setup That Cuts the Risk
The CDC’s STEADI home safety checklist recommends two pieces of lighting: a lamp easy to reach from bed, and a nightlight so the path to the bathroom stays visible. Both cost almost nothing and address the moment most falls happen. Companion measures:
- Keep the route to the bathroom clear of furniture, cords, and clutter.
- Remove loose rugs or tack them down.
- Wear non-slip footwear at night instead of socks on bare floors.
- Place a walker or cane within reach on the side of the bed the person actually exits from.
- Sit on the bed edge for a moment before standing, then rise slowly.
| What’s Working | Why It Helps | Watch Out For |
|---|---|---|
| Mattress top at 20–23 inches | General target for an easy sit-to-stand | Verify with the sit-and-stand test |
| Removing a box spring | Lowers a too-high bed at no cost | Check frame still supports the mattress |
| Sturdy bed risers | Raises a too-low frame | Only if they fit the frame tightly |
| Bed steps with a handhold | Stable platform into a high bed | Won’t fix balance or dizziness |
| Reachable lamp plus nightlight | Keeps the path visible at night | Check bulbs and placement monthly |
| Transfer pole or side rail | Steadier bed exit when matched to the user | Install exactly per manufacturer |
| Sitting before standing | Prevents the head-rush stumble | Needs a moment, not a rush |
The CDC’s STEADI check for safety brochure walks through the full room-by-room version of this setup.
FAQs
Are bed steps safe for someone who uses a walker?
Not on their own. A walker and a bed step compete for the same floor space and the same hands. If the person needs a walker to move around the room, fix the bed height instead, keep the walker parked on the exit side, and skip the step unless a therapist has approved the setup.
How do I know if the bed is too high without a tape measure?
Watch the feet. If they dangle when the person sits on the edge, or if the person has to push off with their arms to get up, the bed is too high. Hips dropping well below the knees is the other clear sign.
Do bed rails prevent falls?
They can help some people and hurt others. Enabling side rails support bed exit when matched to the user’s size and mobility, but poorly fitted rails create entrapment risk. Match equipment to the person and remove hazards, so treat a rail as a careful decision, not a default purchase.
References & Sources
- CDC STEADI. “Check for Safety: A Home Fall Prevention Checklist for Older Adults” Supports the lamp, nightlight, and clear-path recommendations.
- Hill-Rom. “Optimal Bed Height” Source of the 20–23 inch mattress-height target and transfer principles.
- National Council on Aging. “Bedroom Safety Guide” Supports bed-height fit, sit-and-stand testing, and transfer-device caution.
