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We are looking into a bed rail to both keep my father in law from rolling out of bed, which he has done in recent past and give a possible hand in getting in and out if necessary. He bruised his ribs on his last roll out of bed that hasn't healed totally. He sleeps in a twin xl bed and weighs about 200 lbs. Any recommendations?

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wow, most bedrails are not made for that kind of weight. Can you get an Rx from the doctor for a hospital bed with siderails? Medicare would cover 80% of the cost. Sometimes you can pick them up cheap at a thrift store.
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I had heard that bedrails were some sort if strangulation risk, so maybe check that out. Some people have put a padded surface right next to bed, in case they fall. But I would think that is too squishy to walk securely.
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We had a sturdy bed rail to ensure my husband didn't roll out of bed but mostly to give him something to help him pull himself up. I later used it when my mother visited me. It wasn't very high, and it was less than half the length of the bed. It definitely would not prevent someone from easily getting out of bed, but it prevented them from accidentally falling out. It was on a very large thick platform that slid under the mattress, and I'll bet it would handle 200 pounds, no problem. I'll see if I can find a picture of it online. I think Medicare covered it, but it might have been Medicaid. I don't remember.

Do you have any idea why he is rolling out of bed? Is he used to sleeping in a wider bed? Does he act out his dreams?
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I can't find a picture of what we had, but if you Google Safety Bed Rails for the Elderly you'll find a great variety. Talk to his doctor about ordering something, so it will be covered by insurance.
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There are very simple ones that slide in between the mattress and box springs with a sort of grab bar ladder that sticks up along side the bed. You can position it anywhere along the bed. Easy to install with no tools and pretty sturdy. My 84 year old mom loves hers. Home medical supply stores usually have a variety.
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I havea rail like Jeanne is talking about. It is actally made for people to pull themselves up with. But, is pretty good at keeping Mom from rolling out of bed. It does go between the mattress and boxspring. Then, it has a belt (for a better word) your hook onto the end and the frame of the bed to secure it. Bad thing about full length bed rails is the patient may climb over and fall. NHs are not allowed to use them for this reason.
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Here is a picture of what we're talking about.
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Thanks everyone for your recommendations and advice. We had been looking online at a few options and talking to the home aid persons, but they realm cant say one way or other. Adjustable Hand Bed Assist Rail with Floor Support for Fall Management / Prevention by secure is one we were considering, but I will see if I can see about one mentioned here too by Jeanne. Will check computer to see if photo is viewable.

Not sure why he falls out. He was sleeping on a larger bed, but with his brother previously who passed recently. He still exits the bed on same side, and is side he falls from, because we nearly have it against wall now to prevent it him from going off other side.

I was unaware insurance may cover costs, so will tell him this it may be an option if he wants to bring it up with his doctor. Thanks again.
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I have 2, one on platform like mentioned above and the other just slides on bed same way but with a "U" shape , little wider then the bed/hand rail. We have only used to get out of bed, not keep them in. My dad is 250 and they both work for him because he is basically laying on portion of bed where handle is to get himself up.
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The 'bedside assist' is a half rail, slides under the mattress and can help to turn and position as well as get in and out of bed. It prevents accidental roll outs but is short enough to allow the person to get in and out without restriction.
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