My husband, who is 92, is bed ridden. He can't stand up, is six feet tall and very thin. He's in a hospital bed in my livingroom, has diapers, and has difficulty finding his mouth when he eats. His sundowning behavior causes him to try to get out of his bed. He can't stand and thinks he can get out of bed, stand up and walk. He can barely move his legs and spends evenings (and all night) trying to get out of the bed and yelling for people to help him.
The hospital bed has bars on each side, but not at the end of the bed. There is a spacewhere the side bars end and the foot of the bed is. He spends hours trying to get out at those space sites. He has managed to get his legs out of the bed through those openings. Once, he was able to have his legs out one opening and his body out the opposite side's opening. I put chairs with there backs blocking that space. I've stuffed the sides with pillows so that he'd have to raise his legs higher than he can manage. He has managed to move them with his feet. I've tied the chairs to the bed and he gets his legs over the side rails dangling there. I don't need to deal with broken legs. All of these behaviors occur with lots of yelling etc. to me or imaginary people for help in getting out.
Is there any ideas as to how to keep him in bed besides using drugs? At this point I think drugs to calm him and keep him safe is my only options.
My mother suffered from advanced dementia and hospice was wonderful; they helped her stay calm & pain free while she was having a hard time with Sundowning in the afternoons and into the evening hours. I was the one who asked them to increase her Ativan in strength AND frequency b/c there was no point at all in having her suffer with agitation in the last months of her life.
Hospice can also provide him with a bolster pillow device for his hospital bed that will keep him cupped in place, making it harder to get up/out of the bed. An Alzheimer's anti-strip jumpsuit can be purchased here:
https://www.amazon.com/Ovidis-Anti-Strip-Jumpsuit-Men-Adaptive/dp/B07RDWJVGR/ref=sr_1_4?crid=APAHCSY6ZF2A&keywords=womens+alzheimers+clothing+-+alzheimer+anti-strip+jumpsuit+men&qid=1665445896&sprefix=womens+alzheimers+clothing+-+alzheimer+anti-strip+jumpsuit+men%2Caps%2C148&sr=8-4
Dress your husband in a Depends with a booster pad for extra absorbency for bedtime, then the anti-strip suit. He won't be able to take the Depends off and make a mess that way.
Best of luck to both of you.
https://www.rehab-products.com/products/30-degree-full-body-bed-support-system-w-four-attached-bolsters
I would also lower the bed as far down as you can so that even if he does get his legs off the bed he may not have the strength to stand, plus surround the bed with cushioned mats (yoga mats?).
But don't be afraid to try medication, allowing him to remain that anxious, frustrated or angry isn't really a kindness.
His caregiver doesn't like me raising his legs as it puts more pressure on his butt and causes bed sores. If I have to choose between bedsores and broken legs, I chose bedsores.
You sound against meds (me too!) BUT at this point of his life, I would do the meds.
Raising the center/foot of the bed a bit so the knees are bent might reduce him trying to get his legs out of the bed.
I think medication to reduce the agitation would also be a good step. No matter what you do to try to keep his legs in the bed without medication he may try anything to accomplish his goal of trying to get out of bed.
IF he does manage PLEASE do not try to get him up yourself or even have a family member help you. Call 911 ask for a "LIFT ASSIST" they will send paramedics that will in a matter of seconds accomplish what might take you half an hour to do. They will get him up and get him into bed. If there is no transport to the hospital typically the Lift Assist calls are not charged. And if there is no visible injury there is no need to transport.
(If he is on Hospice there is no transport unless authorized by Hospice anyway. But if he is on Hospice notify them of the Lift Assist call)
That worked for my Mom as it took her hours trying to remove that pillow.