In order to provide the best possible support for people in nursing care, you have to think innovatively and be open to changing needs. The Stiegelmeyer Group has helped to shape numerous innovations since it was founded. Manoeuvrable beds, beds with brakes, sit-to-stand beds or machine-washable beds: in all these areas, our development team has repeatedly pioneered the best possible solutions for our customers. That is why "solution-focused" is a core value of our company. The successful presentation of the Tereno ultra-low bed at Altenpflege 2023 underlines this ambition once again. Ilona Wiemann, marketing product manager for the nursing home division, explains the significance of the Tereno for the "floor-level care" concept currently being discussed among experts in Germany.
The term "floor-level nursing care" often causes questions because it sounds so unusual. Is it nevertheless the common technical term?
Yes, in Germany this is a very specific approach in fact that is not yet widely used, however. For example, floor-level care is described by the German author Bianca Schmidt-Maciejewski as a three-phase concept (see references). This concept pursues the goal of returning the resident's urge to move and his/her rest phases to a "normal" daily rhythm without deprivation of liberty safeguards, and to give them back adequate orientation. This would be the “return to normal” phase of Schmidt- Maciejewski’s concept.
Is this a realistic goal, for example for dementia patients?
These residents in particular often have a strong, uncontrolled urge to move and are very restless. Floor-level nursing care aims to protect these people from harm without deprivation of liberty safeguards, to give them freedom of movement and to enable closeness. Activity-based mobilisation promotes increased reorientation in the return phase.
What are the challenges?
If this approach is taken without an ultra-low bed, high expenses for mattresses on the floor, gymnastic mats and upholstered elements are often necessary at first. Relatives must be involved in the planning phase (1st phase of of Schmidt- Maciejewski’s concept). But this can already lead to criticism and discussions: sleeping on the floor will often not be perceived as dignified by elderly people and their visitors. Nursing care is also costly, as personal hygiene and meals cannot take place on the floor. The resident must be repositioned in a wheelchair or nursing chair for this. The entire equipment requires so much space that only a spacious single room comes into consideration, which is not always available.
How can Stiegelmeyer support care facilities with this issue?
As a provider of comprehensive solutions, we can ensure with suitable products that cosiness and homelike feeling is also provided in floor-level care and that nursing staff are fully supported. The use of our new ultra-low bed Tereno is a pragmatic and contemporary solution in this regard.
The Tereno has a wide height adjustment range from 15 to 80 cm. Let's go through the advantages from bottom to top. 15 cm is very low, yet there is a ledge to the floor. Can residents easily overcome this?
Yes. Even with just mattresses on the floor, you would place two mattresses on top of each other, and the height of the ledge to the floor or to a gym mat in front of the “mattress bed” would be very similar. If a safety side is fitted to the Tereno, it can be upholstered with soft foam leather covers from Stiegelmeyer so that no hard edge is created along the top of the bed frame. The head and footboards can also be ordered in an upholstered version on request. At the same time, this enhances the homelike appearance. A beautiful and distinctive bed also promotes the resident's visual orientation, for example immediately after waking up. Our new low Aparto brevo bedside cabinet can also play an important role in this regard. It helps to position photos of family members or the cuddly toy of the grandchild directly in the resident's line of sight - things that immediately support orientation.
We already mentioned gym mats and upholstered elements that are used around mattresses on the floor. Does Stiegelmeyer offer similar products to combine with the Tereno?
We have a range of accessories that are well suited for this purpose. There are fold-out fall protection mats that are simply placed on the floor in front of the bed, or roll-out mats that are attached to the long side of the bed. Our wedge-shaped fall protection pad is pushed up against the bed so that the resident can reach the floor with a rolling movement. All these products protect against fall related injuries, allow free movement and also support the nursing staff when kneeling or sitting on the floor. At the same time, they provide a soft, gap-free transition from the bed or bedside cabinet to the floor. The lowest position of the Tereno is so close to the floor anyway that no limbs can get trapped under the bed.
What are the advantages of the higher positions of the bed?
The height adjustability of the Tereno is a decisive advantage compared to just mattresses, as it enables nursing care at different heights. We have already spoken about the phase model of floor-level care: with the Tereno, the resident can be gradually returned to a normal bed height. Programmable intermediate stops help with this. The ideal stand-up height in each case can be easily set on the handset.
Does the height-adjustable bed also have a positive effect on hygiene in the room?
Yes, because even in the lowest position, the mattress in the Tereno is ventilated from below, so that the risk of mould forming on the underside of the mattress, for example, is reduced. In principle, cleaning a bed made of just mattresses on the floor is difficult: the resident has to leave the room, the mattresses, mats and upholstered elements have to be moved to the side. A cleaning person alone can hardly manage that. The Tereno, on the other hand, scores with its open chassis. If you raise the bed to working height, the floor can be cleaned without any additional effort, which is easy on the back.
What happens once the return phase has been successfully completed?
Then the room simply remains as it is with the Tereno, the bedside cabinet and other furniture and accessories from Stiegelmeyer: a homelike, dignified place of retreat and rest with optimum conditions for nursing care.
Thank you very much for the interview.
Literature references on the topic of floor-level care
The model of floor-level care has been discussed for several years, but has rarely been implemented in practice. We believe that modern products such as the Tereno ultra-low bed or the Aparto brevo low bedside cabinet can give the topic a crucial new impulse. The author Bianca Schmidt-Maciejewski, M. Sc., Advanced Practice Nurse and Head of the Nursing Competence Unit at Wilhelmsburg Groß-Sand Hospital in German, provides comprehensive information on the concept of floor-level care:
Bianca Schmidt-Maciejewski: Bodennahe Pflege. Grundlagen, praktische Umsetzung, Fallbeispiele. Published by Kohlhammer in 2023, 98 pages.
Bianca Schmidt-Maciejewski: Sicherheit vermitteln. Bodennahe Pflege. In: Die Schwester – Der Pfleger, 62. Jg., August 2023, p. 34 – 37.