The concern is in this state she's at increased risk of falling if she gets up while the aide is asleep. I was thinking now might be a good time to transition to the hospital bed and use rails to discourage getting up alone. is this the right solution or is there a better one? Getting two aides is not in the budget.
The new technology is beds that drop to the floor.
Is there something you can place next to the bed which she can hold on to to help support her when she does try to get up and walk?
There is an alarm you can set up to alert someone when she gets out of the bed.
Search: Bed Exit Alarm
My very elderly Aunt with advanced dementia managed to get past the rails and several other barriers they had in place around her bed one time when she uncharacteristically got up and out in the middle of the night, then fell and broke her hip. She passed while still in the rehab facility, still trying to get out of bed.
Putting her mattress on the floor would have been a good preventative solution.
I agree with the others here, no to the hospital bed. There have been cases where elders have broken their leg when it was caught it in the railing, or choking themselves when their head went through the railing.
It might be time to consider Memory Care or a nursing home, where professionals can help out. If your Mom can't budget Memory Care, then check with Medicaid (different from Medicare) to see is she can quality for a nursing home, and Medicaid helps with the cost of the nursing home.
Where does the aide sleep? Is she hired for just night time? If so, she should be able to hear Mom get out of bed. If she has a separate room, get a baby monitor. I live in a split level. My Moms room was on the lower floor and I was at the top of the house. I had a baby monitor so I could hear her when she was up and around. Have you tried having a commode in her room?
Some will even lower to floor level, which will prevent her from getting out of bed and standing up. Assuming she can't get up from the floor unassisted.
There is a covered mattress designed for hospital beds, it is basically foam with a water barrier cover. You could use this on a regular twin bed if you don't get a hospital bed.
My husband uses the side rails to pull himself when turning on his side in bed.
This is another reason why restraints are not allowed anymore. They make the staff feel that the patient is safer being restrained and won't get into trouble. Believe me, a lot of the patients can get into all sorts of trouble if restraints are used.
Falls and injuries will happen at home or in an excellent facility. You just have to try to prevent them if possible.