EP2308439A1 - Hospital bed with standing function - Google Patents

Abstract

The sick- or hospital bed has a base frame, an upper frame and a backrest (80) mounted opposite to the upper frame. The backrest is brought into an erect position by a movement around a pivot axis. The pivot axis projects below the upper frame and on the horizontal in the direction of foot of the bed lying as the backrest.

Description

The invention relates to a patient and / or nursing bed according to the preamble of claim 1.

Since sick and old people often have difficulty getting up from a hospital or nursing bed, devices are known which make it easier to get up. In particular, the person when getting up the turn in bed can cause difficulties and so devices are known in which, as in DE 69530071T2 , a lower part of the mattress and lower leg rest is folded away or as at US 5,682,631 the bed is transformed into a seat so that the person can rise above hand supports. Also can, as under US 4,127,906 represented, the lying surface can be pivoted almost vertically or EP 0,178,951 shows that a patient can be conveyed frontally in a sitting position by rolling band-like rolling a slatted frame with the mattress thereon a patient.

A disadvantage of the known solutions is that they only partially promote the patient's standing up or that they are expensive to manufacture.

It is the object of the present invention to provide a simple and inexpensive device for leaving the bed at its foot-side end face. This device should be easy to handle by the person and the caregiver. Furthermore, this device should be comfortable for the patient in the application and can serve as a stand-up. Also, the device should be able to serve as a Rehagerät by supporting when getting up, so as to let a person practice getting up from a sitting position.

This object is achieved by a device according to claims 1 and 3 and the method according to claim 12. Further developments emerge from the subclaims.

According to the invention, a hospital and / or nursing bed is provided with a base frame and an upper frame. In this case, a backrest is mounted against the upper frame and the backrest can be brought into a substantially flat rest position to the upper frame and erection means from the rest position in a first erected position erectile, which corresponds to an end position of the erector and has a first Aufrichtwinkel. It is from the first raised position defines a second movement of the backrest in a second erected position over which a contact point of the backrest, which is adjacent to the back of a person intentionally on the bed, in the direction of the foot end of the bed is movable. This second movement is also referred to below as pushing out, and thereby the rising of the person is possible or at least facilitated.

In particular, mechanical means, such as a coupling gear described below in the exemplary embodiment, are understood as the erection means. Furthermore, this can be done by a simple storage on a single bearing point (or axis) on the upper frame and pivoting about this bearing point. Also, the erecting movement can be realized by moving in a linear guide with simultaneous pivoting. The erecting means may be an automatic drive such as e.g. include electric linear drive or hydraulic or pneumatic drive or alternatively, a manual operation may be provided by the nursing staff. In order to be able to get off the bed at the front end of the foot, the patient should be moved by the device in this direction or at least supported in this movement. This is realized by moving the contact point. The point of contact is not necessarily a precisely defined point, but may be an area or area on the backrest, and between this area and the person's back is usually a mattress.

According to the invention thus two different movements are provided. First, the backrest is raised, as is known in many beds, to bring the patient into a sitting position. Furthermore, the person is pushed towards the foot end by the second independent movement or at least supported in the movement there. Preferably, at the same time the angle of attack is increased.

The two defined movements can also be activated by the same drive means, such as a common linear drive or motor, but it is essential that the storage and management of the backrest is such that defined different movements are possible.

Advantageously, the first erecting means describe a pivoting movement of the backrest about a first pivot axis, which lies at least partially above a mattress located on the bed and is located in particular in the area of the lumbar vertebra of a person who is intended to be on the bed. As a result, the ergonomic situation is shown that when erecting a person in bed, her upper body pivots around the lumbar vertebrae. As explained in more detail later in the embodiment, a pivoting about a pivot point, which is at the height of the upper frame, cause the person would be squeezed in the abdomen. The first pivot axis, as well as the later described second pivot axis, is thereby a virtual axis and can change its position via the erection process. The lumbar vertebrae are defined herein as at least the five, preferably 10, vertebrae of the spine above the sacrum.

According to the hospital and / or nursing bed on a base and a top frame with a mounted against the upper frame backrest, wherein the backrest can be brought into a substantially flat rest position to the upper frame and erecting means can be erected from the rest position to a first erect position and thereby describes a movement about a first pivot axis, which is located approximately in the area of the lumbar vertebra of a person intentionally on the bed. In this case, the backrest can be brought about a movement about a second Pivotachse in a second erect position and the second Pivotachse is below the upper frame and on the horizontal projected towards the foot end of the bed as the backrest. The function of the first pivot axis is - as already described - to make the erection of the backrest in the first upright position ergonomically comfortable. Since the position of the second Pivotachse is relatively low and seen from the back on the side towards the foot of the bed when moving around this point at the same time the Ausschiebebewegung described is realized at the same time the backrest is raised vertically. Since the mattress is attached to the backrest in the region of its head end, the mattress is also raised by the backrest movement and the person slidingly displaced at the inclination of the mattress in the direction of the foot end, which is a much more ergonomic movement, as a simple exclusively horizontally directed Ausschiebebewegung ,

In general, the concept of pivot points for coupling gears can be defined, which have coupling arms of different lengths. For the purposes of this application coupling mechanism are also included in the concept of the invention, which have the same length coupling arms as Paralellogrammtrieb and whose virtual pivot point is at infinity. Accordingly, a linear guide is included in the concept of the invention, such as a slider in a guideway.

Advantageously, the guiding and / or driving means of the second movement of the backrest comprise guide and / or drive means which differ from the said raising means of movement to the first erected position. The second Aufrichtbewegung in the second erected position is in principle a different movement than the first Aufrichtbewegung and this also preferably also guide and / or drive means are used, which are different from those of the first Aufrichtbewegung. Although some of the same means can be used for this purpose, such as. As a drive element (eg motor or linear drive), which is uniform, but parts of the mechanism are available, such as guides, or sliding surfaces, which used exclusively for the second erection movement. Just by dividing the movements on special mechanical elements of the desired movement can be easily realized.

Accordingly, guides and / or drives can preferably be present in the erection means, which are used exclusively for the first and not for the second erection movement.

In a further embodiment of the invention, the backrest is mounted against a backrest support and in the first Aufrichtbewegung finds no relative movement between the backrest and backrest support instead. By the backrest support, which can be designed as a frame mounted against the backrest and thus has sufficient rigidity, a stable construction can be realized.

Advantageously, in the second erected position, the backrest has a second erecting angle β which is greater than the first erecting angle α of the first erected position. While in the first erected position, ie a seated position in the bed, an angle of about 70 ° to the upper frame level is the maximum angle comfortable for the peson, it is advantageous to support, in the case of getting up out of bed, to increase this angle.

In addition, the position of the contact point in the second erected position may be vertically higher than in the first erected position. This lifting of the backrest and the fact that the person in the bed leans against the backrest, parts of the weight are derived from the back, which reduces the contact force to the mattress in the buttocks area and this reduction, the person easier forward, so glide to the foot area of the bed.

In one embodiment of the invention, the backrest support reaches its maximum possible Aufrichtwinkel in the first erected position and this is 70 ° +/- 10 °, preferably 70 ° +/- 5 ° with respect to the upper frame. In particular, the storage of the backrest support against the upper frame is more stable (ie by wider and / or thicker linkage) designed as the storage of the backrest against the backrest support. At the angles α of the backrest support, which occur in the transition from the rest position to the first erect position, the weight forces of the person must be taken on the storage of the backrest support, while at the described subsequent angles β, the storage of the backrest against the backrest support only va To take on leaning forces, which are lower than the weight forces, so that simply achieves a sufficiently stable construction in this way becomes. Thus, it is advantageous to realize smaller angles of the backrest exclusively by adjusting the backrest support.

In a further embodiment, the backrest assumes its maximum possible Aufrichtwinkel in the second erected position and this is 80 ° +/- 10 °, preferably 85 ° +/- 5 ° relative to the plane of the upper frame. An angle greater than 90 ° is rather unhelpful, because so the person can not slide on a sliding surface in the direction of the foot end of the bed.

Constructively, the hospital and / or nursing bed be designed so that when moving from the first erected position in the second erect position, the contact point K of the backrest by at least 80 mm, preferably by at least 120 mm and most preferably by at least 150 mm in Towards the foot of the bed. With a bed length of 200 cm, the person is moved around a significant area in the manner described.

It can also be moved in the movement from the first erected position to the second erect position, the contact point K by at least 50 mm, preferably at least 140 mm upwards. By this vertical movement, which may be superimposed on the Ausschiebebewegung, the person along the mattress, which is fixed to the backrest and thus moves upward with, sliding towards the foot end moves.

Accordingly, in one method, a first step of erecting the backrest is defined at an angle of 70 ° +/- 10 ° and a second separate movement step of moving the backrest at least 60 mm towards the foot end of the bed. In this case, a contact point of the backrest, which is adjacent to the back of a person in bed, is moved in the first step by at least 10 cm, preferably at least 20 cm in the direction of the head of the bed. This is an ergonomic movement because it does not squeeze the person in the lower abdominal area. Furthermore, a method step can be carried out, by means of which the bed length in the region of the lower leg rest is shortened, and by which a clearance for leaving the bed is created, by a) manual at least partial removal of the lower leg rest and a mattress part thereon or b) can be realized by pivoting the lower leg rest with a corresponding mattress part. This facilitates leaving the bed. Also, the shortening of the bed length can be done by the lower leg rest is pivoted substantially vertically downwards with a mattress part connected thereto and the upper frame of the bed is lowered while the mattress part is compressed in its longitudinal direction.

Fig. 1

mit ebener Liegefläche,

Fig. 2

mit aufgerichteter Rückenlehne in der ersten aufgerichteten Position,

Fig. 3

mit einer hochgeschwenkten Oberschenkellehne,

Fig. 4

mit teilabgeschwenkter Unterschenkellehne,

Fig. 5

mit abgeschwenkter Unterschenkellehne und eingefahrenem Stützelement,

Fig. 6

in der komplett abgesenkten Position,

Fig. 7

mit Rückenlehne in der zweiten aufgerichteten Position,

Fig. 8

mit Anstellung des Obergestells,

Fig. 9

ein Detail der Rückenlehne und deren Antrieb,

Fig. 10

ein Detail des Stützelements,

Fig. 11

ein kinematisches Diagramm des Antriebs der Rückenlehne und

Fig. 12

das kinematische Diagramm mit eingezeichneten Pivotpunkten.

Subsequently, a preferred embodiment will be explained with reference to figures. The figures show a hospital bed according to:

Fig. 1

with a flat lying surface,

Fig. 2

with upright backrest in the first upright position,

Fig. 3

with a raised thigh rest,

Fig. 4

with partly lowered lower leg rest,

Fig. 5

with pivoted lower leg rest and retracted support element,

Fig. 6

in the fully lowered position,

Fig. 7

with backrest in the second erected position,

Fig. 8

with employment of the upper frame,

Fig. 9

a detail of the backrest and its drive,

Fig. 10

a detail of the support element,

Fig. 11

a kinematic diagram of the drive of the backrest and

Fig. 12

the kinematic diagram with marked pivot points.

In Fig. 1 is a hospital and / or nursing bed shown with a base 10 and an upper frame 40, which via two linear actuators 19a, 19b, such. B. electrical thrust spindle or hydraulic drives and lowered and can also be brought into inclinations. The underframe 10 comprises four main wheels 12, with which the bed can be pushed and wherein the main wheels 12 due to a wheel brake (not shown) can be secured against roll over actuation of the brake lever 14. In a release position of the brake lever 14, the associated wheel, or the associated wheels, released and so the bed can be rolled and in a braking position, a braking force is exerted on the wheel.

Fig. 10 shows a retaining hook 15, which is in the release position in engagement with the support member 20 and thus prevents retraction of the support member. If the bed is to be rolled, so the support member 20 can not retract unintentionally. Retraction is defined as reducing the distance of the sliding or rolling surface of the support member against the main wheels 12. In the braking position, the retaining hook 15 is retracted so that the support member can be retracted.

On the upper frame is normally a mattress (not shown), which lies on the backrest 80, the seat part 72, the thigh rest 70 and the lower leg rest 44. The seat portion 72 is fixedly connected to the upper frame 40 and the seat portion 72 or adjacent thereto are bearing points 71, 86d, over which the thigh rest 70 and the backrest 80 are stored.

Fig. 3 shows that bearing points 47, the lower leg rest 44 is pivotable against the thigh rest 70 and is driven by the drive 48. Drive 48 is mounted in the thigh bar 70. The thigh rest 70 is driven by a drive, not shown, which is mounted in the upper frame.

The backrest 80 is, according to Fig. 8 or 9 , mounted on a backrest 88b, 88c against a backrest support 82. The backrest support 82 in turn is mounted on the upper frame 40 via a linkage 86c, 86b. These mentioned linkages are each designed as a four-link coupling gear. In a four-link coupling gear four coupling elements in pairs in bearing points, which have the one degree of freedom of rotation, against each other. Of the coupling elements usually one element is driven, and this can bring all four coupling elements in the desired location and angular position. But it can also be realized a manual drive. The backrest support is designed as a stable frame.

The lower edge of the support member 20 is offset from the plane described by the lower edges of the main wheels 12 and corresponds to a flat floor by a small amount of 7 mm. That Normally, the support element has no contact with the floor. Since the travel of the support member is about 210 mm, it comes arithmetically at a weight load at the foot end of the bed to a tilt around the foot-end main wheels and a corresponding ground contact at a tilt angle of about 2 °. Due to the bed-internal elasticities it comes straight or possibly just not at a lifting of the head end-side main wheels at this tilt angle.

When pushing a bed, there is often the problem that the large weight of the bed (possibly with the patient) makes it difficult to change direction. Since the torque of the resistance of the change of direction results from the product of the resistance forces at the wheels with the lever to the axis of rotation of the direction change, it is advantageous to reduce this lever length by shorter center distances of the main wheels. The concomitant reduction in tipping stability is compensated by the support elements. Thus, in a normal sliding of the bed, the support elements have a certain ground clearance, they do not hinder the roll and direction change properties of the bed. Due to the support element, it becomes possible to adjust the center distance A ( Figure 3 ) of the main wheels to reduce. While in known designs a center distance of 1100 - 1300 mm are common, so the center distance can be reduced due to the support wheels to 920 mm.

Another advantage arises from the folding function of the lower leg rest: To maximize the ease of lying down and getting up from the bed to realize the greatest possible free Be created at the foot of the area. Since usually a relatively large center distance of the main wheels is selected to ensure the stability of the bed, a good tilting security can be realized when pushing the bed by an extended support element and created after retraction of the support member, a large free area at the foot.

In the present case, the support element comprises two wheels whose running direction runs in the longitudinal direction of the bed, that is to say a main sliding direction. Unlike the main wheels 12, there is no freedom in aligning the running direction about a vertical axis with the support member. Alternatively, the support member may also have only a wheel or a skid. In the case of several wheels or sliding elements of the support element, these can be connected to one unit so as to be non-rotating via two guide sleeves with two gas pressure springs 16.

An example of a typical sequence of the different drive means of the bed to illustrate its different functions.

In a first step , the bed, in particular the upper frame 40 is moved via the frame drives 19a, 19b in a middle and horizontal height. This altitude is important only for the subsequent fifth step and does not have to be performed first.

In a second step , the backrest 80 is erected, as in the transition from Fig. 1 to Fig.2 is shown. In this case, the second drive 88a is not used or driven, so that the backrest support 82 remains stationary relative to the backrest 80.

The linear drive of the erector 86a is extended and acts on the backrest support 82 and ensures its erection movement. The erecting means 86 causes a rotational pivoting movement of the backrest about the first pivot axis P1. This is approximately in the area of the lumbar vertebra of a person who is on the bed. As a result, ergonomically the natural erection of the person can be modeled, as well as the upper body of a person when erecting would perform a pivoting movement about this axis.

For example, if the backrest were supported against it by a single pivot point at the level of the upper frame, a point K adjacent to the patient's back (separated by a mattress) would be displaced very far towards the foot end when erected. As a result, the person would be pushed forward and pressed in the lower stomach area. This is prevented by the described pivoting. In this case, the position of the first pivot axis P1 l over the course of the erection process in the first erected position does not remain constant, but may, depending on the design of the linkage 86b, 86c change its position. Advantageously, he always stays above a mattress, which is located on the bed, preferably at least 10 cm above the mattress. This erection process is completed when the erector has reached an end position. The backrest is then in the first upright position and has an angle of about 70 ° +/- 5 °. The movement about the first pivot axis P1 appears to a person in bed as if the backrest were turning about a point which is at the height of the upper frame and at the same time this point would be displaced towards the head end of the bed.

During or before the erection process of the second step, a step 2a may be performed, in which the thigh rest 70 can be brought into an elevated position by a corresponding drive, not shown (automatically or manually). In Fig. 3 the thigh rest was raised accordingly. The angle of elevation can be 10 - 15 °. This will prevent the person from being forced into the first upright position, the foot of the bed, during the second step by raising the backrest 80. The body of the person is thus after the implementation of step 2a in a kind of depression between the raised thigh rest 70 and the backrest 80. Once the backrest is erected in the first upright position, the thigh rest 70 can be lowered back to a horizontal position.

Subsequently, in a third movement step, the lower leg rest 44 as in Fig. 4 shown partially swung by an angle of about 60 ° until a contact between the lower leg rest 44 and the support member 20 is made. Since a mattress located on the bed at the foot of the lower leg rest 44, more precisely on the telescopic part 46 (as will be explained later) is fixed, the mattress follows the Abschwenkbewegung the lower leg rest 44th

At the latest at this time, the fourth step must be performed, in which by turning the brake lever 14 in the locking position of the main wheels of the retaining hooks 15 (see Fig. 10 ) is moved out of the region of the support member 20 and so the support member can retract against the base 10. The blocking position of the brake lever 14 is therefore a prerequisite for initiation of the pivoting of the lower leg rest. This fourth step can also be arbitrarily preferred. Also, the foot part 50 of the bed must be removed. This is fastened with two retaining arms 52 on the upper frame 40 and its preferably manual removal (see the difference of Fig. 1 to Fig. 5 ) can be seen as part of the fourth step.

According to Fig. 5 the fifth movement step is explained. Here, the lower leg rest 44 is further pivoted in the same direction in an approximately vertical position and there is permanent contact with the support member 20, which moves by the contact forces in the direction of the undercarriage 10. The drive 48 of the lower leg rest 44 thus has a double Function, so the angle adjustment of the lower leg rest 44 and the retraction of the support member 20. The retraction movement is performed against the biasing force of a gas spring 16, which presses the support member in its extended position. Preferably, two gas springs are used, which are aligned in parallel and so cause a torsional rigidity of the support member 20 against the base frame. It has been explained above that the upper frame 40 must be lowered or raised to a horizontal and mid-height position prior to the execution of this step. A defined position of the upper frame, such as the horizontal central position is necessary so that the contact of the contact surface of the thigh rest 44 with a contact surface of the support member 20 defines exactly and thus its retraction can be initiated. After completion of the fifth movement step, the lower leg rest is oriented substantially perpendicular (ie an angle of 90 ° +/- 15 °, preferably 90 ° +/- 5 ° to the horizontal) and there is preferably a certain vertical distance from the lower edge of the pivoted lower leg rest the surface of a level floor.

Since the movement of the lower leg rest is a pivoting movement which causes a linear movement of the support element, a certain slip can be used at the point of contact and a torque of the support element downwards (toward the floor) due to the sliding / friction forces. To avoid this sliding, the thigh rest can be swung up by a compensating angle when swinging the lower leg rest.

Now, in a sixth movement step, the upper frame can be lowered via the frame drives 19a, 19b. The frame drives 19a, 19b can be designed as linear drives or as a scissors gear as shown. In a scissors gear, a drive linkage can be mounted via a pivot bearing in the base frame and in the upper frame in a horizontal longitudinal slot via a slider and by a pivoting drive of the drive linkage and corresponding sliding of the slider, the height of the upper frame is varied.

During the lowering movement, a ground contact from the lower leg rest 44 to the floor occurs. Since the lower leg rest is multi-part and has a telescopic part 46 and a guide part 45, then the latter parts can be moved against each other, so that the height of the pivoted lower leg rest (ie in the vertical direction) is reduced. The term "move" is to be understood broadly and refers in particular to a movement of bringing each other closer to each other. On the lower leg rest and / or the thigh rest, the mattress is fastened eg with a tension belt. The mattress is especially in its longitudinal direction in its foot part, so the area which rests on the lower leg rest designed elastically compressible, so that they can follow the collapsing movement of the lower leg rest.

In a seventh step - see the transition from Fig. 6 to Fig. 7 the backrest 80 can be pushed out in the direction of the foot end of the bed, which is defined as the transition from the first erected position to the second erected position and wherein a person in bed is pushed to the foot or at least supports a corresponding own movement of the person becomes. In this case, a contact point K of the backrest, which performs a horizontal movement of about 100 mm in the foot direction and this point K is simultaneously moved by about 140 mm upwards. The mattress (not shown) is secured at its head end with the backrest and by this attachment is in accordance with the vertical movement of the mattress in the region of the back of the person with lifted. This attachment can be designed as a pocket which extends on the underside of the mattress over the width of the mattress, and towards the foot end has an opening into which the upper end of the backrest can be inserted.

By lifting, a sliding movement of the person along the mattress is supported forward. The mattress in the buttocks area of the person has a falling to the foot of the bed slant. A Vorschiebebewegung without simultaneous elevation of the mattress in the back part would indeed perceived by the person as rather unpleasant.

The movement of this seventh step does not have to be done in this order, but can be arbitrary, e.g. following the second step of erecting the backrest in the first erected position or thereafter.

In an eighth step, which is preferably carried out manually, the holding arms 52 are brought by opening a bolt 53 pivoting about a pivot point on the upper frame in an approximately 80 ° almost upright position. On the support arms 52 are handles 54, where the person can hold on standing up and getting up.

Also, several of the aforementioned steps can be performed simultaneously. Thus, in particular, the pivoting of the lower leg rest 44 can be carried out simultaneously with the movement of the backrest into the second erected position (seventh step). A combination of these steps is advantageous because one or more drives can be saved. Thus, for example, the linear drive 48, which is responsible for driving the lower leg rest, connected via a Bowden cable, a cable, a linkage, a hydraulic coupling or a coupling gear with the guide means 88 b, 88 c or the backrest 80 be so that the swinging of the lower leg rest combined with the second erection can be performed combined with this drive.

Now the bed is according to Fig. 7 in a position in which it has been converted into a kind of armchair, although mentally the mattress not shown must be supplemented. The seat is in the lowest possible position, so as to allow the patient to get up. As part of occupational therapy, the person can practice getting up, with or without the assistance of the nursing staff.

In an optional ninth step , the bed can be tilted about the horizontal transverse axis by at least partially extending the bedside frame drive 19a, thus lifting the head end. If, in addition, the foot-end frame drive 19b is extended, the seat surface increases and the person is practically automatically placed in a standing position.

On the longitudinal sides of the bed, a side rail 90 is arranged, which is in the figures in the folded position. It comprises two spars, which can be pivoted vertically erect and struts 92, which are parallel displaceable along guides of the erected uprights upwards, can engage in an upper position, thus creating a falling out of the person preventing side rails.

It was explained that some steps can only be performed before or after other steps. A control of the individual drives ensures that no impermissible sequence of movements can be performed. In this case, a plurality of sensors or limit switches is used, which in each case deliver a signal to the controller after reaching an end position, as a result of which the corresponding drive is stopped. Also, a sensor or state sensor is provided on the brake lever 14, which detects whether the bed is in the braking or release position, since - as explained above - the support member 20 is released only in the braking position of the main wheels in its retraction movement. The drive 48 of the lower leg rest for pivoting into a vertical position is thus activated only in the aforementioned braking position.

The same applies to the reverse movement. The steps can be reversed accordingly.

In order to avoid rubbing or scratching of the telescopic part 46 over the floor, the controller allows only a pivoting of the lower leg support when the upper frame has been sufficiently raised and thus a distance to the floor has been reached. While the telescope part 46 for Guide member 45 has been inserted relative to each other due to the floor contact, so for the first gravity, on the second recorded in the compressed mattress spring forces and / or thirdly in the telescopic part 46 or guide member 45 recorded compression spring (not shown) for the said parts apart to move.

Fig. 11 shows with the solid lines a kinematic diagram showing the position of the Fig. 9 equivalent.

In the two four-link coupling gears of the first and second Aufrichtbewegung let the pivoting movements of the backrest support 82, which corresponds to the first erected position and the backrest 80 as a pivoting movement about a pivot point P1 and P2 represent. These were determined by a graphical construction based on the dotted lines. In this generally known method of construction engineering, initially two different positions of the transmission are needed. This was the Fig. 11 dotted another location of the respective pivot point added. Subsequently, a connecting straight line (also dotted) was drawn between these bearing points and also a middle standard supplemented. The intersection of these means normal is the fulcrum, ie the pivot point P1 or P2 of the respective drive. This is P1 for the first erecting movement and P2 for the second erecting movement. Since P2 is well below the upper frame and is also offset to the foot of the bed, in the corresponding movement - as described - realized in about a parallel displacement of the backrest with slight lifting.

Fig. 12 shows a principal alternative way of realizing the described movements of the backrest without the said linkages 86, 88 and without a backrest support 82. In this variant, two sliding blocks, such as cylindrical sections are arranged on each side of the backrest, which in each case in a sliding guide of the Upper frame are movable. This slide is shown hatched as a section through the part of the upper frame. In the rest position designated R, the sliding blocks are shown and describe the backrest (not shown) in its horizontal position. By a movement of the two sliding blocks in the position A1, the sliding blocks are pivoted to each other and the backrest swings up until an end position is achieved in that no continuous movement without change of direction is possible. This indicates the first upright position. By a shift from the position A1 to the position A2, which corresponds to the second erected position, the described Ausschiebebewegung the backrest is realized in the direction of the foot end of the bed.

Features of different embodiments can be freely combined with each other. Also, movements are reversible, in the sense that not necessarily a drive of the lower leg rest causes a retraction and extension of the support member, but that alternatively a drive of the support element causes a pivoting in and out of the lower leg rest. The same applies correspondingly to the drive of the backrest, which in a combined manner also drive the lower leg rest and can optionally be provided in the region of the backrest or the lower leg rest.

Claims (15)

Hospital and / or nursing bed with a base (10) and a top frame (40) with a against the upper frame (40) mounted backrest (80), wherein the backrest (80) in a top frame (40) substantially flat rest position can be brought is and erecting means (86) from the rest position in a first erected position can be erected, which corresponds to an end position of the erecting means (86) and has a first Aufrichtwinkel (α)
characterized in that
from the first erected position, a second movement of the backrest (80) is defined in a second erected position, over which a contact point (K) of the backrest (80) adjacent to the back of a person intended to be on the bed, in the direction the foot of the bed is movable. Hospital and / or nursing bed according to claim 1, characterized in that the first Aufrichtmittel (86) describe a pivoting movement of the backrest (80) about a first Pivotachse (P1), which lies at least partially above a mattress located on the bed and in particular in the area of the lumbar vertebra of a person intended to be on the bed. Hospital and / or nursing bed with a base (10) and a top frame (40) with a against the upper frame (40) mounted backrest (80), wherein the backrest (80) in a top frame (40) substantially flat rest position can be brought is and erecting means (86) from the rest position in a first erected position, and thereby describes a movement about a first pivot axis (P1), which is located approximately in the area of the lumbar vertebra of a person on the bed
characterized in that
the backrest can be brought into a second upright position by means of a movement about a second pivot axis (P2) and the second pivot axis (P2) below the upper frame (40) and directed towards the horizontal lies further in the direction of the foot end of the bed than the backrest (80 ). Hospital and / or nursing bed according to one of the preceding claims, characterized in that the guiding and / or driving means (88) of the second movement of the backrest comprise guidance and / or drive means (88) which extend from the erection means (86). differ. Hospital and / or nursing bed according to one of the preceding claims, characterized in that the backrest (80) mounted against a backrest support (82) and in the first erecting movement, no relative movement between the backrest (80) and backrest support (82) takes place. Hospital and / or nursing bed according to one of the preceding claims, characterized in that the backrest (80) in the second erected position has a second Aufrichtwinkel (β), which is greater than the first Aufrichtwinkel (α). Hospital and / or nursing bed according to one of the preceding claims, characterized in that the position of the contact point (K) in the second erected position is vertically higher than in the first erected position. Hospital and / or nursing bed according to one of the preceding claims, characterized in that at the first erected position of the backrest support (82) reaches its maximum possible Aufrichtwinkel (α) and this 70 ° +/- 10 °, preferably 70 ° +/- 5 ° is. Hospital and / or nursing bed according to one of the preceding claims, characterized in that in the second erected position, the backrest (82) assumes its maximum possible Aufrichtwinkel (β) and this 80 ° +/- 10 °, preferably 85 ° +/- 5 °. Hospital and / or nursing bed according to one of the preceding claims, characterized in that during the movement from the first erected position to the second erected position, the contact point (K) of the backrest is at least 80 mm, preferably at least 120 mm, and most preferably at least at least 150 mm towards the foot end of the bed. Hospital and / or nursing bed according to one of the preceding claims, characterized in that, during the movement from the first erected position to the second erected position, the contact point (K) is moved upwards by at least 50 mm, preferably at least 140 mm. A method of operating a hospital and / or nursing bed to assist a person in bed as they leave the bed to their foot including a first step of erecting the backrest (80) at an angle of 70 ° +/- 10 ° and a second separate movement step of moving the backrest by at least 80 mm towards the foot end of the bed. A method according to claim 12, characterized in that a contact point (K) of the backrest (80) which is adjacent to the back of a person in bed in the first step by at least 10 cm, preferably at least 20 cm in the direction of the head of the bed is moved. A method according to any one of claims 12 or 13, characterized in that in one method step, the shortening of the bed length in the region of the lower leg rest (44) and thereby creating a space for leaving the bed and that by a a) manual at least partial removal of the lower leg rest and a mattress part or thereon b) by pivoting the lower leg rest (44) with a corresponding mattress part is realized. A method according to claim 14, characterized in that in a first part of the step of shortening the bed length, the lower leg rest (44) is pivoted substantially vertically downwards with a mattress part connected thereto and in a second part the upper frame (40) of the bed is lowered and while the mattress part is compressed in its longitudinal direction.

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