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You might want to consider purchasing pool noodles - they are a floating device that kids use but are wonderful for using under the sheets at the edge of the bed. They act as rails.
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Remove the frame and use only the mattress with its box.
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My mother passed last April at age 95. I had her living with us for almost 3 years but it was getting too hard on me, with my health issues, to care for her 24/7 as she needed more care. She was tiny at about 4'11" and under 100 lbs. I put her in a licensed private care facikity that had 6-7 residents. My mother started getting out of bed and could not, or would not, call for help. She was in a regular bed. I was told they could not put up a rail. They started putting her wheelchair beside the bed but she would scoot down to the end. Long story but I moved her to a different, similar facility where they actually had night staff. She was in a hospital bed at that place and they put both rails up and also put a camera on her to monitor her. Maybe they weren't supposed to but the nurses that came knew it and nothing was said. At least I could finally get some sleep at night. However, one time when she was in rehab, they had rails up and she did scoot down to the bottom and got up. When she was in the hospital, the rails were up. I don't know what the answer is because who can sit and watch them 24/7? Still, I prefer the option of putting rails up.
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My Mom is in assisted living. After about 3 years there in the same bed she suddenly started falling out of bed. She claimed it was because she always slept in a King or Queen size bed when my Dad was alive. 13 years ago. The AL allowed me to get an order from her PCP for a partial rail on one side of her bed. I used a pool noodle on the other side under the sheet. This stopped the falling out of bed problem. The rail I got sets a foot from the top of the bed and in no way hinders her from being able to get out of bed and actually provides an assist to standing up. It has a fabric cover and pockets in it for her to put things in. Like the remote for the TV. When my father was alive he was in the VA the last few months and they didn't use side rails but did have mattresses that the edges were slightly elevated so the patient needed to make an effort to get over it to get out of bed. Made the bed uncomfortable to sit on the edge but worked well to stop falling.
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ZenZen: Write or call your state or county representative on this issue. And if they don't respond, keep at it until they do. I worked with my county constituent on an issue until they did something about it.
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I have already sent a letter to Congress about this six months ago when I had to hire round the clock sitters since the facility he was in would not allow restraints. I was told they would respond. The document itself if you request a copy from the facility will have a box in the middle with the statement that restraints can be used if a doctor requests it. The surgeon did request it but the rehab facility said their policy is not to use them and since the doctor on " their staff" did not want it they are not required to use one. I am waiting for someone to be badly injured or killed and then the lawsuits will begin. Ask your facility to give you a copy. They would prefer we pay to have a sitter, and by the way the sitter can only notify the nurse that the patient needs help. Where my spouse is at least they "cushion and wrap" so hopefully if he falls no injury.
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My mother was fine in her nursing home without them. 18 months in, she was moved to a different unit, where they put the rails up every night. Well, she got used to them and would sleep near the edge, leaning against them (for comfort and a sense of security, I think). Then one day,  presto! the rails disappeared because they were now a hazard. Well, she's used to sleeping at the edge of the bed now. She has fallen 4 times. It's only the mercy of God she hasn't been hurt.

THEY SHOULD NOT SWITCH THINGS UP LIKE THAT ON PEOPLE WITH DEMENTIA!!!

Their solution was to get her a bed that lowers practically all the way to the floor and after fighting another year and a half with them, they added a mat.
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There are some hospital beds that have bed alarms built in that "sound off" when the patient moves off the sweet spot. Anyone have experience with these?
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I forgot to mention that in rehab the aids carried a pager for the alarms. It was silent and no one heard it but the pagers alerted the staff if the patient moved off of the alarm pad.
Still the aids could not just stop what they might be doing. like cleaning and changing a patient or preforming some procedure on a patient.
Only in the hospital did she have to wait for help, up to an hour in a dirty diaper.
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One last thought and I will quit.
Has anyone seen or used those big long pillow things advertised as something to hang onto at night and throw your legs over while sleeping? Wifey used to keep pillows in the bed to throw her legs over and slept really well like that.
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1 - my dad requested & got the rails as he used them as aids to get in & out of bed

2 - when they say that people get injured with the rails have they documented the size of person involved -

My mom is quite large so she could never get trapped in any rail but a tiny person would be in greater danger - if the person's size is not with the information then the information is incomplete so how can it be used to make decisions on - maybe that would be a way to get the law recinded & thrown out - good luck
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Nursing Home Neglect Lawsuit Investigation | Bed Sores, Fractures, Infections
topclassactions.com/lawsuit-settlements/lawsuit-news/10518-elder-abuse-nursing-home-neglect-class-action-lawsuit-investigation/

This is a class action lawsuit and if this site describes what you are experiencing, contact them.
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When my aunt was in long-term skilled Pennsylvania nursing home, bed rails were not allowed. The staff placed long foam noodles (like the kind used in swimming pools for water aerobics) under the fitted sheet on each side of the bed. They helped prevent her from rolling out of bed. Also she had a hi/lo bed which was lowered to about 6-8 inches off the floor at night.
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They should at least lower the bed if they choose to use crash mats.
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Nature73 - bed alarms do alert the staff that a resident has left the bed. Therefore, they don't necessarily keep a patient safer. My mother set her alarm off, when she unexpectedly got up from bed and walked to the bathroom (something that she hadn't done in three or four months. The staff member did see her turn into the bathroom but did not get to her in time to prevent her fall. Bed/wheelchair alarms can help if the patient is very slow moving and the workers are vigilant, but provide a limited form of protection.
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We got bed and chair alarms for my mother. She would manage to I clip them from her clothes. Tried putting them on the back of her clothes. Problem was, she would rise up, set off the alarm and, by the time the Aide got there, she was out of bed. If the Aide is tending to someone else, they just can't leave that person to check on an alarm going off. They put a bed alarm on her bed at Rehab, she got out of bed during the night and nobody heard the alarm! They moved her closer to the nurses station. Having spent my fair share of time in hospitals and Rehabs with relatives, I can see this is a chronic problem, esp with elderly and dementia patients. I have watched them try to crawl over the rails or scoot down to get out of bed. I have caught more then one person from falling out of beds that no rails were up. Of course, I notified someone. The larger facilities can be horribly understaffed and/or have quite a turnover of employees. I don't know what the answer is.
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