Can nursing homes provide bed rails or cushions bedside on the floor?

I would contact the state authorities and have them quote you the laws about rails - especially in nursing homes. And I would check legally with an eldercare attorney if a n.h. can be sued if they do nothing to keep the person "confined" with rails and they fall. I know in assisted living you can't add them to a bed but a n.h. is different.

You can get bed rails from medical supply stores and of course Amazon. I put up bed rails for my wife until I got a hospital bed for her that already had half bed rails that were adjustable. They could be lowered so that any service she required such as changing could be accomplished.

There are beds specially made for people with dementia, prone to leave their beds regardless of age or balance. Unless they are unable to exit the bed and hurt themselves, it’s just a matter of time before a serious injury takes place. Nursing facilities, or even worst, skilled nursing, will not restrain the ability to get out of bed, and of course, can not/will not monitor the welfare of a restless individual 24/7. Someone close to me is the type that keeps doing silly attempts with zero balance, and personally I searched for more guarded accommodations, but besides being expensive for the best, all the naysayers will voice their disagreements with this type of restricted bed, which basically only the caregiver can allow the exit. Otherwise someone has to do owl duty, and that gets old really fast. Worst scenario? Soiled diapers, but no broken bones, and everyone can sleep peacefully knowing all is well in the home front.

I have hear about the rails, but they should allow the bed to be lowered, and a mat next to the bed.

When my husband was hospitalized, the hospitals said there were laws about using bed rails (one said that you could raise ONE).
I guess allowing them to leave the bed doesn't restrict their movements/freedom? But safety is ignored? Perhaps with bedrails up, a patient would climb over it, and that would be a greater fall...I never got a clear answer from the nurses.
However, at one place I was able to get the bed lowered to the floor and they provided a padded mat. His issue was getting up constantly (Parkinsons with dementia). I wonder why your hospital objects to a pad next to the bed?

During one hospitalization (for a week), he fell twice getting out of bed without calling for assistance (he wouldn't know how anyway). In one case he hit his head and needed an MRI (no damage fortunately); in the other case, he severely bruised his hip area, had excruciating pain, and it took months to resolve because of calcifications in the bruised muscle. The hospital had to have a sitter with him all night; and I sat with him during the day to keep him safe.

Disgusted, that's a great link, thank you.

Imho, a restraint is typically against protocol.

Mom lives in an AL in Va and fell out of bed there twice. They asked us to buy a fall mat. They are allowed and they are safe. I found hers on Amazon for about $78.

There are foam bumpers you slip under the sheet that prevents them from rolling and or climbing out. Usually for children’s beds but worked great for my husband who kept falling out of bed.

I had to fight to get rails on my mother's bed when she went to long term care. She wanted them. I wanted them. The facility finally had her evaluated, which I assume included asking her if she had any objection to them, and they installed rails within ten days of her admission.

LTCs tend to err on the side of caution (as it were) because rails are considered a restraint, and restraints, whether physical or chemical, are taboo. It's up to us as family members to insist on them for our loved ones' safety.

PS - I'm in North Carolina. Things may be different where you are.

Medicare guidelines, which NHs have to abide by, have pretty stringent words about the use of bed rails. They don't consider falls a valid medical reason for using bed rails. This is likely not a battle you are going to win. I don't know your mother, but one major concern is a patient who tries to get up, and proceeds to attempt climbing OVER the rail - that could lead to even more serious injury! Perhaps your mother wouldn't try this, but who knows? When wide awake my mother began refusing to stand or walk unassisted, fear of falling and weakness due to inactivity. However they found her several times on the floor in her room. Why would she not attempt to stand and/or walk when awake and others are around, but not when in her room? Who knows?

Anyway, I've posted some of the Medicare guidance in response to others, including a link. For more info, see those. Clearly they don't consider falling out of bed a valid reason for using a bed rail and NHs have to follow Medicare rules/guidance. Some studies have shown that rails and alarms don't see to reduce falls as much as anyone thinks they might. At least one case discussed a woman who DID attempt to climb over the rail and broke her left wrist AND tibia!

I would try some of the other suggested methods (what's wrong with nursing staff that they can't think of or try these suggestions?) If she tends to the right side, have that side against the wall. Wedge up the edges of the mattress or try one of those mattresses that keep you in the middle. I would think pillows or wedges just on the edge of the bed wouldn't help - those can be pushed off the bed easily.

I don't understand them saying the mats are not legal. I certainly WOULD ask for a copy of rules and protocols. Don't point to the mat refusal, just say you're exploring options, and will need to know if any ideas will have to be thrown out per the NH rules/protocols.

Anything that's a form of restraint is not allowed.

Also, many of the things that may seem like they should be allowed (bed rails, floor mats) are hazards themselves. Someone with dementia, or even without dementia, may attempt to get out of bed, be unable to lower the rail and attempt to climb over. The mat on the floor creates an unstable surface that can cause a fall.

Some have mentioned that a 'properly staffed' facility can check on residents often enough to prevent falls. That would require a 24 hour caregiver (with additional caregivers to support breaks) for each resident. The rent would be more than $25,000 per month. Plus, it's an illogical thought. People fall when no one is in the room because they get out of bed when no one is in the room. You could check in on a resident and two minutes later they could decide to get out of bed and fall trying.

Falls will happen. Bed lowered nearly to the floor is the best way to mitigate injury without restricting movement nor creating a hazard.

Yes they can do both they can also lower the bed as far as it will go down do when she falls out of bed she doesn't have as far to fall causing injuries and bruising.

[mutter mutter grumble rhubarb lazy buggers..]

They can put up bed rails. But it is a faff because it involves a great deal of paperwork and training, plus if they do this for your mother they'll have fifteen other families all asking for the same - including some families for whose elders bed rails will not be at all suitable, and then there'll be war.

So they just shrug and say sorry it's the law. And it is the law. But it's only PART of the law. There are other equally important parts that explain when bed rails can be used and how this must be authorised, monitored and documented.

If you Google something like "how to apply for use of bed rails in [your state]" you might get some useful information.

What they do here is put the patient on a mattress on the floor. The cannot stop the patient from falling out of the bed so that is the best alternative.

Someone’s suggested pool noodles as side bolsters. There’s a YouTube video available to demonstrate this. Google “pool noodles help prevent senior bed falls” and several articles/videos show up. Thought this was a good idea for toddlers prone to falling from bed, too.

My dad used a low-rise bed with foam mats on the floor when he was in re-hab to prevent injuries if he tried to get out of bed. He was very disoriented when he first arrived there and I noticed he tried to put his finger in the electrical socket on the wall his bed was up against (outlet was mid-way up wall, not down near floor). Re-hab assistants immediately helped to re-position bed against a wall without a socket! Mentioning this because electrical shock or electrocution from outlet high on wall beside a senior or toddler bed can be a hazard!

My Mom spent her last 5 years in a county nursing home (sundowner's syndrome- a form of dementia). They lowered the bed, put a foam rubber long matte on the floor, and also put alarm for the bed, so every time she got up, it would beep. At times it was annoying, and since I was there visiting her, would shut it off, making sure to put it back on when I left. Later, when she was in the hospital, they also made sure the bars of bed were up when she slept. So can't understand why they said it's against the law. Check it out, and speak to the administrator of the nursing home.

When my dad was in rehab, they didnt allow bed rails(NY) and they did lower the bed as low as it can go and had foam mattress on floor - he was recovering from hip surgery and did fall out of bed a few times.....sadly, the rehab killed him by not keeping his catheter clean and he got a uti which led to mrsa induced sepsis that went to his heart....he was almost 90 and no way to sue or prove it......

There are wedges that can be used to make it more difficult to roll to one side or the other. Sometimes 2 wedges are used to keep someone in a particular position.
The bed should be lowered all the way down so it is less apt to cause an injury if the person rolls out of bed.
Bed rails are not permitted as they are considered a restraint or confinement.
Some facilities will use bed alarms or alarms on the floor that will indicate when a person has gotten out of bed. But the bed alarms can be disruptive.
As far as I know mattress on the floor by the bed is not illegal. You might want to ask to see the facilities policy on that. They should have a book that outlines general practices. You could also contact your States Ombudsman and ask what the regulations are in your particular state. (you might even get that with a Google search)

When my mom was in the nursing home, they had half guard rails on her bed to help for rollout, long padded floor pads on each side of the bed, plus they lowered her bed as low as it could go.

Ricicles.
Bed Rails are not illegal. You should speak with the main person of the Nursing Home and let them know that you will be furnishing a bed rail to kero your mom from rolling off the bed.
Tell them you will be happy to sign something to the effect if they need it.

Go Today and buy a bed rail, they have many types that are easy to install. You can even get one that goes under the mattress that is 1/2 the length of the bed and attach it to the side she usually rolls off of or put one on each side or scoot her bed against the wall.

If they don't allow it let them know you will be calling to report it to the news station and it won't make them look good,, allowing a 96 yr old woman continue to fall out of bed on to the floor.

Im sure they'll see it your way.

All else fails, let them know you will be looking for another Nursing Home to move your mom in to.

Prayers

Our nursing homes do not allow rails, so they lower the bed to the floor put floor mats around the bed.
I always wondered why my mother’s bed was on the floor. At home we have rails. But I wish I could lower it to the floor even with the rails she somehow tries to get up and holds the side of the bed yelling help help in the middle of the night because she is unable to stand or walk. But I guess in her mind she can.

If allowed, placing a pool noodle under the fitted sheet near the edge of the mattress might help. Keeps my toddler grandchildren in the bed!

I can’t believe they can’t put a "fall mat " on the floor. Another option since she sleeps on the right side is to put the right side of the bed next to the wall, lower the bed and place a fall mat on the floor. Do they want to be liable for her injuries? Talk to the head nurse about this.

Most states have gone the direction of assuming that falls will happen instead of assigning blame for falls. However, most facilities have "fall risk" protocols for the clients most at risk of falls. Most fall protocols include: beds in the lowest position possible (some are almost on the floor), mats (similar to gym mats) on sides of beds, no side rails, call bell within reach, frequent checks by staff... Ask the NH for a copy of their "fall risk:" protocol. If she appears to be falling too much, you may want to consider another place since her facility may not have enough staff to monitor her frequently,

Have Hospice come in and assess her. My mom has Hospice and she is not near death. She is in Memory Care. She has a hospital bed pushed up against the wall. It has a rail that is put up at night. She cant roll out but if she sat up she would be able to get out of bed. Hospice also has a floor mat that is put down when she goes to bed at night. Also they have an alarm on the bed that goes off when she tries to sit up. Hospice is wonderful!!

A burrito mattress, is I think what you want. My mil had one while in NH for on respite. It is deeper in middle and sides higher. Bed low as possible and then put a mat next to open side, other open side was against wall. When at home I had the top rails and also bottom rails for her bed. And used swimming pool noodles on the rails for comfort. For a 75 pound woman who is bedridden she could sure rollaround, and potentially hurt herself, without all the preventatives in place.

The assisted living places that I'm familiar with here in Ohio aren't allowed to put up bed railings. I was told that the nursing homes can, but I can't confirm the hearsay.
If it's against the law due to "strangulation", then why can these places install a "rubber bumper pad" on the side of the beds? I'd check into that if I were you. My husband is in the special needs facility for Alzheimers, and doesn't need any railing yet, but if/when the time comes, I will request some kind of bumper padding instead of railing.

In Texas a patient can have a bed rail on one side. Both sides constitutes restraint and that's no allowed. My stepmom did have mats on the floor in case she did fall out of bed.

There may be some state law I am unaware of for your state, but it was commonly done in the California nursing home I am aware of, a very foamy pad for the floor on either side of the bed. However, for one 96, the fragility of bones, the lack of padding often enough in terms of fat layer, may mean injury is almost certain with any fall anywhere.