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Mike fell again today. I asked the nurses if we could put up the bottom rails and they said it was prohibited. Anyone heard of this?



Thanks.
Temper

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temper13, yes, that is a State law in all of the States. Reason for that is due to deaths or serious injuries when a person tries to climb over the rails, and they get their head or legs tangled up in the rails.
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My Mother has an “M” rail. It has helped her to slow down, and not get out of bed so quickly.

You can buy them on Amazon. Is this a possibility for you?
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Yes, in my state it is considered a restraint and restraints are illegal. If your LO is falling out of bed, a solution is to put a mattress next to his bed to soften any fall or to just put the mattress on the floor. This is what my MIL's facility does.
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Yes. It is considered 'excessive restraint' which IMO is ridiculous if the patient or their family requests them.
https://www.nbc26.com/news/health/grandmother-dies-in-indiana-after-nursing-home-bed-rails-removed
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Actually it was because facilities were trying to prevent residents from getting up out of chairs and falling, or wandering out of the buildings. But it caused many other problems:

https://www.nbcnews.com/health/health-news/use-restraints-declines-nursing-homes-flna1c9463695
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Sometimes the railings don't help anyway. Decades ago, my dear grandmother was losing her clarity/reasoning and part of the plan was that all bed rails should be in the up position to keep her safe. Resourceful Grandma crawled to the end of the bed and off the edge - giving herself a black eye in the process. The facility's solution was going to be to tie Grandma to the bed. This was legal at the time. My father allowed this. My mother revoked it. (Yes, bed restraints are still used today, but it needs to be carefully documented. And, restraints need to be removed as soon as the medical need for them has ended.)

Ten years earlier, a different relative in a different facility had a soft strap across his lap to keep him in his wheelchair. We actually did not have a problem with this as the alternative was him getting up and falling. Repeatedly. (To this day, I'd rather see my family member with a strap to remind him to stay in his chair as opposed to needing lift assist to get off the floor many times in a day and dealing with related injuries, but that is a matter of perspective and opinion).

I think bed rails, seatbelts, etc were allegedly overused to account for short staffing and whatever else. Now they can't be used on anyone. I even heard recently that bed alarms are coming under fire in some areas because they are designed to keep people in bed and an argument is being made that even alarms qualify as "restraints." I think safety and dignity need to be balanced.
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Hi there
having rails both sides of the bed in the uk isn’t always prohibited but it’s taken as a removal of liberty rights (or something like that), an alternative is to lower the bed (if hospital bed) and use a crash mat on floor.
that’s the advice we were given by a fab OT who helped with dads rehab,
if in hospital, I think it’s different, I remember dads rails being up when needed
take care
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I will tell you how my RN daughter, who worked in NHs for 20 yrs explained why no rails.

First, NHs, MCs and ALs are the person's residence. The people living there are residents not patients its their home. As such you cannot make them do anything they don't want to and they cannot be restrained. (Have you ever noticed that Hospitals do not have to go by these guidelines)

So, someone did a study and found that some residents had got their heads stuck between the rail and mattress causing death. That some residents tried to climb over the rail, fell and caused death. Now the % of these accidents was very small but because it could happen, railings were banned. Lets not figure in that restraints could also save people from having broken bones and hips that could also lead to death. And make the staffs job a little easier.

Temper, the bed should be as far down on the floor as possible. A pad (like they use in Gyms) can be placed on the floor. My Mom had a concaved mattress.
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Double rails illegal where I live.

Does not prevent climbing over or getting wedged in gaps for those with cognitive issues & determined to get out.

Low lying bed & crash mats used instead. These won't prevent all falls - but does minimise damage rolling into crash mat instead of from a height.
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The rails near the top of the bed are designed to allow the patient to have something to hold onto when turning on one side, or trying to sit up more in the bed. The only purpose of the lower rail is restraint, so not allowed. A patient whose bed is a mattress on the floor is harder for caregivers to change, bath, transfer to WC, etc. Alarms can work..bed alarms go off if too much weight is lifted off the mattress. The clip on alarms on clothing - residents can figure out how to undo the clip...and go for a walk, or try to get out of bed. No easy answers.
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JoAnn29 Apr 2022
Hospital beds can now be lowered to the floor. When needed, brought back up to do any caring. Mats are put on the floor as a safety measure.
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