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I have a relative that likes for her bed to be placed right next to the wall. She has speech problems and there are printed messages taped on the wall that she can point to indicating what she wants the nurses to do, ie change her positioning, get her out of bed, etc., The administrator says that there are regulations in California that dictate the bed has to be a certain distance from the wall, even though her bed's been in the same position next to the wall for years. Evidently the regulation stems from court cases where patients somehow got stuck in between the bed and the wall. Though this is not a concern for my relative since she can't roll over on her own and never had an incident in countless years.


I'm wondering can a patient sign a waiver of some sort (similar to a bed rail consent form) so that they can keep their bed next to the wall? He wasn't sure about this issue and told me to ask around to see if there was any way around it.

Let me relay an experience I had. One morning I came into the room a little earlier than norm. In less than thirty minutes I had six nurses surrounding DW and working like crazy on her. If her bed had been up against the wall , it would have had to be moved before they could accomplish their task. And all of the accessories would have to be on one side of the bed. Hoses and wires, etc. Checking bp on one side while administering meds on the other side.
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Reply to OldSailor
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Speak to the Ombudsman.
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Reply to Llamalover47
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Is her bed a hospital bed, on wheels? That eliminates the maneuvering issue for nurses and making the bed. Does it have or could it have a bedrail (hospital beds usually do) and would that cover the protection from her getting stuck between bed and wall?
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Reply to Lymie61
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If she is that incapacitated then the regulation comes from protecting the staff as they need to access her on both sides to avoid injuring themselves - there is little chance if that is the reason for it to be changed - even when they change her sheets they need to access both sides as well as clean that side of her bed which is necessary when someone is in it constantly
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Reply to moecam
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Try putting her message board on a clipboard instead of the wall. If her bed is next to the wall, she may stay in that sidelying position too long.
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Reply to Bigsister7
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If you've spoken with the administrator, then that is usually about all you can do as to actual bed placement. It depends on the facility and the state you are in.
I have seen a long term care (Medicaid) facility in Michigan that allowed beds to be turned along one wall- but that depended upon the resident's ADL functioning. If a resident needs staff assistance with turning and such, the bed will often be where it is best accessible for the staff to assist the resident.
Sadly, one strange but harming case happening to one person somewhere can affect the liability and safety rules for the whole country. Some rules and regulation changes are good... others are a bit odd, in my opinion. ( I am a nurse...)
You CAN be the squeaky wheel and make very large, laminated poster board items that could possibly be placed/ hung somewhere near her that indicate what she would like... maybe in different colors and with easily seen universal symbols/ graphics ( similar to the simple figures used for restrooms)... the staff CERTAINLY would appreciate knowing exactly what she is needing (saving time)... and perhaps then the administrator would come along eventually in helping you out more.
Be creative ~ keep trying ~ ask the nurses/ caregivers for their ideas what could help (not just the administrator) ~ ask if her speech therapist or doctor can help out with any signage or provide her with a communication board ~ you might just think of and come up with a great solution that many others in similar situations are facing.
All the best ~
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Reply to RedBerryFarm
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It is easier to change a brief during the night if they have both sides of the bed.
Also, they can easily change her position from one side to the other to avoid getting breakdowns.
Very important as you age to avoid that...the skin becomes very thin.

I don't know about the law around it.
Maybe contact the state and see what they say about it.
If it's not law, they have to honor your request.
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Reply to Savitaa
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Talk to the Ombudsman for the facility. Their contact information must be posted...it’s probably on a bulletin board somewhere or ask the admin assistant. They will be able to do the research for you (probably know the regulations by heart) and can help you figure this out.
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Reply to rocketjcat
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I found this, courtesy of California Advocates for Nursing Home Reform:

Accommodation of Needs
A resident has the right to reside and receive services in the facility with reasonable accommodations of individual needs and preferences.(5) The facility should attempt to adapt such things as schedules, call systems, staff assignments and room arrangements to accommodate residents’ preferences, desires and unique needs.(6) ...

If language or communication barriers exist between residents and staff, the nursing home is required to use interpreters or other measures to ensure adequate communication.(8)

http://www.canhr.org/factsheets/nh_fs/html/fs_CareStandards.html (See the footnotes for references to US or California code.)

That said, I haven't looked at the actual California code for nursing home room arrangements and bed placement. Your best bet is to request a copy of the state law from the administrator. If it's such a big issue, he or she should be able to recite it chapter and verse from memory AND provide a copy.

If they are adamant about keeping the bed away from the wall, you may want to consider making up a "booklet" for your relative to use when she has a request. If she does not have visual acuity or reading comprehension problems, you could print pages with written requests, or pictures of the service/activity requested, laminate them (or place them in document protector sheets), and fasten them together with a key ring or other device. She could then keep her booklet on top of her coverlet, on her bed table, or in her nightstand drawer, whichever is easiest for her to reach depending on her level of mobility.

Or get spiral-bound index cards and block print her various instructions on them, and she can simply flip to the card she needs at the time. This method will, of course, also depend on her visual acuity and fine motor skills.

Best of luck with this. In all of my years of caregiving, I've learned how to get inventive.
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Reply to PeeWee57
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Buy her a pointer.
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Reply to IsntEasy
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Could she use a "pointer stick" to get around all the problems?
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Reply to garylee
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Judysai422 Feb 19, 2019
Even better, make the facility provide a communication board. A good speech therapist can assist you.
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In some cases it may be considered a "restraint"
But these can be worked around I would look for the specific wording in the codes and determine if being against 1 wall (2 actually if you think of the headboard if there is one or the wall if the head of the bed is against another wall)
But if the notes are her means of communication I do not think they can take a way a patients means of communication so this might be "an exception to the rule" and it might have to be approved in writing.
Ask for a copy of the regulations where it states that a bed can not be placed against the wall. I am sure it will not specifically say that but it is an interpretation. They should have a copy of "Minimum Standards" on site if not I am sure you can get it on line.
Personal opinion here but California can go a little overboard with some of the regulations...some are great some can make things more difficult.
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Reply to Grandma1954
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This goes hand in hand with the regulations against allowing rails and it seems as though the rules are often applied arbitrarily according to how strictly area inspectors and facility administrators choose to interpret them. In the mean time do you think could she make due with an easel set beside the bed?
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Reply to cwillie
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Cheeky beggar. If he's going to block your request with Healthandsafety regulations then it's for HIM to get to grips with the issue and find a way to make his resident feel secure in her own bed. Can't believe the nerve and idleness of these people.

Still. You might be able to find books of regulations on your state or county's website: I'd start digging there.

By the way, though - I'd have thought the regulations actually stem from protecting workers. There has to be minimum space for them to work in when they're moving patients or changing bed linen, otherwise they tend to stress their backs. Is the bed on wheels? Is there plenty of space to move it out from the wall when your relative's not in it?

Good luck getting this one solved, it's worth a bit of a battle at least :)
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Reply to Countrymouse
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