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This law/policy forces my mother w/Alzheimer's and recent hip fracture, to sleep on narrow bed without bed rails, at a post-op facility. She has a history of falling, and hallucinates at night making that the most dangerous time. I offered to sign a waiver, or to stay the night at the facility to guard her, but was denied.


I understand restraints were over used in the past, and they are dangerous to some people, but our situation was an obvious, more danger without the bed rails(allowed in hospitals). I want to advocate for patients Right to Not Fall.

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Wiley Coyote ;; So I agree its unreal ...all the restrictions about restraints .. but also I agree thats it is necessary to have these laws because of all of the NEGLECT and ABUSE that has happened in the past..
At horrific places like PENHURST it is unbeleivable the abuse and neglect that went on in Penhurst its haunting , because of Bad things in the past that have happened in Nursing homes and Insain Asylums we can not use restraints in most situations ...its sad but has to be this way ...we had FLOOR BEDS with very THICK floor mats on eaither side also half rails with velcro pads wrapped around them so arms and legs are safe .the tall reclineing wheelchairs are good because they lean backwards ,,but thats not enough sometimes ...familys would hire private caregivers to sit with loved ones...if the falling was just ongoing..good luck to you!!
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Reply to Lorraine12
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In Ontario Canada we have a common sense legislated Bill of Rights for people who live in long term care homes. (nursing homes)
Every resident
“who is being considered for restraints
has the right to be fully informed about the procedures and the
consequences of receiving or refusing them.”

In other words...
You have the right to get information about restraints. A restraint is
anything that limits your movement. Some examples of restraints are:
medication or drugs, wheelchairs with lap belts, mittens — so you do not scratch yourself, and bed rails — so you do not fall out of bed.
Restraints should not hurt you or make you uncomfortable.
Sometimes you may need a restraint for your safety.
Your doctor has to tell you if he or she is planning to use a restraint
on you. Your doctor must explain the steps. You must be told
what will happen to you if you agree to the restraint and what will
happen if you do not.
If you are competent, no one can make you use a restraint if you do not agree. You may want a friend, family member, or advocate to help you decide.
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Reply to cwillie
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Just an observation: I am somewhat surprised several people in this thread seem to think you should be apprised of the dangers and then allowed to decide for yourself what risk you want to take. That's a very libertarian point of view.
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Reply to TNtechie
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rovana Oct 23, 2018
I think it might be more a matter of "one size does not fit all" i.e. there are cases where bed rails do make good sense and others where they are restraints without an urgent need.
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I work in a LTC as a RN manager. Our facility has adopted the "no bedrail" policy. At first I was skeptical . I have made my share of phone calls to family regarding falls out of bed. But then I found an elderly ( over 90) resident with her fragile arm caught in a bedrail with the rest of her body on the floor and it was terrible to see the damage inflicted on her. As a suggestion as to what to do... we occasionally put a mattress on the floor beside the bed so if the resident rolls out they roll right onto the mattress- no injury. It can be cumbersome and may not work if there is a co-resident sharing the room but it does help in certain cases. Have you tried hi-lo beds, bed alarms, sometimes there are bed foam wedges that keep the residents from rolling...just a few suggestions. It is frustrating for staff... I dread the " someone is on the floor-come quick" phone call.
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Reply to wileycoyote6
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Holy cow! I did not know the “right to fall” was real until I googled it. What a BS excuse by the nursing home to not be held responsible for falls in the facility. What’s next - right to slit my wrist because it is too much work for nursing home staff to restraint me?
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Reply to Worriedspouse
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There have been serious and tragic accidents with bed rails where the presence of the bedrail was identified as the cause. Death and serious injury have resulted. It has happened. This is undeniable.

But. Although I have not researched the records methodically, I have noticed that in many of the incidents I have seen reported the problem was not the bed rail itself, the problem was *misuse* of the bedrail through lack of training, lack of attention to specifications, lack of time to do it properly. So that staff were not locking the rail in place, and it slipped on being leaned on; or a facility ordered rails which did not match the beds to which they were fitted, leaving a gap just large enough for people's heads to get stuck in; or an aide was called away urgently and didn't notice a trapped arm. That kind of thing. These are "never" events, they should never happen. But, very rarely though still sadly, they do.

Well. One way of making sure that bedrails are never misused is to ban them. The great benefit of this approach is that you cannot be sued for negligence, and at the same time you can claim the moral high ground as a defender of elders' rights to liberty. Neat, isn't it?

But I do not myself know of anyone whose loved one is a falls risk who is not driven to apoplexy by this issue.
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Reply to Countrymouse
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I just got a call last night that my Mother fell out of bed AGAIN at the Nursing Home. There should be a way for them to help prevent the falls and I was thinking of asking if they will put the bed rails back on, but I'm sure they won't. It doesn't make sense that the law does not allow the bed rails for those who continue to fall out of bed. It's so frustrating! I don't know what else to do. They already lower the bed, supposedly. CNA turnover is high, so who knows.
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Reply to Caregiverhelp11
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Good grief, that phrase gave me flashbacks to the heated conversation my DH had with one of Moms LPNs at the NH, who after Mom fell from her wheelchair during a UTI, was told “she has the right to fall”. He went ballistic and demanded to see the director of nursing. She put her on 1-on-1 aides until the UTI was over.
After a huge fall out of bed and horrible bruise, the “solutions” she now has a very wide bed, they lower the bed to the floor, rubber mats both sides, move all furniture away from where she could hit it, pad sharp corners of the AC unit and is on 15 minute bed checks. They pack pillows around her at night and raise her mattress foot and head a little to make a little well, but these 2 tricks are under the radar and not documented, since even those are considered restraints, by the brain trusts. She still manages to roll out of bed somehow, but hasn’t been seriously injured since then.
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Reply to rocketjcat
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My mother experienced more falls out of bed once the rails were removed. The facility had no idea what they were doing - one person told me I could request the rails be put back if I signed a waiver, another said no, I couldn't do that - that they would work with Mom on PT to improve her "bed mobility", but the rails would never be put back. They were solid plastic rails with very small hand openings in them - and mom was a very large woman - no way was she ever going to get her head caught in them.

I agree that the pendulum has swung too far in the other direction - there has to be a middle ground on this situation that allows for safety to be considered.
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Reply to AnonymousMember
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The no rail rule started when patients started to break their legs or were strangled when their head got caught in the railing. I can see how one could roll out of bed, those beds are so very narrow.

It wasn't easy keep my elderly Mom in bed when she was in long-term-care. She had forgotten how to walk or even stand. Thus the bed was lowered, rubber mats on both sides of her bed, and pillows tucked all around her.... being the bed was so darn narrow, Mom wasn't able to turn herself over :(
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Reply to freqflyer
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But...a post op bed should have bedrails,no?
What is a post op facility? If it’s rehab then unfortunately bedrails are not allowed. Silly silly rule.
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Reply to Shane1124
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Wiley,

My Mom was in a nursing Home. Physical restraints or anything that remotely physically restrained the patient were not allowed by State Law.

Bed rails were not allowed either. I don’t remember if that was State Law or the Nursing Home rules. There was a fear the patient would get themselves stuck in the bed rails or try to go over the bed rail. I only remember it was not an option.

As Barb mentioned above, my Mom was placed in a floor level bed. The frame was constructed out of PVC pipe. There were crash mats placed around her bed. Bed alarms were used along with an alarm cushion in her wheelchair. The alarms just sounded Mom was out of place and “on the move”.
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Reply to lizzywho61
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Get her a bed that can be lowered to the floor, or placed on the floor. Crash mats on the floor. Her bed pushed against a wall on one side. See if her doctor can order temporary restraints.
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Reply to BarbBrooklyn
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State laws restrict the use of restraints in post-op facilities, and bed rails are restraints. It's crazy. The pendulum has swung too far in my opinion.
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Reply to jjariz
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