Bed Side Rails - Home needs permission/signature - any additional advice?

CraigC

Registered User
Mar 21, 2003
6,633
0
London
Hi All,

My dad fell out of bed last night and had some skin tares on his face. Apart from that he seems ok and unshaken. The home have asked me to sign a consent form for using bed side rails in the future so it doesn't happen again. I recall it is a legal issue as it is seen as using restraint.

I'm going to sign the form as it seems to make sense but wonder if anyone else has had similar issues regarding the need for bed side rails? And whether the are any cons? Or is there anything I can suggest? eg making sure they put extra pillows by the rails.

I have a couple of pending referrals for OT and geriatrician but then are taking forever. Just want to make sure he is comfortable and safe until I get more advice.

thanks
Craig
 

Saffie

Registered User
Mar 26, 2011
22,513
0
Near Southampton
I had to sign to give permission for my husband's bed to have rails up as he tried to get out of bed the first night in the nursing home - and as he is unaware his leg has been amputated, and his other leg cannot take any pressure, he would obviously fall out. I don't think there are any problems with it. He is always hoisted and has a special chair to sit in but he still fell out of the space between the top (head) and bottom (foot) rails a few months ago, He now has a low rise bed and mats placed either side of the bed. They are obviously taking no chances.
 

CraigC

Registered User
Mar 21, 2003
6,633
0
London
Thanks both :)
My main concern is that he may lean against them and get pressure sores. I'll check if you can get pads to run along them. Dad has an inflatable pressure mattress so he may have turned as they can get a little uncomfortable compared to a standard mattress. They prevent pressure sores but are not the most comfy solution.

Weighing it up, the risk of harm from falling is higher than the risk of pressure sores.
 

Kathphlox

Registered User
Dec 16, 2009
1,088
0
Bolton
I was refused bed rails for dad, even though he fell out a few times or tried to climb out. The District Nurses said they don't allow them with dementia patients as they try very hard to get over them and in some instances have caused injury. I then asked for nets for the side of the bed, but that was also refused.

The only thing we have is a crash mat and I bought an alarm to go on top of it so I know when he's fallen out, which he's not done for some while.. fingers crossed that carries on ;)

I was thinking of getting bed wdeges, but they are not suitable for air matresses :(

There are lots of options to think about, just knowing about them is a step in the right direction, nobody ever tells you about the equipment available :mad:

http://harvesthealthcare.biz/Harvest-Bedrail-Bumpers/
 

CraigC

Registered User
Mar 21, 2003
6,633
0
London
Thanks Kathphlox, really really helpful. Great link - Ill send it to the home.
It sounds like I need to sign the form BEFORE the OT turns up. Ultimately you'd think it should be a next of kin decision.
 

Saffie

Registered User
Mar 26, 2011
22,513
0
Near Southampton
My husband's home has pads that can be placed around the rails though mu husband doesn't have them. These would make them much softer and more comfortable. He also has an air pressure mattress - yes, it doesn't look the most comfortable thing in the world but he has had one now since he was taken into hospital nearly 15 months ago so I think he's probably used to it by now!

I don't think my husband would even try to get over the safety rails, he slipped between them as his amputation makes his lean to one side and he becomes a bit lopsided.

Most of the residents on his wing, which is the nursing wing rather than the dementia one, have rails. A lot of the residents there do suffer from dementia even so.
 

geum123

Registered User
May 20, 2009
4,604
0
Hi Craig,
I signed to allow dad to have bed rails.

He has climbed over and even through the bed rails and fallen even though he has no mobility to walk.
He now has bumpers over his bed rails,
and personally I'd insist on these,
because I think there is less possibility of being trapped.

But Google danger of bed rails for more info.

Bumpers are exactly like the ones mentioned above by Kathphlox
 
Last edited:

Saffie

Registered User
Mar 26, 2011
22,513
0
Near Southampton
They use these bumper pads in my husband's home to prevent slipping between the horizontal rails, rarther than comfort and can see why they would have used them with your dad Geum. My husband went through the gap between the upper and lower end of the bed rails. since he has the low rise bed which is dropped to virtually floor level at night, he seems to be ok.
 

CraigC

Registered User
Mar 21, 2003
6,633
0
London
But Google danger of bed rails for more info.
Yikes :eek: wish I hadn't done that.

In all seriousness, you can see why the care home wants you to sign a consent form. I had no idea about the risks.
 

Padraig

Registered User
Dec 10, 2009
1,037
0
Hereford
My biggest regret is not to have had rails fitted to my wife's bed. As she could not turn on her own, nor lift her hand to her face I figured she could not fall out of bed. She did however have seizures from time to time and that is the only conclusion I can come to for her only fall. I had only left the room for seconds to empty a basin of water having washed and changed her prior to lifting her up for teatime.
 

CraigC

Registered User
Mar 21, 2003
6,633
0
London
Padraig, I think we have to make a lot of tough decisions and it is so difficult to know what was right or wrong at the time. Difficult choices. You've made me think again actually - it could well have been another seizure last night as dad may have had a TIA a short while back. thanks
 

Jayne61

Registered User
Aug 28, 2011
31
0
Staffordshire
I don’t think it’s an issue of restraint really, more of safety. There have been cases where people have become trapped between the rails, & risk assessments are supposed to be carried out before using them. People with dementia are in the higher risk group for entrapment. See link (hope it works!)

http://www.mhra.gov.uk/home/groups/dts-pcc/documents/publication/con2025397.pdf

At mum’s care home she is in a bed which can be lowered right down & she has padded mats on either side of the bed, won’t stop her rolling out but at least she shouldn’t hurt herself & I think they consider it less of a risk than bed rails.
While she was in hospital recently they did use bed rails but she had a padded bumper over them which covered them completely.
Hope this helps
 

Padraig

Registered User
Dec 10, 2009
1,037
0
Hereford
Once I took control of my wife's care I made the decisions. I'm afraid I did not allow outside interference. Only when it was a case of health matters did I involve doctors and even then I wanted to know what was happening.
As you say I had to make some tough decision, some of which with hindsight I would have done differently. By and large I did a far better job than professionals and learned a very great deal 'on the job' alone 24/7 for the final five years. As one Psychologist who left the NHS sent me an email saying;'you proved them all wrong.' She was one special lady who really cared.
 

Saffie

Registered User
Mar 26, 2011
22,513
0
Near Southampton
Actually, now you come to mention it Jayne, I'm not sure that my husband does have the rails now that the bed is lowered to floor level at night. He does spend a lot of his time in bed though as he is only supposed to be in his special easy chair for 4 haurs ata time.
 

Grannie G

Volunteer Moderator
Apr 3, 2006
81,445
0
Kent
Hi Craig

My mother had a mattress on the floor beside her bed so she could fall onto it. Previously she too had carpet burns. Cot rails were not for her, she was too active.

Cot rails were not advised for Dhiren. In the home he has a profile bed which can be lowered but he hasn`t fallen out for ages.
 

alans

Registered User
Jan 2, 2012
9
0
Essex
Hi Saffie, I had to sign a consent form for my Mum because apparently care homes are not allowed to put up bed rails without permission because it is deemed to be unauthorised 'restraint.' Possibly political correctness gone mad. Alan
 

Saffie

Registered User
Mar 26, 2011
22,513
0
Near Southampton
Hi Saffie, I had to sign a consent form for my Mum because apparently care homes are not allowed to put up bed rails without permission because it is deemed to be unauthorised 'restraint.' Possibly political correctness gone mad. Alan

Yes, I did say i had signed one early on in this thread. Necessary I think because of H&S and the possibility, as someone has pointed out, that the rails might cause their own problem, though probably not as severe a opne as a fall.
 

sammie

Registered User
Aug 2, 2007
21
0
west yorkshire
hi

my dad fell out of bed often and although his bed has rails on they are never raised up due to health and safety there have been cases of people hurting themselves with the rails.

he has a crash mat on the floor next to his bed , the bed is on the lowest setting. however he fell recently during the night probably straight after they had done the nightly check. so we dont know how long he was laid on the floor and he had been banging his head on the side of the bed (he looked a mess) so now they have an alarm mat that activates to alert staff he has fallen
 

CraigC

Registered User
Mar 21, 2003
6,633
0
London
Thanks for so many helpful replies.
I decided to sign after a long discussion with nurse. I don't want this to happen again and it seems the best option for now. We will review in a few weeks but the bed is not very wide so it is likely to happen again. I dread to think how long he was on the floor, but best not to think about it. Scars healing but dad is still definitely out of sorts.

DSC08282.pngDSC08283.png
 

DeborahBlythe

Registered User
Dec 1, 2006
9,222
0
Your dad looks very comfy in that picture, Craig.

My mum fell out of bed on the first day in of the homes she was in. After that they put a crash mattress beside the bed. Later on in her care, I signed for cot rails, but one day she caught her leg between the rails and it was badly bruised and bleeding. (I noticed this, not the staff). After that I asked them to find bumpers for her, which they did and all was fine. By that stage she was quite unable to get out of bed by herself.

Just one caveat, she managed to lose a denture once down the gap where the bumper met the mattress. :) Not a big deal, but there's always summat to think about.:)
 

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