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Strict laws make it hard to alert caregivers when loved ones get out of bed

Carol Bradley Bursack, Minding Our Elders columnist

Dear Carol: My 96-year-old mother has moderate signs of dementia and lives in an assisted living facility. Mom can feed herself but she needs assistance with most other activities, including transferring from her bed to her lift chair or wheelchair, but she won’t use her call light to get help. Last evening, Mom had tried to move from the lift chair to the wheelchair and an aide found her on the floor. Mom wasn’t injured this time, but what about the next time? The facility says they can't use any alarms to alert staff that Mom is trying to get out of her bed or chair because these alarms are considered illegal restraints. Do you have any suggestions? — KB.

Dear KB: I’m sorry that you and others are faced with this agonizing situation. I went through something similar with my dad so I can relate to your frustration and emotional pain, though now laws are even tighter, as they should be. Most restraints, no matter how well-meaning, either incapacitate the elder (drugs), imprison them in some way or cause frustration and anxiety, which is the case for the pinned-on alarms. None of these effects are acceptable, yet safety is a legitimate concern.

Several years ago, alarms that attach to clothing were one of the only types of “restraint” considered legal. During that time, my dad moved into a nursing home after surgically triggered dementia. The stress that he endured when an alarm went off each time he moved was intolerable. This is the reason for current laws that make seemingly innocuous pinned-on alarms illegal. This document explains the law: CMS.gov/regulations-and-guidance.

Like you, we were left with essentially no workable options since we had to choose between Dad suffering psychological distress and the risk of frequent falls because he was determined to get up from his chair or bed on his own. Unlike your mom, Dad would generally use his call button so that even if he wouldn’t wait for the staff, at least they knew he was on the move. Still, falls happen quickly, and he did take some serious tumbles.

Currently, there is at least one newer type of alarm that alerts only the staff and doesn’t bother the resident. This system makes it necessary for facilities to upgrade their technology, though, and sadly, such upgrades take time and money.

I did find a wireless alarm on Amazon that alerts the caregiver but doesn’t disturb the elder. I’m not sure it would work in a facility setting, but you could check into it. The search words are “wireless cord-free bed alarm.” Comments from users range from being thrilled to complaints about battery life. As mentioned, I’m not certain that these could work for facilities, but they may help people at home, so I’m referencing them here.

I wish that I could be more helpful. If readers know of a solution, please let me know and I’ll pass the information on to the writer.