Hospital staff rarely insisted on putting up guardrails on my mother’s bed. Things changed at the rehabilitation facility. The staff always put the guardrails up, whether a patient needed them or not. That sent my mother into a rage. No one was going to control when she got up to go to the bathroom. Furthermore, she let us know, she was not going to risk waiting on help when she needed to go. I wish I had known about Bed Alarms then. I might have been able to intervene.
What is a Bed Alarm, and does it prevent falls? A Bed Alarm is tool to alert caregivers that a patient is getting up from bed. Use these alarms in beds, chairs, wheelchairs and toilets. Bed Alarms do prevent falls, so long as the caregiver responds to the alarm. I call the Bed Alarm the “Mom needs help but refuses to ask for it alarm.”
How Do Bed Alarms Prevent Falls?
A Bed Alarm sounds when the patient tries to get out of bed.
Caregivers use Bed Alarms with patients who might fall without assistance.
The caregiver can respond to the alarm, assist the patient trying to get up, and prevent a fall.
Who Can Benefit from a Bed (“Mom’s Going to Fall but Refuses to Ask for Help”) Alarm?
People who need to pee at night often refuse to wait for help. They get out of bed to pee, and that is when they fall.
Some patients refuse to ask for help. They don’t want to bother anyone. Or they don’t believe that help will arrive quickly enough.
It is not just giving up independence. We are asking our mothers and fathers to be OK peeing around their kids. Of course they resist letting us know when they need to get out of bed.
The Bed Alarm alerts the caregiver that the patient is getting out of bed.
Because the caregiver knows the alarm will warn of this activity, the caregiver can relax. Everything is OK so long as the alarm is not triggered.
The most frequent comment caregivers give about Bed Alarms is: “I’m finally getting some sleep.”
Which Patients Benefit from Bed Alarms?
The at-risk patient is the patient who is likely to fall after standing up.
The single greatest predictor of whether a patient will fall is if they have had a fall in the past.
If left to themselves, the ones who fall are the ones who will fall again.
Use Bed Alarms for patients who:
- have problems walking
- lack strength
- lack flexibility
- lack balance
- cannot stand without assistance
- have neurological problems
- take four or more medications (especially tranquilizers and medications that affect the central nervous system)
- get up at night to pee
- are incontinent and want to clean up
- have fallen in the past
- have balance or gait problems
- have inhibited motor skills
- have confusion
- have disorientation
- have impaired memory
- have difficulty judging safe distances
- require assistance at the toilet or kitchen (or wherever the patient thinks she wants to go)
Why Use a Bed Alarm?
The Bed Alarm alerts the caregiver that the patient is getting up without assistance.
The Bed Alarm is really an in-motion alarm. If the alarm is going off, the event is already in progress.
Manufacturers like to call them “early warning” systems, but I think of them as “last second” alarms.
Despite that difference, they are enormously successful alarms that are good at preventing falls.
How Do Bed Alarms Work?
There are three Bed Alarm types:
- Pull Cord Magnetic
- Pressure Pad
- Motion Detection
Pull Cord Fall Alarm
A Pull Cord Alarm is a base with a magnet attached to a tether cord with a clip. You attach the base to the wall. bed, or chair. You clip the tether to the patient’s clothing. When the patient moves, the magnet pulls from the base, which sounds the alarm.
The base has to be attached to a stationary object. Depending on the alarm, you can use screws, Velcro, or a spring-loaded clip to secure the base alarm.
Be aware that you should not use some pull cord alarms with cardiac pacemaker or implantable cardioverter defibrillator devices. The ones causing issues for these patients should be labeled with warnings not to use them.
In a regular Pull Cord Alarm, the alarm noise sounds in the room with the patient. You can also get a remote Pull Cord Alarm. This allows you to move the alarm tone to another room as much as three hundred feet away from the patient, depending on the model.
Pressure Pad Bed Exit Fall Alarm
A Pressure Pad Bed Exit Alarm senses the patient’s weight. When she gets up, there’s less weight on the pad. The change in weight triggers the alarm.
You place the pressure pad under the patient. In a bed, you put it under the fitted sheet.
Look for skin-friendly pressure pads. They should also be well sealed, to avoid damage from incontinence.
You can put a thin pillow or a sheet between the patient and the pad. As long as there is weight on the pad, it will act as an alarm.
The patient can turn over in bed without triggering the alarm. Pressure pads should respond to weight anywhere on their surface. So long as there is some weight on the pad, it will not sound.
A very lightweight patient cannot use a pressure pad alarm. The pressure pad needs a minimum weight to activate. Some alarm pads expect 70 lb., for example. If the patient weighs less than the minimum, the alarm will not activate. Once the alarm is activated, it will trigger when the weight on top is less than its minimum.
It is best to get a cordless version of this alarm, because cords themselves can be a trip hazard. The tether is an unavoidable string, but it is small and is not likely to cause a problem unless it falls off the patient onto the floor. Good clips will not fall off the patient’s clothing.
Some Pressure Pad Alarms have a remote feature to send the alarm to a caregiver up to a few hundred feet away from the patient.
Motion Detection Fall Alarm
A motion detection alarm goes off when the patient breaks the infrared beam
A Motion Detection Alarm uses a beam of light aimed toward the patient. You aim the light where the patient will put her feet when attempting to stand. The motion breaks the beam, which triggers the alarm.
The sensor is also the alarm. When it detects movement, the alarm sounds. Some models will stay quiet in the patient’s room, but send a message or alarm to the caregiver up to a few hundred feet away.
You can place a Motion Detection Alarm across the room from the patient. This makes it harder to disable than a Pull Cord or Pressure Pad monitor.
The key to using a Motion Detector Alarm is to test whether you have aimed it properly. Will the alarm still detect the movement if she exits the bed from the opposite side? Caregivers like to aim Motion Detector Alarms under the bed so that it covers any area where feet might hit the floor.
Floor Mat Fall Prevention Alarm
A Floor Mat Alarm is the opposite of the Pressure Pad Alarm. The patient triggers the Floor Mat alarm when she steps on it. Adding weight triggers the alarm noise.
I do not like the idea of a floor mat for the elderly… it is a trip hazard.
Floor Mat Alarms come in plugin-in and battery-operated models. The battery eliminates the cord, which I like. However, I do not like the idea of a floor mat for the elderly. I might consider using this device, but I would definitely seal it to the floor to avoid creating a trip hazard. I can imagine it working under a carpet, if it is flat enough not to create a bump.
How Do Bed Alarms Alert the Caregiver?
A Bed Alarm uses sound and sometimes light to alert the caregiver of patient movement.
Some alarms have multiple sound levels from quiet to loud.
Some alarms have a remote feature to alert the caregiver in another room.
What Type of Bed Alarm Do You Need?
The Pull Cord Alarm rings when the tether attached to the patient pulls a magnet off the base. The Pull Cord Alarm works best with willing patients who do not mind the tether clip and pulling.
For less-than-willing patients, clip the tether to the back of their clothing. Out of site and reach is the hardest alarm to deactivate. Of the four Bed Exit Alarms we are discussing, the Pull Cord Alarm is the easiest for the patient to deactivate.
The Pressure Pad Alarm rings when the patient gets off the bed. The Pressure Alarm works well with both willing and unwilling patients. It is harder to deactivate than the Pull Cord alarm. Since the Pressure Pad is under the sheets, the patient will have a harder time deactivating the alarm.
By the time a Pressure Pad Alarm sounds, the patient is off the bed. It gives less warning time than the Pull Cord Alarm.
The Motion Detector Alarm rings when the patient steps into the beam of light. The Motion Detector Bed Alarm is best for unwilling patients. You can place the alarm across the room, making it the hardest of the four alarm types to deactivate. To defeat a Motion Detector Alarm, the patient would have to step outside of the light beam.
Motion Detector Alarms do not require you to put anything near the bed. The patient is not clipped to anything or lying on anything.
Motion Detector Alarms give the caregiver a little bit less time to respond than the Pull Cord Alarm. They give about the same amount of warning time as the Pressure Pad Alarm. The patient’s feet are nearing or on the floor when the Motion Detector Alarm goes off. You can point it higher, but you will get more false positives if you do.
The Floor Pad Alarm rings when the patient steps on the pad. I would only use a Floor Pad alarm if it is very flat, has a good grip, and you have taped the edges to the floor. I just do not like any floor mats in an elderly care situation.
Which Alarm Would I Get My Mom?
I like the Motion Detector Alarm, followed by the Pull Cord and Pressure Pad Alarms in 2nd and 3rd place. I do not really like the Floor Pad Alarms. Anything on the floor is a trip hazard.
You can place the Motion Detector Alarm well out of reach of the patient. She is not going to turn it off or unplug it from bed. You can get a Motion Detector Alarm with a remote feature to avoid sounding the alarm in the patient’s room. The Motion Detector Alarm does not need to touch the patient or her bed. It is not going to get in her way, and she is not going to pee on it.
The Pull Cord Alarm gives you the most warning that she is trying to get up. You can shorten the tether, but you will get more false alarms that way. Some patients do not like the tether clipped to their clothing, but the overwhelming majority of reviews I have studied tell me this is not a common problem.
The Pressure Pad Alarm is not attached to the patient, and that might be just the thing to make it work for your situation. Pads are usually sealed to repel accidents. Note that she will be completely off the bed before the alarm is triggered.