LTC nurses--tell me about bed alarms...

[mustlovepoodles, RN]

I am not asking for medical advice. I am a peds nurse with 34yrs experience, but this has me stumped--

My youngest DS15 is profoundly mentally handicapped, like a 1yo. He walks, but has no self-help skills and NO sense of danger. Lately he has taken a few falls--he is very off-balance due to seizure meds and low muscle tone. He has suffered a few head injuries and some broken bones falling down the stairs, so we accompany him now and we have put a gate over the basement stairs so he can't go down there, even if he lurched into the gate. We are also addressing the balance & walking issues in PT. We have a CNA who comes in every evening to feed & play with DS and bathe him, things that are harder for us. The CNA is with DS constantly, so DS never falls when the CNA is here.

Sometimes DS falls out of bed with a seizure. Putting bed rails on the bed backfired--in his confusion during a seizure he tries to escape and hit his head hard enough to cause a concussion. It has been suggested to us by authorities that we invest in door alarms or bed alarms (gotta love CPS--NOT) We are not too keen on door alarms because he opens and closes doors for entertainment but we might want to look into the bed alarms depending on how they work.

How loud are the alarms? Describe how the alarm goes off--is it short or is it loud? Once it is tripped, is it constant? I have no problem with having an alarm, but I don't want some ear-splitting noise that's going to wake everyone in the house. What I need is something that goes off briefly, just enough to get our attention.

Any suggestions?

[SuesquatchRN, BSN, RN]

Forget the alarm. By the time you get there he'll be on the floor and possibly injured.

Put the mattress on the floor and put mats around it at HS. Seriously. We do something very simlar for some of our residents. Make sure there is nothing nearby he can smack his head on so that if he does seize in bed he is protected. And he won't get hurt falling because he is already on the floor.

{{{{poodles family}}}}

[~Mi Vida Loca~RN, ASN, RN]

I'm not a LTC nurse but I have seen plenty of bed alarms in the hospital and my LTC rotation.

When it was set it was very loud and constant until you shut it off. It was a big pad that went under the sheet and was connected to a box that had the on and off switch that plugged in.

Not sure if it would wake everyone up or not, nothing wakes my husband up and I wake up for the littlest thing, the ones in the hospital were set up to whatever system to alert the whole wing.

The one in the LTC facility weren't as loud. An option would be to get a baby monitor so you can hear it good but not the rest of the house. If it's anything like in the LTC facility I doubt it would wake everyone else up unless they are in the same room or in very close proximity and again, depends on how they sleep.

[~Mi Vida Loca~RN, ASN, RN]

Forget the alarm. By the time you get there he'll be on the floor and possibly injured.

Put the mattress on the floor and put mats around it at HS. Seriously. We do something very simlar for some of our residents. Make sure there is nothing nearby he can smack his head on so that if he does seize in bed he is protected. And he won't get hurt falling because he is already on the floor.

{{{{poodles family}}}}

That's a great idea. I might still do the alarm so that someone still knows and can come make sure he is ok after. You just never know. But the mattress on the floor seems like a great solution to the fall risk.

[nyteshade, BSN]

I've used two kinds of alarms: one programed into the bed, and the rinky dink one you clip on the patient. The flaw with the clip on kind is that if the patient sees this thing clipped to him, he will unclip himself . However, there is some value in the built-in types...like the patient being unable to undo it. Both are loud enough, and constant...they must be deactivated by someone.

[mustlovepoodles, RN]

Hmmm, I hadn't even thought of using a baby monitor. I can't have an alarm that's going to wake up everyone and the neighbors. DH is disabled with heart/lung disease and it would probably scare the bejesus out of him. We did put his mattress on the floor when he was younger, but now that we are in our mid-50s its getting nigh impossible for us to get up off the floor and we can't get DS off the floor either(he's the size of a normal 15yo, ie., taller and stronger than me). We diaper him on the bed, so getting down and up off the floor several times a day would be a hardship (knees, hips, arthritis, ugh--it's hell getting old.)

[Pepper The Cat, BSN, RN]

I'm with the mattress on the floor. Bed alarms are OK - but they are prone to false alarms too, if the person moves around alot. I am assuming that at 15 he probably moves around in bed at night.

A mattress on the floor would prevent him from falls, and if he does have a seizure, there would be less risk of injuring himself again a side rail, head board etc. Or you could get an air bed - I use one when I have company and it is very low to the ground, but very comfortable.

Still - I am thing mattress on the floor might be the best route. I would try a double just to give him more room to move about

[Forever Sunshine, ASN, RN]

Bed alarms will go off when he tries to get out of bed, falls out of bed, or sometimes even the slightest movement will set it off. Sometimes it goes off for no reason at all.

They are very loud. I hear them from the nurses station all the way down the hall. I go home at night and the bed alarm song is all I hear in my head.

Seriously, try the mats around his bed.. Also does he have a bed that is low to the ground?

[mustlovepoodles, RN]

He sleeps on a day bed up against the wall. We have carpet, but I bet I could get a tumbling mat to put down next to him. At night we lock his door from the outside with a hasp lock, something that we can easily unlock in case of emergency. We did that after he got up in the middle of the night a few times and raided the freezer for ice cream and then started playing the piano. At 2am. Silly boy...

[~Mi Vida Loca~RN, ASN, RN]

He sleeps on a day bed up against the wall. We have carpet, but I bet I could get a tumbling mat to put down next to him. At night we lock his door from the outside with a hasp lock, something that we can easily unlock in case of emergency. We did that after he got up in the middle of the night a few times and raided the freezer for ice cream and then started playing the piano. At 2am. Silly boy...

They sell foamy square mats that lock together for kids, they are pretty firm yet impact absorbent. Google Foam Mats and it will pull all kinds up.

[Pepper The Cat, BSN, RN]

Maybe a trundle bed? He could sleep on the main bed and then have the trundle part pulled out for protection??

[mustlovepoodles, RN]

Maybe a trundle bed? He could sleep on the main bed and then have the trundle part pulled out for protection??

We could do that. Right now I have the trundle set up as a second twin bed in his room, just for those times when he wets the bed and needs a clean one. But we could reconfigure the room and put the trundle back under and just pull it out at night. Thanks! I promise I'm not an idiot, just a concerned mama...