While families and caregivers have serious concerns that patients will fall out of bed, others have concerns that patients will die or seriously injure themselves when getting caught on the side rails. Some patients are quite confused, others are agitated, and this is especially a concern for terminally ill patients who become agitated.
Terminal agitation is one of the common symptoms of the end of life phase.
The agitation may be so extreme that patients act completely contrary to their usual personalities. Nursing homes have been threatened with lawsuits by families who insist that the bed rails be up at all times, so that their loved one does not fall out of bed. On the other hand, nursing homes have also been threatened with lawsuits by other families who insist that the bed rails not be used, because of their dangers. It is obvious to those who observed the improvements in infant crib safety where the bars were placed closer together, that similar design changes would help prevent many of the accidents where patients get entangled in the bed siderails. Padding of the side rails would also help, or even making the siderails solid with no spaces to put a hand or arm through, would be helpful.