There is conflicting data in the literature about the effectiveness of bed alarms. Bowman is concerned about how imposing alarms on residents interferes with their choice to move and be active.
“Alarms meet the definition of restraints,” she says. “When we use them, we are teaching people not to move and encouraging immobility. This, in turn, contributes to the very maladies we are trying to prevent.” While staff might see alarms as protective devices, she says, they actually can cause problems for residents.
“Alarms can be very agitating, especially for individuals with dementia, and once they get agitated, they can stay that way for awhile,” she says. Bowman also notes that residents can develop a Pavlovian response to the sound and associate it with something negative.
The Case Against Alarms
Bowman relates a story of a friend who was in a facility and experienced a fall. Staff installed a bedside alarm without seeking her input. “My friend says it was terrible, that it made her feel like she was in prison. She felt that staff weren’t listening to her,” Bowman says.
“I asked the social worker to help my friend, but a month later, I went back and the alarm was still in effect.” She says that although she is a former surveyor and understands the need for facilities to prevent falls, residents shouldn’t have to sacrifice their quality of life or happiness. “How dare we do this to older people at the toughest time of their lives?” she says.
The Joint Commission requires all health care facilities to have a falls prevention program, and bed alarms often are a part of it. However, some studies question their effectiveness. For example, Cummings and colleagues conducted a study of a few falls prevention strategies that found no single intervention—including bed alarms—had been proven to be effective in preventing falls in high-risk individuals (Cummings et al., 2008).
Bowman suggests that residents’ behavior speaks volumes about the effectiveness of bed alarms. She says, “We see people sneaking out of bed, clipping the alarms on chairs or something else. When they do these things, they are telling us that they don’t want these alarms. We need to listen to them.”