I have a relative that likes for her bed to be placed right next to the wall. She has speech problems and there are printed messages taped on the wall that she can point to indicating what she wants the nurses to do, ie change her positioning, get her out of bed, etc., The administrator says that there are regulations in California that dictate the bed has to be a certain distance from the wall, even though her bed's been in the same position next to the wall for years. Evidently the regulation stems from court cases where patients somehow got stuck in between the bed and the wall. Though this is not a concern for my relative since she can't roll over on her own and never had an incident in countless years.
I'm wondering can a patient sign a waiver of some sort (similar to a bed rail consent form) so that they can keep their bed next to the wall? He wasn't sure about this issue and told me to ask around to see if there was any way around it.
I have seen a long term care (Medicaid) facility in Michigan that allowed beds to be turned along one wall- but that depended upon the resident's ADL functioning. If a resident needs staff assistance with turning and such, the bed will often be where it is best accessible for the staff to assist the resident.
Sadly, one strange but harming case happening to one person somewhere can affect the liability and safety rules for the whole country. Some rules and regulation changes are good... others are a bit odd, in my opinion. ( I am a nurse...)
You CAN be the squeaky wheel and make very large, laminated poster board items that could possibly be placed/ hung somewhere near her that indicate what she would like... maybe in different colors and with easily seen universal symbols/ graphics ( similar to the simple figures used for restrooms)... the staff CERTAINLY would appreciate knowing exactly what she is needing (saving time)... and perhaps then the administrator would come along eventually in helping you out more.
Be creative ~ keep trying ~ ask the nurses/ caregivers for their ideas what could help (not just the administrator) ~ ask if her speech therapist or doctor can help out with any signage or provide her with a communication board ~ you might just think of and come up with a great solution that many others in similar situations are facing.
All the best ~
Also, they can easily change her position from one side to the other to avoid getting breakdowns.
Very important as you age to avoid that...the skin becomes very thin.
I don't know about the law around it.
Maybe contact the state and see what they say about it.
If it's not law, they have to honor your request.
Accommodation of Needs
A resident has the right to reside and receive services in the facility with reasonable accommodations of individual needs and preferences.(5) The facility should attempt to adapt such things as schedules, call systems, staff assignments and room arrangements to accommodate residents’ preferences, desires and unique needs.(6) ...
If language or communication barriers exist between residents and staff, the nursing home is required to use interpreters or other measures to ensure adequate communication.(8)
http://www.canhr.org/factsheets/nh_fs/html/fs_CareStandards.html (See the footnotes for references to US or California code.)
That said, I haven't looked at the actual California code for nursing home room arrangements and bed placement. Your best bet is to request a copy of the state law from the administrator. If it's such a big issue, he or she should be able to recite it chapter and verse from memory AND provide a copy.
If they are adamant about keeping the bed away from the wall, you may want to consider making up a "booklet" for your relative to use when she has a request. If she does not have visual acuity or reading comprehension problems, you could print pages with written requests, or pictures of the service/activity requested, laminate them (or place them in document protector sheets), and fasten them together with a key ring or other device. She could then keep her booklet on top of her coverlet, on her bed table, or in her nightstand drawer, whichever is easiest for her to reach depending on her level of mobility.
Or get spiral-bound index cards and block print her various instructions on them, and she can simply flip to the card she needs at the time. This method will, of course, also depend on her visual acuity and fine motor skills.
Best of luck with this. In all of my years of caregiving, I've learned how to get inventive.
But these can be worked around I would look for the specific wording in the codes and determine if being against 1 wall (2 actually if you think of the headboard if there is one or the wall if the head of the bed is against another wall)
But if the notes are her means of communication I do not think they can take a way a patients means of communication so this might be "an exception to the rule" and it might have to be approved in writing.
Ask for a copy of the regulations where it states that a bed can not be placed against the wall. I am sure it will not specifically say that but it is an interpretation. They should have a copy of "Minimum Standards" on site if not I am sure you can get it on line.
Personal opinion here but California can go a little overboard with some of the regulations...some are great some can make things more difficult.
Still. You might be able to find books of regulations on your state or county's website: I'd start digging there.
By the way, though - I'd have thought the regulations actually stem from protecting workers. There has to be minimum space for them to work in when they're moving patients or changing bed linen, otherwise they tend to stress their backs. Is the bed on wheels? Is there plenty of space to move it out from the wall when your relative's not in it?
Good luck getting this one solved, it's worth a bit of a battle at least :)