Over the last few decades there has been a movement to reduce bed rails and other variations of restraints that are used on nursing home residents. This movement has been growing ever since Congress enacted the Nursing Home Reform Act in 1987. This law included a prohibition on restraints being used for the purpose of discipline or staff convenience and not for medical purposes.
The goals of the restraints were to improve resident safety in nursing homes. However they often have the opposite result and lead to more injuries, deaths, and deprive the residents of their dignity and freedom.
Rails can be especially hazardous for residents suffering from dementia. They can fall from greater heights if they attempt to climb over them and sustain more serious injuries (especially head injuries). There are also issues with entrapment.