Thanks for all the suggestions every one I'll start looking at peoples ideas and see what works best for me.
For Jonboy53 I got supplied with the following alarm system and I attach it to the end of the bed as my arms won't work. I also bring it into the hospice as I can't use their alarms.
I just touch the switch with my foot and the pager is activated. It's quite loud and works well at home. In the hospice I have the pager taped to the wall as the range is limited and works best at home but the pager is loud enough to bring the care staff running. I just have to make sure it's reset properly each time I set it off. When I got it the pager was included but some companies sell them separately for some reason.