Installed this for a patient that has hemiparesis after a stroke. Could get in and out of bed during the day, but when tired or just waking up in the morning, simply didn't have enough energy to prop himself up on one elbow and push up to a sitting position. Received it - very light and compact vs. the board-mounted rails, the steel frame rails, and other rails I've compared before buying. Aluminum, nylon strap, easy to put together - slide strap over a rail, then simply click the rail together in three locations, the push pins lock it into place, and you're done assembling. To install, simply lift the bed at the edge you want it installed on, slide the bottom of this rail under the mattress. Take the strap by one hand, lift the edge of the bed as you walk around to the other side. Once opposite the rail, simply pull the strap to make sure there's no slack underneath the mattress. Next, and this may require help if you're not strong, you'll need to push up to lift both the mattress and box frame just enough to slip one end fo the strap around the metal bed frame (or, if you've got some more complex wood frame, around all that, which may require lifting the mattress and box frame up, then the wood frame up, too). Click ends of strap together, tighten belt, and you're done. Installed in less than a few minutes on a standard queen size mattress without any trouble at all. (I can lift 50+ lbs, so pushing up both the box frame and mattress enough wasn't an issue - else, get help, or get a jack under that bed to jack it up - might need a piece of wood under the bed to prevent the jack from poking through the box frame. Hm, otherwise, might have to flip the mattress off, then you can lift the easier box frame by hand.) Naturally, all of these bed frames will wobble a little bit, but some are less 'safe' than this one. For example, there's one where a steel bed frame is bolted by only 2 bolts to a wood board, which then slips under the mattress. Huh?! Not even solid wood - more like compressed, and it's one easy way to fall because someday, the patient will put too much on those bolts, and the wood will split and fail. This one has the strap pulling across the bed, so there's no way a normal patient can pull the frame out on the side it's installed on. You'd have to apply so much force that you'd have to break the nylon strap. (Go take any backpack, that thin, 1-2" wide strap - just go try pulling it to break it. Not possible - and you can easily hang your entire weight off one.) The frame slips far enough under the mattress that it can't tilt up and somehow slip out either (besides, the nylon strap will prevent the tilting, too.) You could slide it asymetrically towards the front or end of the bed... if you had enough strength to pull the bed rail in a circle pivoting around the strap tied to the bed frame...along with the mattress on top. But again, not going to realistically happen with any patient in real life. Thus, quite safe when installed - it isn't going to ever fail or move from your installation point. You can hold it and lean over the rail and it won't move, slip out, flip, etc. Pull on it outwards and it's not going anywhere. Put body weight on it and it's not going anywhere. And you can't feel it under the mattress either (you may if you've got a super-cheap, thin mattress). Not that it was ever 'designed' to hold your entire weight - but it's sturdy, built out of aluminum, and that nylon strap isn't likely to fail, so there's not much that can fail. Slip on carry is nice - nylon, stiched fine, no issues here. Not cheap thin, but decent. One side has a full width pocket (for magazines), the other side is divided into three pockets (for remote control, glasses, etc). You'll have to decide which should face you in bed, and can easily reverse the slip on. Foam padding on bar is solid and nice - not cheap, a good, stiff foam that's like to last awhile. Doesn't go all the way down the frame in case you decide not to use the slip on - just the top curve of the rail. But what's exposed is generally smooth and not much there to catch on or poke you. Super-easy for patient to get himself up with one hand now. Not so wide/long that it blocks him from pivoting up and swinging his legs off the bed. Have it installed so half the frame covers the lower half of his pillow, the other half covers the bed. Just about the right mounting location for easy reach. At the current price, a touch pricey vs. the cheaper models available, but now that it's installed and having compared against all the rest for the use for this particular patient, an ideal purchase and very satisfied. Would not get any other since it also has the benefit of being very compact and easy to pack for storage and travel, in addition to the secure mounting method . (Box about 1 1/2" deep and the size of the upper frame when disassembled.)