In the UK we do all our bed control via enviromental controls system, using interfaces supplied and approved either by the environmental control suppliers, or directly from the suppliers of the bed control systems. There is quite strict safety legislation around this kind of automation now, and given the litigational culture in USA, I am slightly surprised to hear a more relaxed atittude to this area. This approach was driven by serious accidents, primarily by the user causing serious injury to children in the vicinity, rather than to themselves. Having said that, any system properly designed, risk assessed and documented can do the job, so I am very interested to hear the outcome of this discussion. I will provide some info, from our perspective, in case that is of any help.

The standard relay system that we interface to beds with is made by Possum Controls, but there are others. You can use a dipswitch on the board to set the maximum time that the relay can activate for, and importantly, there is a delay of 4 seconds after removal of the signal, before it will respond to another command. With these elements there are built-in saftey measures that prevent accidental multiple, or continuous movement commands. This would seems absolutely necessary to me if proposing voice control, where there is no guarantee that a spurious sound would not cause activation. 

 In terms of using switches to operate environmental control systems from bed, the first one we always try is the Tash Pillow Switch, and it works 95% of the time. Where someone's head/neck movement is so limited that they cannot use this effectively we usually use a Ping Pong Switch, attached to an adjustable Manfrotto arm. The Ping Pong Switch looks a bit daft but is very effective; it has good sensitivity, good feedback but is not too directional, so easier than the other sensitive switches to set up.

If it is specificallly iOS based control that you are looking for, based on the Blumoo reference, The Housemate Pro, by Unique Perspectives is now available with iOS compatibility. We have used it with one ALS client very effectively and I was quite impressed.

We have various ALS clientts who are using a Gridpads/i12 with a head mouse (Smartnav, Quha etc.) during the day when up. Some of these also prefer this method when in bed, but we still always provide the backup of switch access for emergencies.

cheers

Jeremy