Systems and methods for controlling an alarm state, such as volume, based on the presence or absence of a caregiver in a patients room. More specifically, a local sound producing device provides an audible alarm within a room when a caregiver is in the room, while a remote sound producing device provides an audible alarm external of the room when the caregiver is not in the room. Accordingly, volume levels of the sound producing devices depend on the sensed presence or absence of the caregiver within the room. For example, when the caregiver leaves the room, the local sound producing device is deactivated and/or the remote sound producing device is activated, thereby allowing the patient to enjoy a more relaxed environment within the room, yet still continue to be monitored. Conversely, when the caregiver enters the room, the local sound producing device is activated and/or the remote sound producing device is deactivated, thereby allowing the caregiver to monitor the patient when within the room, yet allow decreased monitoring external of the room.