Quick answer: for someone who spends many hours in bed but can still move, a viscoelastic (memory) foam mattress or mattress overlay (static) is usually enough to prevent pressure sores. For someone who is permanently bedridden, cannot change position on their own or already has a pressure sore, the best option is an alternating-pressure system with a pump. In either case, the mattress does not replace regular changes of position.
Choosing a pressure-relief mattress is one of the most important decisions when caring for someone who is bedridden. In this guide we explain the differences between the types of mattress, how to choose according to the level of risk, and what else you can do to protect the skin of the person you care for.
What is a pressure sore and why does the mattress matter?
A pressure sore (pressure ulcer) is damage to the skin and the tissue beneath it, caused by prolonged pressure on the same area, especially over bony areas such as the sacrum (lower back), heels, hips and elbows. When a person stays in the same position for many hours, blood circulates poorly in these areas and the skin begins to suffer.
A pressure-relief mattress helps in two ways: it spreads the body’s weight more evenly, reducing pressure on the main contact points, or it keeps shifting the contact points over time, in the case of alternating-pressure systems.
The two main types of pressure-relief mattress
1. Static mattresses (foam and viscoelastic)
These are foam mattresses or mattress overlays, often with a viscoelastic layer that moulds to the body. They need no electricity and make no noise.
- Suitable for: prevention in people at low to moderate risk who spend a lot of time lying down but can still move or be repositioned regularly.
- Advantages: silent, maintenance-free, comfortable and stable.
- Limitations: they do not replace changes of position and may not be enough where the risk is high.
2. Alternating-pressure systems (with a pump)
These are mattresses or mattress overlays made up of air cells that a pump inflates and deflates in turn. This way, the body’s weight shifts between contact points over time, relieving the pressure on each area.
- Suitable for: people who are permanently bedridden, with little or no mobility, or at high risk of pressure sores.
- Advantages: active, continuous pressure relief.
- Limitations: they need electricity, make some noise and require you to keep an eye on how the pump is working.
Mattress overlay or mattress? A mattress overlay sits on top of the existing mattress; it is the most affordable and easiest option to set up. A full mattress replaces the current one and is generally more stable and better suited to long-term use.
How to choose: a simple rule for each situation
| The person’s situation | Most suitable type of mattress |
|---|---|
| Spends many hours lying down but moves on their own | Static mattress or mattress overlay (foam / viscoelastic) |
| Spends many hours lying down and needs help to change position | Higher-quality static mattress or alternating-pressure mattress overlay |
| Is permanently bedridden and barely moves | Alternating-pressure system |
| Already has a pressure sore | Alternating-pressure system, with guidance from a nurse or doctor |
This table is general guidance. Each person’s level of risk should be assessed by a healthcare professional, such as the community nurse, who uses specific scales for this.
What to check before you buy
- Size: check the width and length of the bed (or profiling bed) so that the mattress fits snugly, with no gaps.
- Height: a mattress overlay makes the bed higher, so check the height of the side rails, if there are any.
- Cover: choose waterproof, easy-to-clean covers, especially in cases of incontinence.
- User weight: check the maximum weight stated by the manufacturer.
- Noise and electricity: with alternating-pressure systems, think about where the pump will go and whether there is a socket near the bed.
The mattress is only one part of prevention
No mattress, however good, replaces the rest of the care:
- Change position regularly, as advised by the healthcare professional.
- Protect the areas most at risk, such as the heels, with heel protectors and suitable cushions.
- Keep the skin clean, dry and moisturised, and check it every day for red areas.
- Look after diet and hydration: nutrition plays an important role in skin health.
You can read more in our article How to prevent a pressure sore and in our guide to supplements for wounds and pressure ulcers.
At Saúde em Sua Casa
In our Anti-Bedsore category you will find static and alternating-pressure mattresses and mattress overlays, seat cushions, heel protectors and other prevention accessories. If you are unsure which to choose, call us on +351 258 023 198 or email [email protected] and we will help you find the most suitable option.
Frequently asked questions
What is the difference between a static pressure-relief mattress and an alternating-pressure one?
A static mattress (foam or viscoelastic) spreads the body’s weight over a larger surface. An alternating-pressure mattress has air cells that a pump inflates and deflates, shifting the contact points over time. The latter is recommended where the risk is higher.
Is an alternating-pressure mattress overlay enough?
In many situations at home, yes: it is the simplest and most affordable option. For long-term use or very high risk, a full mattress may be more stable. Follow the advice of the healthcare professional who looks after the person.
With a pressure-relief mattress, does the person still need to be repositioned?
Yes. The mattress reduces pressure, but it does not replace changes of position or the rest of the skin care.
Does a pressure-relief mattress make noise?
Static mattresses make no noise. Alternating-pressure systems have a pump that makes some noise while it is running.
This article is for information only and does not replace advice from a healthcare professional.
