Why Pressure Injury Prevention Is a Major Long-Term Care Challenge

Residents in nursing homes who spend long periods sitting or lying in the same position may be at greater risk of pressure-related skin damage, particularly when mobility is limited.

This is why pressure injury prevention is not simply a mattress purchasing decision. It requires coordinated attention to resident mobility, repositioning, support surfaces, skin condition, moisture, nutrition, caregiver routines, and individual clinical needs.

A nursing home bed can support this care process by making positioning and caregiver access easier, but no bed function or mattress should be treated as a substitute for an appropriate professional care plan.

Start by Identifying Which Residents Need More Pressure Management Support

Not every nursing home resident has the same level of risk.

Residents May Need Closer Assessment When They:

• Spend most of the day in bed
• Have very limited mobility
• Cannot reposition independently
• Require extensive caregiver assistance
• Use wheelchairs for long periods
• Have fragile or vulnerable skin
• Have other clinical factors identified by healthcare professionals

Risk Assessment Should Be Individual

Facilities should follow appropriate clinical assessment procedures rather than assuming every resident requires the same bed or mattress configuration.

Different Nursing Home Bed configurations can then be matched with individual mobility and care requirements.

1. Repositioning Remains an Important Part of Pressure Management

Residents who cannot change position independently may require caregiver-assisted repositioning according to their individual care plan.

Position Changes May Involve:

• Changing lying positions
• Adjusting backrest angle
• Changing leg position
• Moving between bed and chair where appropriate
• Supporting different resting positions

There Is No Universal Repositioning Schedule for Every Resident

The appropriate frequency depends on the resident's clinical condition, support surface, mobility, skin condition, and professional assessment.

Facilities should follow qualified clinical guidance rather than relying on one fixed schedule for every resident.

2. Adjustable Beds Can Make Position Changes Easier

An adjustable nursing home bed can help caregivers create different supported positions without relying entirely on pillows or manual bed structures.

Useful Functions May Include:

• Backrest adjustment
• Knee or leg adjustment
• Overall height adjustment

The Goal Is Better Positioning, Not Simply More Functions

A five-function bed is not automatically better for pressure management than a simpler bed.

Facilities should select functions according to the resident population and actual care routine.

3. Mattress Selection Is Critical for Residents With Higher Pressure Management Needs

The mattress is the primary support surface between the resident and the bed platform.

For residents who spend extended periods in bed, mattress selection deserves careful attention.

Buyers Should Consider:

• Resident mobility
• Time spent in bed
• Mattress dimensions
• Support characteristics
• Bed articulation compatibility
• Cleaning requirements

One Mattress Is Not Suitable for Every Resident

Some residents may use a standard healthcare foam mattress, while others may require a more specialized pressure redistribution surface based on clinical assessment.

Facilities can also review compatible Air Mattress solutions for applications where additional pressure-management support is required.

4. What Is a Pressure Redistribution Mattress?

A pressure redistribution mattress is designed to manage how body weight is supported across the mattress surface.

Different Technologies May Include:

• Specialized foam structures
• Air-cell systems
• Alternating pressure systems
• Other therapeutic support surfaces

Mattress Technology Should Match Resident Needs

The most advanced mattress is not automatically necessary for every resident.

Clinical requirements, mobility, care environment, maintenance, and budget should all be considered.

5. Why Mattress Thickness Must Match the Nursing Home Bed

Facilities sometimes purchase a specialized mattress without checking how its thickness affects the complete bed system.

A Thicker Mattress Can Change:

• Final sleeping height
• Side rail relationship
• Transfer height
• Caregiver working position

Bed and Mattress Should Be Evaluated Together

Before changing mattress type, confirm that its dimensions and thickness remain compatible with the nursing bed and side rail configuration.

6. Bed Platform Articulation Must Work With the Mattress

An electric nursing home bed changes shape as the backrest and leg sections move.

The mattress needs to follow these movements appropriately.

Check Whether the Mattress:

• Flexes with the backrest
• Follows knee adjustment
• Remains correctly positioned
• Does not interfere with bed functions

Poor Compatibility Can Reduce Usability

A mattress designed for a flat bed may not necessarily perform appropriately on a highly adjustable platform.

7. Mattress Movement Should Be Controlled

If the mattress shifts when the bed articulates, resident positioning can become more difficult.

Check:

• Mattress retainers
• Platform dimensions
• Mattress fit
• Movement during backrest elevation

A Correct Fit Supports More Consistent Positioning

The mattress should not be significantly smaller or larger than the intended support platform.

8. Avoid Excessive Sliding When the Backrest Is Raised

Raising the backrest can cause some residents to move gradually toward the foot of the bed.

This May Be Influenced By:

• Backrest angle
• Leg position
• Mattress surface
• Bedding
• Resident mobility

Use the Complete Positioning System

Backrest and leg positioning may need to be adjusted together according to the resident's comfort and care plan rather than simply raising the backrest as high as possible.

9. Caregiver Access Influences Repositioning Quality

Even a suitable mattress cannot compensate for a room where caregivers cannot reach the resident properly.

Facilities Should Provide Appropriate Access For:

• Position changes
• Skin observation
• Bedding changes
• Personal care
• Transfers

Bed Placement Matters

Positioning the bed too close to walls or oversized furniture may make regular care activities more difficult.

10. Height Adjustment Can Support Caregiver Working Position

Repositioning and personal care may require caregivers to work beside the bed repeatedly throughout each shift.

Electric Height Adjustment Can Help During:

• Repositioning assistance
• Changing bedding
• Personal hygiene
• Skin observation

Return the Bed to the Appropriate Resident Position After Care

The best caregiver working height is not necessarily the correct resting or transfer height for the resident.

11. Skin Observation Should Be Part of the Care Routine

Equipment alone cannot identify early skin changes.

Residents who require pressure injury prevention measures may also need regular skin assessment according to facility protocols and professional guidance.

Care Teams May Pay Attention to Areas Exposed to Sustained Pressure

Any concerning skin changes should be handled according to the resident's clinical care process.

Early Recognition Matters

Facilities should train appropriate care staff to follow established observation and reporting procedures.

12. Moisture Management Is Also Important

Skin exposed to excessive moisture may require additional care attention.

Care Planning May Consider:

• Personal hygiene
• Continence management
• Breathable support surfaces
• Appropriate bedding
• Timely changing of wet materials

Mattress Covers Need Practical Cleaning Properties

For nursing home environments, mattress surfaces should be selected with both resident comfort and routine hygiene management in mind.

13. Bedding Should Not Create Additional Problems

Sheets and protective layers should be managed appropriately so they do not become excessively wrinkled or interfere with the intended mattress surface.

Check:

• Sheet fit
• Wrinkles
• Excessive layers
• Moisture
• Mattress cover condition

Do Not Alter Therapeutic Mattresses Without Guidance

Additional pads or covers can potentially change how a support surface performs, so facilities should follow the mattress manufacturer's recommendations.

14. Nutrition and Hydration Are Part of the Bigger Picture

Pressure injury prevention is not an equipment-only issue.

Residents with nutritional or hydration concerns may require appropriate professional assessment and support as part of their overall care plan.

Bed Purchasing Cannot Replace Clinical Care

A nursing home should avoid marketing or operational assumptions that a specialized bed or mattress alone can prevent all pressure injuries.

15. Mobility Should Be Encouraged According to the Resident's Abilities

Where appropriate within the resident's care plan, supporting mobility and activity can reduce the amount of uninterrupted time spent in one position.

This May Include:

• Independent position changes
• Supported sitting
• Transfers to a chair
• Rehabilitation activities

Activity Must Match the Individual

Mobility recommendations should be based on the resident's capabilities and professional care guidance.

16. Wheelchair Users Need Pressure Management Outside the Bed Too

A resident may spend several hours in bed and several more hours seated in a wheelchair.

A Complete Care Plan Should Therefore Consider:

• Bed support surface
• Wheelchair seating
• Transfer routine
• Position changes

Do Not Focus Only on Night-Time Bed Use

Pressure management should consider the resident's complete daily routine.

17. Air Mattresses Require Proper Setup and Monitoring

Powered air mattress systems may require additional operational attention compared with standard foam surfaces.

Facilities Should Understand:

• Correct setup
• Power requirements
• Air pump operation
• Hose connections
• Alarm functions where available
• Cleaning requirements

A Therapeutic Mattress Is Only Useful When It Is Operating Correctly

Care teams should follow the manufacturer's operating and maintenance instructions.

18. What Happens During a Power Failure?

Powered pressure-management mattresses may depend on an electrical pump.

Nursing Homes Should Know:

• How the mattress behaves without power
• Whether backup procedures are required
• How long therapeutic performance may be maintained
• What staff should do during an outage

Include Mattresses in Emergency Planning

Facilities should not prepare power-failure procedures for electric beds while forgetting other powered care equipment.

19. Maintenance Affects Mattress Performance

Support surfaces need regular inspection just like nursing home beds.

Check:

• Cover condition
• Foam condition
• Air cells where applicable
• Hoses
• Pumps
• Electrical cables

Damaged Support Surfaces Should Be Evaluated Promptly

Facilities should follow manufacturer guidance for repair, replacement, and continued use.

20. Standard Mattress Purchasing May Not Work for Every Resident

From a procurement perspective, purchasing one mattress model for every bed is simple.

From a care perspective, different residents may need different support surfaces.

A Practical Facility Strategy Can Use:

• A standard mattress for general residents
• A higher-specification pressure redistribution option
• Specialized support surfaces based on clinical assessment

Standardize Categories Instead of Forcing One Mattress on Everyone

This can balance purchasing efficiency with individualized care requirements.

21. Keep Pressure Management Equipment Available for Changing Needs

Resident conditions can change after admission.

Facilities May Need Flexibility To:

• Upgrade a mattress
• Reassign specialized equipment
• Change the bed configuration
• Increase caregiver support

Fleet Planning Helps Reduce Emergency Purchasing

Maintaining a practical mix of equipment can help facilities respond when resident needs increase.

22. Caregiver Training Is Just as Important as Equipment Selection

A high-quality bed and mattress will not produce their intended benefit if staff do not understand how to use them properly.

Training May Cover:

• Bed adjustment
• Resident positioning
• Mattress operation
• Alarm response
• Cleaning
• Equipment inspection
• Reporting problems

Keep Procedures Simple and Consistent

Standardized equipment can make training easier across multiple rooms or facilities.

23. Include Pressure Management in Bed Procurement Discussions

When requesting quotations for nursing home beds, buyers should discuss more than the bed frame itself.

Ask Suppliers About:

• Compatible mattress dimensions
• Recommended mattress thickness
• Air mattress compatibility
• Mattress retainers
• Bed articulation
• Side rail compatibility

The Bed and Mattress Should Be Specified Together

This reduces the risk of receiving a mattress that does not work well with the selected nursing bed.

Common Pressure Management Equipment Mistakes

• Assuming an air mattress prevents all pressure injuries
• Using one mattress type for every resident regardless of needs
• Ignoring repositioning requirements
• Using an incompatible mattress on an adjustable bed
• Choosing a mattress that changes side rail protection
• Ignoring wheelchair seating time
• Not checking powered mattress operation
• Failing to maintain mattress systems
• Relying on equipment instead of a complete care plan

Nursing Home Pressure Management Checklist

• Resident risk assessed by appropriate professionals
• Mobility reviewed
• Repositioning plan established where required
• Bed functions matched to care needs
• Mattress type selected appropriately
• Mattress dimensions confirmed
• Mattress thickness checked
• Side rail compatibility reviewed
• Caregiver access maintained
• Skin observation procedures followed
• Moisture management considered
• Powered mattress operation checked
• Maintenance procedures established
• Staff training completed

Pressure Injury Prevention Requires a Complete Care System

Nursing home beds and pressure redistribution mattresses can support resident positioning and pressure management, but they are only parts of a broader prevention strategy.

Effective long-term care requires individualized assessment, appropriate repositioning, suitable support surfaces, skin observation, moisture management, nutrition support where clinically indicated, caregiver training, and ongoing review.

For procurement teams, the most useful approach is to stop asking only “Which mattress should we buy?” and instead ask “What bed and support surface combination best supports our residents and our clinical care process?”

Expert Tip

When reviewing mattresses for a nursing home, classify residents into general support, increased pressure-management needs, and specialist clinical assessment groups. Then define suitable mattress categories for each group rather than purchasing one support surface for the entire facility.

If you are planning nursing home beds, mattresses, or long-term care equipment for a senior living facility or elderly care project, Contact Us to discuss compatible bed and mattress configurations.