Preventing bed sores at home comes down to a short routine a caregiver repeats every day: change the person's position at least every two hours, check their skin from head to toe, keep it clean and dry, help them eat and drink well, and give them a pressure-reducing surface to lie and sit on. Bed sores (pressure sores) can form within hours, so the routine matters more than any single product. Down-Under Wool has supplied caregivers with wool pressure care and medical sheepskin since 1988; this page turns Mayo Clinic, NHS and MedlinePlus advice into a checklist you can print.
Why does a daily routine prevent bed sores?
A daily routine prevents bed sores because they are caused by things that happen every day: pressure, friction and moisture on the same patch of skin. Mayo Clinic describes bedsores as injuries to the skin and the tissue below it from pressure on the skin for a long time, and names three main causes:
- Pressure that cuts off blood flow, usually over bones with little padding: the tailbone, hips, heels, spine, shoulder blades and elbows.
- Friction when skin rubs on clothing or bedding, which does more harm when the skin is moist.
- Shear, when the body slides one way and the skin stays put, for example when someone slips down a bed with the head raised.
The people most at risk are those who can't change position on their own, have lost feeling, are incontinent, eat or drink poorly, have diabetes or poor circulation, or are over 70. For the bigger picture, including the stages, see our guide to bedsore prevention.
Daily bed sore prevention checklist
Print this checklist, or copy it into a notebook, and tick each line as you go.
| When | Task | What to do or look for | Done |
|---|---|---|---|
| At least every 2 hours, day and night, in bed | Change position | Back, then one side, then the other. Lift, don't drag. Write the time in the turning log. | ☐ |
| Every 15 to 20 minutes when sitting | Shift weight | Lean forward, then left, then right, or do a seated push-up if able. | ☐ |
| Once a day (the morning wash is a good time) | Head-to-toe skin check | Tailbone, hips, heels, ankles, elbows, shoulder blades, back of the head. Look for discolored patches that don't fade when pressed, or skin that is warm, spongy or hard. | ☐ |
| After every episode of incontinence or heavy sweating | Clean and dry the skin | Gentle cleanser, soft cloth, pat dry. Barrier cream if the nurse recommends it. Change wet pads and linen. | ☐ |
| Each time you straighten the bed | Check the bed surface | Sheets dry, smooth and wrinkle-free; no buttons, zips or thick seams pressing on the skin; wool pad or sheepskin in place under the body. | ☐ |
| Each repositioning | Heels and elbows | Heels lifted off the mattress with a pillow under the calves, not the knees; heel and elbow protectors on and straps not too tight. | ☐ |
| Meals and between meals | Food and fluids | Enough calories and protein; water offered through the day. | ☐ |
| Weekly, or when it smells | Care for wool bedding | Shake and air the pad; wash in a sheepskin wash and dry slowly. | ☐ |
Repositioning: the basics
A bedridden person is usually repositioned at least every two hours, day and night, unless their nurse sets a different schedule; current guidelines ask for a schedule set for the person and the mattress they lie on. Roll rather than drag, use a 30-degree side tilt, keep the head of the bed at 30 degrees or lower and float the heels. Our guide on how often to turn a bedridden patient has the full guidance, step-by-step turning and a printable 24-hour schedule.
How do you check skin for early signs of a bed sore?
Check the skin by looking at and gently touching every bony area once a day, in good light. For someone in bed, Mayo Clinic lists the back or sides of the head, the shoulder blades, the hips, lower back and tailbone, and the heels, ankles and the skin behind the knees. Our page on pressure points for pressure sores shows where they are.
According to the NHS, early signs of a pressure ulcer are:
- discolored patches that don't change color when pressed: red on white skin, purple or blue on black or brown skin;
- a patch of skin that feels warm, spongy or hard;
- pain or itching in that area.
If you see a warning sign, take pressure off the area straight away and keep it off. Mayo Clinic advises contacting a healthcare professional if the area doesn't improve in 24 to 48 hours. Don't massage or rub the area either; the UK's NICE pressure ulcer guideline advises against skin massage to prevent pressure ulcers. If the skin is broken, don't try to treat it yourself: ask a nurse or doctor.
Does hygiene and moisture control prevent bed sores?
Yes, keeping the skin clean and dry is one of the main ways to prevent bed sores, because skin that stays damp from urine, stool or sweat breaks down more easily under friction. Mayo Clinic's skin care advice is to wash with a gentle cleanser and pat dry, use moisture barrier creams to protect the skin from urine and stool, change bedding and clothing as often as needed, and watch for buttons and wrinkles that irritate the skin. MedlinePlus adds: clean the area right away after urine or a bowel movement, dry it well, use a soft sponge or cloth rather than scrubbing, and put pads under the bottom to absorb wetness.
What the person lies on matters too. Wool absorbs moisture well: dense wool pads such as our Pressure Smart XD1900 Cushion-It can absorb up to a third of their own weight in moisture without feeling wet, so the skin next to them stays drier than on a synthetic cover. If incontinence is part of the picture, read bed sore prevention in incontinent patients and see our urine-resistant incontinence bedding.
What should a bedridden person eat to prevent bed sores?
A bedridden person needs enough calories, protein and fluids every day to keep the skin strong. Mayo Clinic says people need enough fluids, calories, protein, vitamins and minerals every day to maintain healthy skin, and MedlinePlus advises eating enough calories and protein and drinking plenty of water. The NHS also lists a healthy, balanced diet and not smoking among the ways to prevent pressure ulcers.
Offer small meals and snacks if appetite is low, keep a drink within reach, and tell the doctor if the person is losing weight or eating very little; ask before starting any supplements.
Which support surfaces help prevent bed sores at home?
A surface that spreads pressure, keeps the skin dry and lets it glide instead of drag helps most. Mayo Clinic recommends cushions or a special mattress that relieves pressure, and the NHS mentions specially designed mattresses and cushions. A wool layer under the body is one of the simplest options for home: in a 2004 randomized trial of 441 patients at a Melbourne teaching hospital, 9.6% of patients given an Australian Medical Sheepskin developed a new pressure ulcer, compared with 16.6% of those given standard care.
Wool works best when the skin lies directly on it, day and night. Options for the bed:
- Medical sheepskin: the Australian Medical Sheepskin (M102C) is 24" x 36" with a dense 30 mm wool pile, large enough to cover the shoulders to below the buttocks. It is urine resistant, can be washed hot, and is warranted for at least 50 washes in Woolskin. Our page on how to use sheepskin for bed sores shows where to place it.
- Machine-wash-and-dry wool pads: the Pressure Smart XD1900 Overlay (26" x 40", 1,900 grams of Merino wool per square meter) or, for head-to-toe cover, the 30" x 60" Superior Overlay XD.
- Whole-mattress cover: the Hospital Bed Nursing Fleece (35" x 80") fits a standard hospital bed.
Comparing toppers? See the best mattress topper for bed sores. Our bedsore prevention packages combine a sheepskin or wool overlay, a foot pad and Woolskin; the full range is in our bed sore prevention products store.
Protecting heels and elbows
Heels and elbows have almost no padding, so they need their own check at every turn. Float the heels with a pillow under the calves, and add a wool layer where the feet rest: the Pressure Care Assistant (M103XD) is a 12" x 26" wool pad that straps across the foot of the bed and still lets the feet move. A medical sheepskin heel pad cups one heel with a hook-and-loop strap, and XD1900 elbow protectors come in pairs. For a side-by-side comparison, read heel protectors for bed sores.
How do you prevent bed sores when the person sits in a chair?
Someone who sits for long periods should shift their weight every 15 to 20 minutes and sit on a cushion that fits the chair. MedlinePlus advises leaning forward, then left and right, every 15 to 20 minutes, and using a foam or gel cushion that fits the wheelchair. Mayo Clinic suggests "wheelchair push-ups" (raising the body off the seat with the arms) for those strong enough, and a tilting wheelchair for those who aren't.
In a chair, the tailbone, buttocks, shoulder blades and the backs of the arms and legs take the pressure. A wool pad on the seat keeps the skin drier than a plastic or foam cover alone. More detail is in our guides to wheelchair pressure sore prevention and medical sheepskin for recliner chairs.
When should you call a nurse or doctor?
Call a nurse or doctor if a red or discolored area hasn't improved 24 to 48 hours after you took the pressure off it, or straight away if you see signs of infection. Mayo Clinic and the NHS list these urgent signs:
- fever or a high temperature;
- pus or drainage from a sore, or a sore that smells bad;
- skin around a sore that is hot, swollen or red;
- severe or worsening pain.
The NHS also suggests asking a GP for a pressure ulcer risk assessment for anyone cared for at home, so a care team can plan prevention with you. Any wound care belongs to that team.
Bed sore prevention at home FAQs
How often should a bedridden patient be turned?
At least every two hours, day and night (Mayo Clinic); MedlinePlus says every one to two hours. If a nurse has set a schedule, follow theirs. See our guide on turning a bedridden patient for a printable schedule.
Can bed sores be prevented?
Yes, many bed sores can be prevented with regular position changes, daily skin checks, clean and dry skin, good nutrition and a pressure-reducing surface. Because they can appear within a few hours (NHS), report early signs promptly. The best single step is taking the pressure off: the rest of the checklist works alongside movement, not instead of it.
How do you prevent bed sores on the heels?
Keep the heels off the mattress with a pillow under the calves (not under the knees), check them at every turn, and use a heel protector or a wool pad at the foot of the bed. Our heel protector guide compares the options.
How do you prevent bed sores on the buttocks?
Turn the person off their back regularly, keep the head of the bed at 30 degrees or lower, clean and dry the skin quickly after incontinence, and have them lie directly on a medical sheepskin or wool pad.
What is the best mattress to prevent bed sores?
A pressure-relieving mattress or overlay chosen with the care team; for very high risk, a nurse may recommend a specialist mattress. At home, a medical sheepskin or dense wool overlay on the existing mattress is a simple addition.
Should you use a doughnut cushion for bed sores?
No. Mayo Clinic and MedlinePlus both advise against doughnut-shaped cushions, because they concentrate pressure on the ring of tissue around the hole.
The short version
Turn at least every two hours, shift weight every 15 to 20 minutes in a chair, check the skin once a day, keep it clean and dry, keep food and drinks coming, and give the body a soft, dry surface such as a medical sheepskin. Use the checklist and the turning log above, and call a nurse or doctor at the first sign that a red area isn't fading. Questions about which product suits your situation? Contact us; we've been helping caregivers since 1988.
