When someone you love starts spending most of the day in a bed or a chair, pressure injuries — the sores families still call bed sores — become one of the quietest risks in the house. They start out looking like almost nothing: a patch of redness on a heel or a hip you might not notice on a busy morning. But skin under constant pressure loses its blood supply, and once it breaks down it can take months to heal — and nearly everything that prevents that happens at home.
The short version
- Pressure is the problem — skin squeezed between bone and a mattress loses blood flow, so the fix is moving that pressure around, often.
- Look before you assume — check bony areas daily. Redness that does not fade when pressed is an early warning sign.
- Moisture makes it worse — damp skin breaks down faster, so keeping things dry matters as much as turning.
- The surface counts, but is not enough — a pressure-redistribution mattress spreads weight, but HealthLink BC notes such surfaces "don't take the place of turning the person."
What a pressure injury actually is
A pressure injury is skin and tissue damage caused by staying in one position too long. As HealthLink BC explains it, "putting pressure on one spot for long periods of time decreases blood flow to that area. This damages or kills the cells and creates a sore." It happens fastest where bone sits close to the surface — which is why heels, tailbones and hips are usually first.
Two forces make it worse. Shear happens when someone slides down a bed with the head raised, so skin stays put while the bones keep moving. Friction happens when someone is dragged across a sheet instead of lifted or rolled.
In an early pressure injury the skin is not broken — it is simply red, and the redness does not blanch: it stays red when you press a fingertip on it and let go. On darker skin tones, feel for an area that is warmer, cooler, firmer or more painful than the skin around it.
Who is most at risk
Risk rises sharply when someone cannot easily shift their own weight: after surgery or a stroke, with advanced dementia, using a wheelchair full-time, or in palliative care at home. Poor nutrition, dehydration, thin skin and incontinence add to it. If a parent has just come home from hospital, ask the nurse one question — is this person at risk, and how often should we reposition?
Move the pressure — on a schedule, not a guess
Repositioning is the single most effective thing a family caregiver does. HealthLink BC's caregiving guidance suggests changing position roughly every two hours in bed and every fifteen minutes in a wheelchair, though your nurse or occupational therapist may set a different rhythm.
- Write the schedule down. A sheet on the fridge or a repeating phone alarm beats memory when several people are helping.
- Side, back, other side. Rotating spreads the load instead of trading one sore spot for another.
- Float the heels. A pillow lengthwise under the calves lifts them clear of the mattress entirely.
- Use pillows as spacers between knees and ankles so bone is not pressing on bone in side-lying.
- Roll, do not drag. Two people and a draw sheet are kinder to skin than one person pulling under the arms.
An adjustable bed makes this easier: raising it to your own hip height saves bending over a low mattress forty times a week, and the head and knee angles give you more positions to use.
Check the skin every single day
Build the check into something that already happens — washing, changing, getting dressed — so it is not one more task. Work down the body where bone sits close to the surface.
Lying down
Back of the head, ears, shoulders, elbows, lower back and tailbone, hips, inner knees, heels.
Sitting
Tailbone and sitting bones, shoulder blades, and the backs of arms and legs against the chair.
Easy to forget
Under oxygen tubing, catheter lines, braces and splints — and anywhere a wrinkled sheet presses in.
Do not rub or massage a reddened area — it can damage the tissue underneath. And skip ring or doughnut-shaped cushions: HealthLink BC warns that "doughnut-type devices, may actually cause pressure injuries."
Keep skin clean, dry and well fed
Moisture softens skin and makes it far easier to damage, so incontinence and heavy sweating are genuine risk factors, not just a laundry problem. Wash with gentle soap and warm — not hot — water, and pat dry rather than rubbing. HealthLink BC advises against moisturizer in creases and folds such as the groin, since "more moisture can lead to rashes and infections"; a barrier cream is better there. A bed pad under the hips catches most of what would otherwise sit against skin all night, and is quicker to change at 3 a.m. than a full set of sheets. Nutrition matters too — HealthLink BC recommends "a healthy diet, with lots of protein and fruits and vegetables," plus water.
The surface underneath
Every mattress is a support surface, but an ordinary one concentrates weight on whatever sticks out. A pressure-redistribution mattress lets the body sink in slightly so the load spreads wider.
| Option | How it helps | Best for |
|---|---|---|
| Standard household mattress | No redistribution built in; relies entirely on repositioning | Someone still moving well on their own |
| Foam overlay on an existing bed | Adds a softening layer, but the mattress underneath still sets the shape | Short-term recovery, lower risk |
| Pressure-redistribution foam mattress RECOMMENDED | Layered foam spreads load, reduces shear and offloads heels by design | Anyone at real risk who is in bed most of the day |
| Powered alternating-pressure mattress | Air cells inflate and deflate in cycles to shift pressure points | Higher-risk situations, on a clinician's recommendation |
If the person also spends hours in a wheelchair, the chair deserves the same thought. And if this is a six-week recovery rather than a permanent change, renting may beat buying — see what it costs to rent a hospital bed in BC, and how to choose a hospital bed for home for sizing, side rails and room clearance.
What we carry for pressure care
Gravity 9 Pressure Relief Mattress
A full top layer of visco-elastic memory foam plus a sloped, channel-cut heel section that offloads the heels. 450 lb capacity, latex-free, removable fluid-resistant cover.
Drive Full Electric Low-Height Bed
Head, foot and height all adjust from a hand pendant, so you can raise the bed to your own working height for turning. 350 lb capacity, manual emergency crank.
Washable Incontinence Bed Pads
A soft, breathable top layer over a water-resistant backing keeps moisture off skin and mattress. Machine washable, in 18"×18", 24"×30" and 30"×60".
Folding Tilt-In-Space Wheelchair
45° of tilt-in-space shifts weight off the sitting bones without a transfer. Adjustable width, depth and back height; cushion and footrests ordered separately.
All of it can be bought or rented, and 0% financing is available. Our own team delivers and sets up across Metro Vancouver and the Fraser Valley.
Your quick checklist
- Ask the care team whether this person is at risk and how often to reposition
- Post a turning schedule where everyone helping can see it
- Float the heels off the mattress with a pillow under the calves
- Check bony areas daily for redness that does not fade when pressed
- Keep skin clean and dry, and change a damp bed pad right away
- Call the nurse about any skin that breaks, weeps or smells
Common questions
How quickly can a bed sore form?
Faster than most families expect — skin under constant pressure can begin to show damage within hours, especially on heels and the tailbone, and especially if it is damp or fragile.
Do I really have to turn someone every two hours overnight?
HealthLink BC points to roughly every two hours as a general rule, but the right interval is a clinical judgement. Ask the nurse or occupational therapist involved in their care: some people need more frequent changes, some can safely go longer on a good support surface.
What should make me call someone right away?
Any break in the skin should be reported to the person's nurse or doctor. Seek care promptly for signs of infection — redness or warmth around a sore, red streaks leading away from it, a foul odour, drainage, or a fever.
Is a therapeutic mattress covered in BC?
It depends on the plan. Some extended health plans and programs may contribute toward pressure-relief equipment when a care provider recommends it, but eligibility varies and nothing is automatic — check with your insurer before you buy. We can provide receipts and documentation for a claim, and our guide to what MSP does and does not cover explains the wider picture.
Not sure what your setup is missing?
Tell us the situation — who you are caring for and what room you are working with — and we will tell you honestly what would help. Visit the showroom at 12987 80 Ave, Surrey, or call or text us anytime.
Call 604-240-2450 See pressure relief mattressesThis article is general information, not medical advice. Follow the guidance of your doctor, nurse or occupational therapist for your specific situation.
