Pressure Relief Cushions and Mattresses at Home

What a support surface does

Pressure relief cushions and mattresses are called support surfaces. They spread body weight over a larger area so that no single spot, such as the tailbone or a heel, carries too much for too long.

A support surface is one part of preventing and caring for pressure injuries. It works together with position changes, skin checks, nutrition and moisture care. No surface removes pressure completely, so it does not replace a repositioning schedule.

The main types, in plain terms

The treating clinician decides which surface fits a person’s skin, weight, mobility and wounds. The general categories are:

Foam mattresses and overlays. Dense, shaped foam that lets the body sink in slightly.
Gel or air-cell overlays and cushions. Sections filled with gel or air that shift as the person moves.
Alternating pressure mattresses. Powered air cells that inflate and deflate in turn, so pressure moves from area to area.
Low air loss mattresses. Powered surfaces that pass a gentle flow of air under the cover to help with heat and moisture.
Wheelchair and chair cushions. Foam, gel, air or a mix, sized to the person and the chair.

An overlay sits on top of an existing mattress. A replacement mattress takes its place. Ring or donut cushions are generally not recommended, so ask the clinician before buying one.

Questions to ask the treating clinician

Which type do you recommend, and what is it meant to do for me?
Does this change how often I need to turn or shift?
How should the heels be protected on this surface?
How many sheets and pads can go on top? Extra layers can cancel out part of the benefit.
How do I check that I am not sinking through to the firm base underneath?
What should I watch for on my skin, and how soon will you recheck it?

Questions to ask the supplier or your plan

Support surfaces are usually ordered by a clinician and delivered by a medical equipment supplier. Coverage depends on the plan, the type of surface and the documented need, so ask before delivery.

Is this item rented or purchased?
What paperwork is needed from the clinician?
Who delivers it, sets it up and shows us how to use it?
What is the weight limit, and what size bed or chair does it fit?
Whom do we call if it alarms, leaks or stops working, including after hours?
How is it cleaned and returned?

Gateway can help with wound supply and equipment coordination so the order, the supplier and the care team stay in step. Our guide to insurance and cost questions lists more to ask your plan.

Daily checks that keep a surface working

A surface only helps when it is set up correctly. Check each day:

Powered mattress: the pump is plugged in and running, hoses are not kinked, and the settings match what you were shown.
Air cushion: it is inflated as instructed and has not gone soft.
Cushion direction: the front, back and top are where they belong, especially after someone else has moved the chair.
Cover: it is intact, clean and dry.
Layers: only the linens you were told to use are on top.
Sharp objects, pins and pet claws are kept away from air-filled surfaces.

Foam wears out. If a mattress or cushion stays flattened or has a hollow where the body rests, tell the supplier and the clinician.

Safety when a mattress or cushion changes

A thicker mattress raises the sleeping height and can leave less rail above it. A softer edge makes sitting on the side of the bed less steady, and a thicker cushion changes how transfers feel.

Ask the clinician or therapist to look at transfers and fall risk and mobility after any change, and ask the supplier about gaps between the mattress and rails.

Signs the surface is not doing its job

Tell the treating clinician about:

New redness or discoloration that does not fade, or a wound that is getting worse
Feeling the hard base through the mattress or cushion
Sliding down or leaning to one side
More pain, sweating or damp skin on the surface

Call 911 for an emergency, such as fever with confusion, trouble breathing, or a fall with injury.

Gateway arranges visits with partner clinicians in Greater St. Louis and the Metro East for pressure injury prevention and wound follow-up. To ask about a visit, request care or call 314-325-0126.

Common questions

Do we still need pillows with a pressure relief mattress?

Often, yes. Pillows and positioning wedges keep knees and ankles apart, support a side-lying tilt and help lift the heels, which a mattress alone may not protect. Ask the clinician where supports should go on your surface, since poor placement can create new pressure points.

Will an egg crate foam topper be enough?

A thin, wavy foam topper can make a bed more comfortable, but it is generally not considered enough protection for a person at high risk or with an existing pressure injury. If a topper is what you have now, tell the clinician and ask whether a different surface is recommended.

What happens to an air mattress if the power goes out?

Ask the supplier before you need to know. Powered mattresses differ in how long they hold air and whether they have a setting for outages. Keep the supplier’s phone number and instructions near the bed. During an outage, check the surface often, and call the supplier and the care team if it is going flat.

How do I know when a wheelchair cushion needs replacing?

Look at it and feel it regularly. Foam that stays compressed, gel that has shifted or hardened, an air cushion that will not hold its fill, or a torn cover are all reasons to call the supplier. New redness on the sitting area is another.

General information to help you talk with your own clinician. It is not medical advice, and the treating clinician makes every clinical decision. For a medical emergency, call 911.

Updated October 2026

Pressure relief cushions and mattresses: questions to ask.