Turning Schedule for Bed Sores at Home

Why changing position protects skin

When a person stays in one position, body weight presses skin and muscle against bone. Blood flow drops in that spot, and after long enough the tissue is damaged. That is how pressure injuries, also called bed sores, begin. A turning schedule for bed sores at home is a written plan for moving that pressure from place to place, day and night.

The areas most at risk lie over bone: the tailbone, hips, heels, ankles, shoulder blades and elbows.

Start with the plan from the treating clinician

You may have heard “turn every two hours.” That is a common starting point, not a rule for everyone. How often a person needs to move depends on their skin, their health, how much they can move on their own, and the mattress or cushion under them. The treating clinician sets the interval.

Ask these questions and write down the answers:

How often should the position change in bed, and how often in a chair?
Which positions should be avoided, such as lying on an existing wound?
What is the plan overnight?
How high may the head of the bed be raised?
Are there limits because of surgery, breathing, a feeding tube or pain?

Sitting concentrates weight on a smaller area, so people are usually asked to shift more often in a chair than in bed.

Build a schedule you can actually keep

Build the routine around the household you have.

Write the times and positions on one page (back, left side, right side, chair) and post it where everyone can see it.
Rotate through the positions in the same order so no one has to remember which side was last.
Tie turns to things that already happen, such as meals, medicines and toileting, and set a phone alarm for the gaps.
Decide who covers which hours, including weekends.
Have each helper initial the page after a turn and note anything seen on the skin.

Overnight, combine turns with other night care so sleep is broken fewer times. If the overnight plan is not possible in your home, tell the clinician instead of quietly skipping it.

Move in ways that are kind to skin

Dragging a person across the sheets rubs and stretches the skin. Lifting or rolling is gentler than sliding, and a folded sheet under the person helps two helpers move them together. Our guide to lifting and turning safely covers body mechanics for the helper.

Ask to be shown side-lying positions. A partial tilt supported by pillows is often taught instead of lying straight on the hip bone.
Place a pillow between the knees and ankles so bone does not rest on bone.
Ask how to keep the heels off the mattress. Heel pressure ulcers are common in people who spend long hours in bed.

Small shifts between full turns count, so encourage a person who can move a little to do so.

Check the skin at every turn

Each turn is a chance to look at the area that was just under pressure. Tell the treating clinician about a spot that stays red after the pressure is off. On darker skin, look for an area that appears darker, purple or shiny, or that feels warmer, firmer or softer than the skin around it.

Keep weight off that spot as much as you can and do not rub it. Regular skin checks for older adults can be part of primary care visits.

When the schedule is not working

Tell the clinician if turning causes strong pain, if the person resists being moved, if new red areas appear despite the routine, or if the helpers cannot keep it up. The clinician may look at the cushion or mattress, the timing of pain relief, or whether more help at home is needed.

Gateway arranges visits with partner clinicians across Greater St. Louis and the Metro East for pressure injury prevention and wound follow-up. You can request care or call 314-325-0126. If you are worn down, our guide on caregiver burnout may help.

What to report and when to call 911

Call the treating clinician about:

A discolored area that does not fade, a blister or an open area
An existing wound that looks larger or deeper
New drainage, odor or increasing pain
Skin that stays wet from sweat, urine or stool

Call 911 for an emergency, such as fever with confusion, trouble breathing, a person who is very hard to wake, or a fall with injury.

Common questions

Do we really have to wake someone at night to turn them?

It depends on the person’s risk, their skin and the surface they sleep on, which is why the overnight plan should come from the treating clinician. Some people need turns through the night. Others may be allowed longer stretches. Explain what your household can manage, and report any morning redness.

What should we do if we miss a turn?

Turn as soon as you notice, check the skin that was under pressure and note it on the chart. Do not make up for it by leaving the person longer on the other side. If turns are missed often, tell the treating clinician so the plan can be reviewed.

How do I keep a schedule going when I am the only caregiver?

Be honest with the care team about what one person can do, especially overnight. Ask whether the interval, the support surface or the positions can be adjusted, and whether home health or paid home care could cover part of the day. A plan one caregiver can sustain is safer than one that collapses.

Should the chart include time spent sitting up in a chair?

Yes. Chair time counts as a position. Write down when the person gets up, how long they sit, and when weight shifts happen. Ask the clinician how long each sitting period should last and whether the chair needs a cushion.

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

Building a turning schedule for bed sores at home.