Mattresses:

How to Match Mattress Types to Different Patient Needs

Sponsored by: Mason Medical

• By Joseph Duffy
• Jul 01, 2010

The type of sleeping surface people use can affect every aspect of their life, including rest, pain and skin integrity. The scope of the importance of using a proper sleep surface (most typically a mattress) becomes obvious once you consider that Americans spend an average one-third of their lives lying down. When addressing patients who are on a bed even longer, the effect of sleep surfaces on overall health and wellbeing becomes even more profound.

Therefore, it is integral to patients’ qualify of life to best mach mattress type to their different needs.

“The ramifications of using a mattress that is not meeting patient needs can be extensive,” says David Hartley, CEO, Home Health Depot & Adaptive Mobility. “Patients can stop using their hospital beds, the mattress can cause pain (not reduce it) and patients can develop pressure ulcers.”

Hartley points out that patients with a history of skin breakdown or neuromuscular patients who have decreased sensation and/or are unable to reposition themselves need to pay particular attention to the type of mattress they use.

“The foremost concern of matching mattress type to different patient needs is to prevent pressure sores,” says Hartley. The constant pressure that mobility patients endure by being in bed and not able to reposition themselves, combined with factors such as moisture and shear force, can result in a pressure sores. Serious, stage four and unstageable pressure wounds can exacerbate to the point of requiring surgery in order to repair, which can entail lengthy post-surgery bed rest. That, of course, can impact the mobility patient’s therapy and daily living.

Understanding patients’ needs

To provide the best mattress to meet patients’ needs, providers must understand the common patient ailments and what is available to help alleviate those problems. According to Hartley, here are common patient problems and what you can do:

• History of skin breakdown — A dry pressure mattress, gel overlay or Alternating Pressure or Low Air Loss (APP/LAL) mattress will prevent pressure sores much more effectively than innerspring mattresses.
• Complete/partial lack of sensation (Patients are at particular risk since they can’t feel the need to reposition) — Group II mattress category is best (Hartley prefers LAL for this patient group).
• Incontinence — LAL mattresses are designed to wick away moisture from the skin.
• Respiratory problems such as fl uid buildup — Group II mattresses are available with lateral turn features to prevent fl uid buildup.
• Chronic Pain — Group I or II mattresses, particularly a dry pressure foam (Group I) or APP/LAL (Group II), are much more supportive and comfortable than standard innerspring mattresses.

Also, two very important indications that a patient’s current mattress is not meeting his or her needs are the complaint of back pain that wasn’t present before the current mattress and the redness of skin in contact with the mattress, says Hartley. When matching mattress to patient needs, Hartley says, “First, ask for a history of mattresses used in the past. From there, having a clear understanding of the qualifications (certifying statement) for Group I support surfaces is critical. We find that many patients that meet criteria for a hospital bed also meet the criteria for a Group 1 mattress. Anytime we can keep a patient off of a standard innerspring, we feel like we’ve won. Group II mattresses are an entirely different animal — many referral sources and patients request these but few actually qualify. Memorizing the LCD’s for both groups is the key to success.”

Finally, Hartley offers the following advice for providers to make sure patients have a comfortable, rewarding experience: “I would only buy mattresses from reputable manufacturers who actually makes their own equipment. We use the ‘grandma test’ — feel it, lie on it. If you wouldn’t supply that mattress to your own grandmother, it’s probably not good enough for your patients. Also, don’t try to save a few pennies by buying the lowest cost Group II mattress you can find. Make sure the pump and mattress are the highest quality you can buy. This equipment gets used every day and must last five years. One or two service calls (most of which are emergency calls) will eat up any savings you may have thought you negotiated. Lastly, one of the challenges for Group I business is the requirement that the certifying statement be complete before dispensing. This is particularly difficult on short-notice discharge orders. You really need to educate the referral sources.”

This article originally appeared in the July 2010 issue of HME Business.