Q: We have many different types of beds at our facility for residents with potential skin breakdown or with actual breakdown. Can you tell me the difference between reactive and active support surfaces?

A: The National Pressure Ulcer Advisory Panel (NPUAP) says a reactive support surface is a powered or non-powered support surface that has the ability to change its load distribution properties ONLY in response to an applied load. An active support surface also is a powered support surface, but is able to change its load distribution properties with or without an applied load.

Here’s an example of the types of devices that fit these categories:

Reactive devices: Very few adjustments, if any, are needed. They work by adjusting themselves to a resident’s movement. Foam mattresses, cushions, non-moving air mattresses, overlays, heel cushions, water-filled and sheepskin items fit this category.

Active devices: Require adjustments to modify itself to the patient/resident, are powered, have programmed therapeutic response to the resident. This category includes alternating pressure mattresses, cushions and overlays with pulsing and vibrating surfaces, and other support cushions and surfaces with powered functions.

A word of caution about some of the non-electrical surfaces: They don’t last forever, as some may think. Note, too, that the egg crate-type cushions cannot be washed because that removes the fire protection.

If you have an incontinent resident, definitely spend the money and get a washable pad.

Do your homework and get a check-off sheet of wants and needs. You will have many choices, but remember: You are getting these for the residents’ needs — not someone else’s.

Please send your resident care-related questions to Sherrie Dornberger at [email protected].