Cushion Covers, Washing and Hygiene

Why cushion hygiene matters

• Skin health. Sweat, urine and bacteria trapped against skin can cause rashes, irritation and, for frail skin, breakdown; see incontinence-associated skin damage and pressure ulcers: stages, wound care and prevention.
• Infection. Some germs survive on soft surfaces, which matters after illness, diarrhoea or wounds, and when equipment is shared.
• Odour and dignity. A smelly cushion is embarrassing and can discourage a person from sitting in company.
• Allergy. Dust mites and mould in old cushions aggravate asthma and rhinitis; see pillow hygiene, dust mites and allergies.
• Longevity. A clean cushion lasts longer.

Types of cover

Cotton and cotton blend. Soft, breathable, washable. Good for general use and hot weather; absorbs moisture and takes longer to dry.

Polyester and microfibre. Quick-drying, durable and easy to wash. Can feel warmer.

Mesh and spacer fabric. Open weave gives airflow, helpful for long sitting and in heat; often used on gel and wheelchair cushions.

Two-way stretch fabric. Moves with the cushion and avoids bunching; common on medical cushions.

Waterproof or water-resistant covers. A polyurethane or vinyl layer that blocks liquid, protecting the foam from spills and incontinence. Choose breathable waterproof fabric if possible. Plain plastic or vinyl can cause sweating and skin problems.

Antimicrobial covers. Treated to resist bacteria and odour. Useful, but not a substitute for washing.

Flame-retardant covers. Required for some uses; check labels.

Sheepskin or fleece covers. Soft and cool in hot weather, warm in cold; need special washing.

Choosing a cover

• Fit. Snug, without wrinkles that press into the skin.
• Removable and washable with a zip that is easy to use, not sharp against the skin.
• Non-slip base to keep the cushion in place.
• Seams. Flat or covered seams, with no thick seams under the buttocks.
• Material. Breathable if the person sits long hours; waterproof inner layer only where needed.
• Colour. A darker colour hides stains but also hides skin marks; a light cover makes dirt visible, which is useful for carers.
• Spare. Keep at least two, so one is in use while the other is washed and dried.

Washing covers

1. Read the label. Follow the maker's instructions. 2. Remove the cover and shake out loose debris. 3. Pre-treat stains with cold water, not hot water, which sets protein stains such as blood and urine. 4. Wash at the temperature indicated, commonly 30 to 40 degrees Celsius for synthetic fabrics and up to 60 degrees for cotton. For soiling after illness, use the hottest setting the fabric allows, as advised by a nurse, or a disinfectant laundry product. 5. Use a mild detergent, without bleach or fabric softener on waterproof or medical covers, which can damage coatings. 6. Rinse well, because detergent residue irritates skin. 7. Dry fully. Line-dry in shade or tumble-dry on low if the label permits. Do not dry waterproof covers on high heat, which can crack the coating. Do not put a damp cover back on the cushion.

Wash covers every one to two weeks as routine, and immediately after any soiling.

Cleaning the cushion itself

Foam cushions. Do not machine wash. Spot clean with a cloth dampened with mild soap and water, then wipe with a clean damp cloth and let air-dry fully in a shaded, ventilated place. Never soak foam, because it holds water and grows mould inside. Never leave in direct sun, which degrades foam.

Gel and gel-foam cushions. Wipe the gel surface with a damp cloth and mild soap. Keep the base dry. Do not use sharp tools or harsh solvents.

Air cushions. Wipe the exterior. Check valves and inflation as per instructions. Dry thoroughly.

Memory foam. Spot clean only. Air regularly.

Disinfecting. For shared or soiled cushions, wipe with a suitable disinfectant wipe or a diluted solution recommended by a nurse, then rinse and dry. Not all products suit all materials; check labels.

Airing. Every week, take the cushion outdoors or to a ventilated spot in shade for an hour or two.

Incontinence and accidents

If a person may have accidents:

• Use a waterproof cushion cover or a washable waterproof protector over the cushion, with a breathable cover on top.
• Use washable underpads or disposable pads on the seat; see underpads guide and washable underpads care.
• Change pads and clothing promptly, and wash skin and dry it gently; see barrier creams and skin care.
• If urine soaks through to the foam, wash the cover, wipe the foam with a mild disinfectant, rinse with a damp cloth and dry thoroughly. If the foam stays damp or smells, replace the cushion.
• Keep a spare cushion for use while one dries.

See also managing incontinence at night and incontinence in older adults explained.

Humidity, mould and the monsoon

In humid or monsoon weather:

• Dry cushions often. Air them in a sunny but shaded, breezy place; avoid direct sun for foam, but strong airflow helps.
• Do not store damp cushions in a cupboard or plastic bag.
• Use silica gel sachets or a dehumidifier in closed cupboards.
• Check for mould: black or green spots, a musty smell and a damp feel. Wipe small areas with a cloth dampened in diluted white vinegar or a mild disinfectant; if it is widespread or inside the foam, discard the cushion.
• Do not use a mouldy cushion. Mould spores can trigger asthma and lung problems in older adults.
• Keep covers dry and replace damp ones.
• Sun covers on a line if material permits.

Sharing and second-hand cushions

Do not share cushions that touch skin between people, especially when one is ill. Do not buy second-hand cushions or mattresses for pressure care; hygiene and performance cannot be assured. If a cushion was used by someone with a skin infection, a wound or diarrhoea, discard it.

When to replace

Replace a cushion or cover if:

• the foam has flattened, crumbled or lost bounce;
• the gel has leaked or thinned;
• the cover is torn, stained beyond cleaning or smells after washing;
• there is mould or persistent dampness;
• the waterproof layer has cracked; or
• the person's skin shows pressure marks despite proper use.

Typical lifespans vary: a few months to a year for cheap foam, longer for gel and quality foam. Replace sooner with heavy use.

A simple care routine for carers

A short, regular routine is easier to keep than an occasional big clean. Each day, check the cover for dampness and the cushion for odour whenever your parent gets up, and let the seat air for a few minutes. Each week, take the cushion outside or to a ventilated spot for an hour, wipe the surface and check the seams and base for wear. Every one to two weeks, swap the cover for a clean one and wash the used cover. Each month, look closely at the foam or gel for flat spots, leaks or discolouration and press it to feel whether it still springs back. Keep a second cushion and cover set so that nothing has to be put back damp. If your parent is bedridden or spends long hours seated, write the checks on a card and tick them off, so that nothing is missed when different family members or attendants take turns. If you ever find a cushion that is stained through, smells strongly after washing or has any mould, retire it at once rather than hoping it will recover.

When to ask a professional

Ask a nurse or occupational therapist if your parent has recurring skin problems, incontinence, a pressure sore or sits for long periods. See a doctor for skin that is red, itchy, broken or smelly. Our care advisors can recommend cushions, covers and incontinence products and arrange a nurse visit.