Mattress Protectors for Incontinence

What a mattress protector does

A protector is a waterproof layer between the mattress and the bottom sheet. It stops urine, stool and fluids from reaching the mattress, protects against dust mites and allergens (some types), and makes the bed easier to keep hygienic. It is the second line of defence after an absorbent product on the body and an underpad on the bed; see underpads: disposable and washable options and pull-ups or briefs: choosing the right product.

Types of protectors

Fitted sheet-style protectors. A waterproof layer attached to a fitted sheet or fabric top, with elasticated corners or sides that pull over the mattress. Easy to put on, stays in place, can be washed and used like a sheet. Popular for home beds.

Encasement (zip-around) protectors. Wrap all the way around the mattress, sealed with a zip, protecting all sides. Useful when leakage is heavy or when infection control or bed bugs are concerns. More effort to fit, but very thorough.

Flat waterproof sheets. A rectangular sheet placed over the mattress, tucked in at the sides, sometimes with straps. Can slip and wrinkle, but cheap and versatile.

Quilted or absorbent protectors. Layers of fabric over a waterproof backing, providing some absorbency, like a large washable underpad.

Rubber or PVC sheets. Old-style plastic sheets, waterproof but non-breathable, hot, noisy and sticky; they trap heat and moisture and are not recommended directly against the skin or in the heat. If used, cover with a cotton sheet.

Disposable bed protectors and pads. Used for short-term situations.

Protectors for hospital beds and air mattresses. Special sizes and low-noise, breathable materials; see below.

What to look for

Waterproofing. The best protectors use a thin, flexible waterproof membrane, such as polyurethane, bonded to fabric. It should be truly waterproof, not merely water-resistant, and tested for leakage. Check the maker's description and reviews.

Breathability. Look for a protector that allows moisture vapour to pass, which reduces sweating and heat. Breathable membrane layers, cotton or bamboo tops, and avoiding vinyl all help. Breathability matters for skin health and comfort, particularly in hot climates; see summer heat and bedridden care.

Quiet and soft. Crackly protectors disturb sleep and can distress people with dementia or sensory sensitivity. Test the sound by rubbing.

Fit and size. Measure the mattress length, width and depth, and choose the right size: single, double, queen, king or hospital bed size. For thick mattresses, check the skirt depth. A loose protector wrinkles and bunches, which can cause pressure marks.

Fabric on top. A soft cotton or terry top feels comfortable. Terry can be warm; brushed cotton or bamboo blends are cooler.

Edge design. Elasticated skirts, deep pockets or straps help hold it in place.

Washability. Choose a protector that can be washed at least at 60 degrees Celsius, for hygiene, and that tolerates frequent washing without cracking, peeling or losing waterproofing. Check the label.

Durability. A quality protector lasts for months to years of regular use; cheap ones fail quickly.

Allergy and chemical safety. Choose materials free of strong odours. If your parent has sensitive skin or asthma, avoid heavily scented or treated products.

Safety and fire. Choose products sold with clear labels. If oxygen is used in the bedroom, follow fire rules; see safe use of oxygen and electrical equipment.

Price. Costs vary widely. A more expensive protector is not always better, but very cheap ones often fail. See an incontinence products budget: what a month costs.

Using a protector correctly

1. Fit it directly over the mattress, below the bottom sheet, smooth and taut. 2. Add a bottom sheet of breathable cotton over it, tucked in smoothly. Avoid wrinkles. 3. Place an underpad over the sheet, under the hips, as a first absorbent layer. 4. Use a spare protector so that one can be washed while the other is on the bed. 5. Check regularly for tears, cracks and leaks. 6. Check the mattress occasionally for damp patches by lifting the protector. 7. Replace when worn.

Do not rely on the protector alone: if a protector is wet, the underpad has failed and the skin may be sitting in moisture. Change promptly. See how to change an adult diaper in bed.

Skin, pressure and heat

• Non-breathable covers trap heat and moisture, which can macerate skin and raise the risk of pressure sores; see preventing bedsores at home and pressure ulcers: stages, wound care and prevention.
• Layers add up: protector plus sheet plus pad plus blanket. Keep the layers minimal, thin and smooth, especially on pressure-relieving mattresses.
• Sweating at night, damp skin or a rash under the person may signal that the protector is too hot or not breathable.
• Check the skin regularly; see incontinence-associated skin damage: prevention and care.
• Use breathable bed linen; see bed linen for sensitive older skin.

Air mattresses and hospital beds

Pressure-relieving mattresses, such as alternating pressure or foam types, need protectors that do not interfere with their action. A thick, stiff plastic cover can stop air cells or foam from conforming to the body.

• Use only protectors recommended by the mattress maker, or breathable, stretchy, thin covers designed for such mattresses.
• Avoid tight sheets over air mattresses. Allow stretch.
• Do not put plastic sheets over an air mattress.
• Check the noise and pump function.
• See air mattress for pressure sores, choosing an anti-bedsore mattress and nursing care bed for dementia.

For hospital beds, buy protectors in the right bed size, with a deep skirt, as hospital bed mattresses are narrower and often thicker; see hospital room at home: complete setup.

Washing and care

• Follow the care label.
• Wash regularly, weekly or after soiling, in hot water if allowed.
• Avoid fabric softener, bleach and strong chemicals, which damage the waterproof layer.
• Do not dry clean.
• Tumble dry on low if allowed, or air-dry. High heat can degrade the membrane. Do not iron.
• Dry fully before putting it back, especially in monsoon; see washable underpads: washing, drying and lifespan.
• Wipe clean with a damp cloth and mild soap between washes for small spills.
• Store dry and flat or loosely folded.

If the mattress is already soiled

• Act quickly: remove bedding, blot urine with absorbent cloth (do not rub), and use cold water and an enzyme cleaner or mild detergent solution sparingly.
• Do not soak the mattress; water goes deep and is hard to dry.
• Dry thoroughly in sun and airflow, standing the mattress on its side in a ventilated place, then replace the protector.
• Odour: sprinkle baking soda, leave for several hours and vacuum, or use an enzymatic cleaner.
• Mould or persistent odour: the mattress may need replacing. See pest, damp and mould at home.
• Consider replacement or a specialist mattress if heavy damage exists.

Practical considerations

• Number needed: at least two protectors for each bed.
• Budget: a good protector is cheaper than a new mattress.
• Buying: buy from reliable sellers and check returns.
• Chairs and wheelchairs: use cushion covers or seat protectors; see gel cushion for pressure relief.

When to ask a professional

Ask a nurse or occupational therapist for advice about protectors if your parent has a hospital bed, an air mattress or a pressure sore, or heavy leakage. Ask a doctor about sweating, rashes or skin damage. Seek urgent help for fever with confusion, blood in urine, deep or spreading sores or no urine for many hours; call 112 for emergencies.