If someone in your care is spending most of the day in bed, a sheepskin rug can add real comfort and help protect the skin. But the details matter: where it goes, whether it sits under or over the sheet, and how you keep it clean.
This guide covers the practical questions carers ask most. It focuses on comfort and skin protection, not on replacing the clinical pressure management your healthcare team has in place.
In this article
- Under the Sheet or on Top? What the Difference Means for Skin
- Where to Place the Rug on the Bed
- Daily Care: Skin Checks, Rotation, and Washing
Under the Sheet or on Top? What the Difference Means for Skin
Why direct wool contact matters for pressure care
The main benefit of a medical sheepskin rug is what the wool fibres do in direct contact with skin. The dense pile, typically 25 to 30 mm of wool, distributes body weight across a larger surface area and reduces the pressure at any single point. It also wicks moisture away from the skin, which is important for anyone lying still for long periods.
For those benefits to work, the wool needs to touch the skin. Placing the rug directly under the person (with nothing between them and the wool) gives the full pressure-relieving effect. A 2004 randomised controlled trial published in the Medical Journal of Australia found that hospital inpatients using the Australian Medical Sheepskin had a pressure ulcer incidence of 9.6%, compared to 16.6% in the control group. That study tested the rug in direct contact with skin, not under a sheet.
When a sheet over the rug makes sense
There are practical reasons you might lay a light cotton sheet over the rug. If the person has very sensitive or fragile skin, a thin barrier can reduce friction during repositioning. If continence is a concern, a washable draw sheet over the rug makes clean-up faster and protects the sheepskin from repeated soiling.
If you do use a sheet, keep it as light and smooth as possible. A heavy or bunched sheet reduces the pressure-relief benefit. Re-tuck it after each repositioning so it lies flat.
Where to Place the Rug on the Bed
Full-length coverage for all-day bed rest
A full-length rug (typically 90 to 105 cm long) covers the middle third of the bed: from the lower back to below the knees. This protects the sacrum, hips, and thighs, which carry most of the body's weight when lying flat or semi-reclined.
For someone spending most of the day in bed, full-length coverage is usually the best starting point.
Targeted placement: heels, sacrum, and shoulders
If the person already has an alternating-pressure or foam overlay on the mattress, you may want to target the rug to the highest-risk zones rather than doubling up everywhere. The three most vulnerable spots for pressure injury in a bedridden person are:
- Heels and ankles (especially when lying on their back)
- The sacrum and tailbone
- Shoulders and shoulder blades
A smaller pad or the same rug folded can be placed specifically under the heels. Some carers use a second smaller rug under the shoulders and a full-length rug across the sacral area.
Using a sheepskin rug alongside an alternating-pressure mattress
Alternating-pressure mattresses work by cycling air between cells to relieve pressure at regular intervals. A sheepskin rug placed on top of an alternating-pressure mattress will reduce its effectiveness because the wool compresses the cells and slows the airflow cycle.
If your healthcare team has prescribed an alternating-pressure mattress, check with them before adding a sheepskin rug on top. In some cases, targeted placement under just the heels or shoulders is a better approach. If the mattress is a standard foam pressure-relief mattress rather than an alternating-pressure system, a sheepskin rug on top is generally compatible.
Sheepskin rug vs sheepskin mattress topper for someone who is bedridden
| Feature | Sheepskin rug | Sheepskin mattress topper |
|---|---|---|
| Coverage | Targeted or mid-bed | Full bed surface |
| Repositioning | Easy to move with the person | Fixed to mattress |
| Wool pile | 25 to 30 mm (medical grade) | Varies; medical grade also available |
| Washing | Remove and wash independently | Requires full bed change to remove |
| Best suited to | Targeted pressure zones, transfers, chair use too | All-over comfort, full-time bed use |
For someone who is fully bedridden, a sheepskin mattress topper covering the whole bed may offer more consistent protection. A rug is often easier to manage day-to-day, however. You can move it when repositioning the person, take it away for washing without stripping the whole bed, and use it in a chair or recliner during the day as well.
Daily Care: Skin Checks, Rotation, and Washing
The daily skin check routine
A sheepskin rug supports the skin. It does not replace the need to check it regularly.
Each time you reposition the person (typically every two to four hours), take a moment to check the bony pressure points: heels, ankles, sacrum, hips, shoulders and elbows. Look for any redness that does not fade within 20 to 30 minutes of relieving the pressure. That sustained redness is an early sign of a pressure injury and needs attention from a nurse or GP.
If the person is at high risk of pressure injury, your healthcare team will have a repositioning and monitoring plan in place. Work within that plan rather than substituting the rug for clinical assessment.
Rotating and airing the rug
Wool can flatten with continuous use. Rotating the rug end-for-end every few days distributes wear more evenly and helps the pile recover its loft. If you have two rugs, rotate them on alternate days so one always has time to air out.
Whenever the rug comes out from under the person for repositioning, give it a gentle shake and smooth it flat before placing it back.
Washing a medical sheepskin rug
Medical grade sheepskins meeting the Australian Standard AS4480.1 are designed to wash at up to 80 degrees Celsius, which is important for infection control. For home use, washing at 60 degrees with a wool-safe detergent is generally adequate. Check the care label on your specific rug for the manufacturer's instructions.
Wash promptly after any soiling. For routine hygiene, washing every one to two weeks is a reasonable guide. Air dry in the shade: direct sunlight can dry out and crack the leather backing. Give the wool a gentle brush while still slightly damp to restore the pile.
When a sheepskin rug is not enough
A sheepskin rug is a supportive comfort aid. It is not a clinical pressure injury management device on its own. It works well for someone at low to moderate risk who has good skin integrity and is repositioned regularly.
For anyone who already has a grade 2 or higher pressure injury, or who is at high risk and cannot be repositioned frequently, a sheepskin rug should sit alongside a prescribed clinical intervention: a proper pressure-relieving mattress, regular wound care, and input from a nurse, GP, or wound specialist.
If you are unsure about the right level of pressure care for your situation, Wounds Australia's resources for carers and clinicians are a good starting point. Your GP or a community nurse can also provide a pressure injury risk assessment.
Key takeaways
- Direct skin contact gives the best pressure-relief benefit. Use a sheet over the rug only when there is a clear reason to do so, and keep it light and flat.
- Target the rug to the highest-risk zones (heels, sacrum, shoulders) if a clinical pressure mattress is already in use.
- A sheepskin rug is easier to manage day-to-day than a full mattress topper: you can move it during repositioning and wash it without stripping the bed.
- Check the skin at every repositioning. Redness that does not fade is a sign to seek clinical help.
- Wash medical-grade rugs regularly (every one to two weeks, or after soiling) and air dry in the shade.
- If pressure injury risk is high or a wound is already present, a sheepskin rug alone is not enough. Seek clinical advice.
If you would like help choosing the right medical sheepskin product for your situation, we are here to help. Give us a call and we will talk through the options with you.