A Mattress Expert’s Advice On The Best Mattress For In-Home Hospice Care

Even when we’re at our best and in perfect health, having a mattress that is inviting, soothing, and nest-like, is an essential part of our day. For most of us, a mattress is a sanctuary, a place where we relax, rejuvenate, and get the restorative sleep we need to enjoy life.

It’s just as important to consider how comforting our mattress needs to be in end of life situations, too. Choosing the right mattress for in home hospice care, unlike institutional settings, can be even more challenging when you consider the factors involved.

After spending 25 years designing mattresses in the industry, and  speaking with hundreds of customers who were making end of life choices for bedding, either for themselves or their loved ones, I received an enormous amount of direct feedback that honed my skills. 

The biggest problem people faced, which brought the highest level of frustration, was simply the overwhelming number of mattress choices that people had, and having to wade through the options created a lot of stress. We’re going to narrow your options to only a handful of mattresses we recommend. Not to worry. If you want to jump down to our list of the nine best mattresses, click here.

There are physical elements of a good mattress that can offer a comforting and soothing experience for anyone going through an end of life process, so we’ll start with several factors that should be considered when choosing the perfect bed. Let’s narrow them down.

A mattress should be supportive and comfortable, first and foremost. For cancer patients, or for people who are experiencing other terminal illnesses, and are likely dealing with general de-conditioning and pain, comfort and anxiety free rest is critical. In fact, the proper bed should actually provide soothing relaxation, and be an enjoyable experience.

Ideally, the mattress should be as firm as can be tolerated by the patient. A bed in a box mattress, the kind that are pre-compressed and rolled, are ideal for home hospice care, because they are easy to order online, are fairly easy to handle in the home, and are typically made with supportive, durable, and comfortable components.  

A mattress for end of life application can bed wonderfully enjoyable, comfortable, and soothing.

A mattress for end of life application can bed wonderfully enjoyable, comfortable, and soothing.

I’m going to provide a selection of mattress options below that you can order online, that are designed to be used for this setting, and are rated typically as medium firm. It’s important to understand that virtually all of these beds have a supportive and uplifting bottom layer, but it’s what’s on top that makes the mattress exceptional.

There are a few options that I highly recommend that offer a more yielding and sumptuous top layer that relieves pressure and cradles the body,

while still making it easy to turn and transfer in and out of the mattress in effortless fashion. So, firm on the bottom, softer up top.

I recommend a few options for the top most surface of a great mattress for in home care. I designed and sold latex mattresses for years, and they worked extremely well for end of life cases. Patients found them delightful because there was no indentations, gulleys, or sense of feeling trapped in latex.

Quite buoyant and deliciously comfortable, and you get a lot of “push back” with latex, that is, the rubbery and flexible nature of this material offers spring-like elements, pushing up on the body rather than creating a melting sensation. It’s also easy to sit on the edge of a latex mattress and is great for making transfer easier.

Latex is spongy, slightly bouncier, and resists indentations and gulleys.

Latex is spongy, slightly bouncier, and resists indentations and gulleys.

If you go with an all natural latex mattress, too, you get the hypo-allergenic benefits of latex as well, it’s odor free, and resists dust mites mold, and mildew.

A latex hybrid or all latex mattress is a little heavier to handle and may be slightly more expensive, but it’s easier to turn on, and is a better fit for those with restless leg syndrome.  It’s not the best fit for hot sleepers, but many in end of life situations complain of being cold, and latex will provide some extra warmth that other materials will not provide.

Another excellent material to have on top as the body contact layer is memory foam, often combined with gel foam and referred to as “gel memory foam”. Memory foam is an outstanding comfort material because it melts up around the body, and in cases where there is a lot of back pain, it might be the single best option.

Memory foam tends to “ooze” into void areas, responding to body heat and filling in areas between hips and rib cage, especially for side sleepers, and it also fills in areas between shoulder blades, and is great for this who sleep in the fetal position, which often is the case in advanced end of life situations.

If the case is advanced, I would probably go with a memory foam type bed, because the benefit of immersion into the material outweighs the need to transfer in and out of bed, and since memory foam is excellent at pressure point reduction, it can keep bed sores at bay, too, simply because of its ability to distribute load sideways, like spreading a pizza dough, rather than downward, creating pinpoint pressure points.

Ability To Transfer Is Of Paramount Importance

Ability to transfer in and out of a mattress is the single most important element to consider when purchasing a home hospice mattress, which is why I strongly suggest to err on the side of firm rather than too soft, since transfer requires tremendous energy and can be exhausting.

The trick to easy transfer, whether by patient or with assistance is to first measure and fit the patient with the ideal bed height. Measure ground to finished height, including any base or foundation.

The trick to easy transfer, whether by patient or with assistance is to first measure and fit the patient with the ideal bed height. Measure ground to finished height, including any base or foundation.

The ability to sit on the edge of your mattress to transfer either to upright position, or to a wheelchair, is mission critical. 

Another strong consideration that I recommend is the use of an adjustable bed, along with the right mattress, which adds an additional level of comfort and relief to end of life situations.

how an adjustable bed base can dramatically improve being confined to bed

For one, sitting upright is important, since a lot of bed bound folks are still able to function pretty well, and eating and drinking, socializing with friends, reading, TV watching, and other activities are a lot easier with an electrically controlled base.

For swollen feet, edema of the legs, and other conditions, raising the foot end of the bed is a wonderful experience and offers great benefit. Also, a foam mattress is easily bendable and is perfectly suited for use on and adjustable base. 

All of the mattresses we suggest below are designed to be used on either a flat foundation, box spring or base, and can also be used on an adjustable bed. Many of the companies shown also sell adjustable bases on their sites, and are often offered as a package deal.

The adjustable base of today doesn’t have that clinical or institutional look of old school bases either, and are designed to like flat when sleeping or when not in use during the day, and look like any other mattress or bed.

One thing that I’ll mention is that a commercially available adjustable bed will have advanced features that are desirable, such as safety rails that can be operated with a remote control or other device. But you can typically use whatever mattress you like with these bases. These adjustable bases, like most others, are usually twin long size, measuring 38x80 in width and length. 

That said, I know a lot of couples who sleep together until the very end. In that situation, there certainly is no need to opt for a mattress that is a twin or twin long size. A full, or double, sized mattress offers more room for the user, and is great for couples who still enjoy sleeping or resting together. Even a queen size mattress, if you have the room, is something to consider, either with or without an adjustable base.

You can visit our Bed Sizes page, which takes the mystery out of choosing the right size mattress for your application.


Don’t think that an end of life situation forces an individual to be confined to a smaller size mattress. If you are at home, consider larger sizes if you wish to bed share with your loved one.

In our recommended list of mattresses shown below, you can choose from all standard industry sizes, from single sized beds (called twin or twin long) to full or queen options as well.

If you like, we also have some recommendations for adjustable bases on our Adjustable Base page.

If you are using an adjustable base in a palliative care setting, consider the height of the mattress you are purchasing as well, and test the height of the mattress in combination with the base or foundation to make sure it is a desirable height, making transfer in and out as easy as possible for the user.

our list of TEN outstanding mattresses which are perfect for palliative care and in home hospice applications