During heel off-loading during side-lying positioning, what is the primary purpose?

• A. To prevent heel ulcers by keeping the heels off the bed.
• B. To prevent foot alignment.
• C. To encourage ankle movement by pressing the heel.
• D. To reduce friction on the sacrum.

Answer: (A)

Heel off-loading focuses on protecting skin by removing pressure from a vulnerable area: the heels. When a person is side-lying and immobile, the heels can bear sustained contact and pressure against the bed, increasing the risk of pressure ulcers. Elevating or cushioning the heels off the surface distributes pressure away from the calcaneus and allows blood flow to the tissue, helping prevent tissue damage.

This isn’t primarily about keeping the feet in a particular alignment or actively moving the ankle by pressing on the heel, which would counteract the goal. It also isn’t chiefly about reducing friction at the sacrum; sacral protection comes from padding and proper turnover elsewhere. The main purpose of heel off-loading is to prevent heel ulcers by keeping the heels off the bed.