When my mother lived in assisted living, the big staff activity every morning was getting everyone into their compression hose for the day. By the time all the residents were properly outfitted, the poor aids were all worn out and sweaty.
Many a caregiver has told me that next to incontinent care, the daily ritual of putting compression hose on was one of the hardest physical things they had to do for their elder. Many wondered just why these hose had to be so darned tight and hard to use, and asked why they couldn't just buy support hose that would be easier to use.
Support hose aren't the same thing at all. Support hose have the same degree of elasticity along the entire length of the stocking. They don't provide the graduated kind of compression that those with circulation problems require. If the stockings are not significantly tighter at the ankle, they aren't compression stockings. And, of course, that's what makes them so hard to get on.
Compression hose are designed to help with poor circulation in the legs. They provide "gradient compression," which means the greatest compression is at the ankle and less down toward the toes and as the stocking goes up the leg toward the heart. In simple terms, this pressure helps counteract the effects of gravity on weakened veins in the legs. "Squeezing" the leg pushes blood and fluid from the skin and superficial veins back into the deeper leg veins, so it will not "pool" in the lower leg and it can more efficiently be pumped back into the heart.
Instead of simply using terms such as "tight, tighter and tightest," which aren't very informative, the amount of pressure provided by compression hose is measured in millimeters of mercury (mmHg). On every label you will find the amount of compression provided by the hose inside in terms of "mmHg:"
8-15 mmHg, 12-16 or 15-20 mmHg are the lightest compression. These are primarily used to combat tired, achy legs at the end of the day. These are the easiest to put on.
15-20 and 16-20 mmHg is considered to be moderate medical compression. They are most often used for mild varicose veins and minor edema/swelling.
20-30 mmHg is firm compression used to combat moderate edema, some healed leg ulcers, moderate varicose veins and after surgery. You should not use this level of compression without consulting with your physician.
30-40 mmHG is extra firm compression and the decision to use this level of compression should only be made by a physician.
Putting On Compression Hose
There are some tricks to putting on compression hose:
Avoid lotions or anything else that might make the skin sticky. Bathe and use lotion at night, so the skin has time to dry completely.
Put on compression stockings as soon as possible after getting out of bed in the morning, before legs have had a chance to swell. One of the reasons the assisted living aids had such difficulty was their inability to get to every resident before they had been up and walking around.
Use a thin layer of cornstarch or powder on the leg to decrease friction.
Here's a good video showing how to put these stockings on without breaking your back:
Sometimes it helps to wear rubber gloves to prevent rips and tears from fingernails and to provide more gripping power for your fingers.
The top of knee high stockings should be two finger widths below the crease at the back of the knee. Thigh high stockings should be two finger widths below the groin.
Of course, many of us don't have the nice, slim legs on the model in this video. The job may take a bit more time and effort with heavier legs.
If you find that compression stockings are becoming easier to put on, it probably isn't only because you're getting better at it. Sadly, when they become easier to put on, compression stockings are probably just losing some of their firmness and should be replaced. The average length of life for these stockings is 3 to 4 months.