Compression stockings and circulation aids — the unglamorous essentials

This article provides general information about compression therapy and circulation aids. Your parent's specific medical condition and compression needs should be determined by their doctor. Never start compression therapy without medical guidance.

There's nothing glamorous about compression stockings. They're not fashionable. They're uncomfortable to put on. They roll down at inconvenient moments. My aunt complained about them relentlessly when her doctor prescribed them for venous insufficiency. And yet, once she understood why they mattered for her circulation, she stopped fighting them.

These unglamorous items actually do something important. They're not just an old person thing to endure. They're a tool that keeps blood flowing properly when your parent's body can't quite manage it on its own.

Why Circulation Matters

Our circulatory system is a closed loop. Blood pumps out from the heart, travels through arteries to deliver oxygen and nutrients to tissues, then returns to the heart through veins. It's elegant, but it depends on the heart being strong and the veins being healthy.

As we age, our veins lose elasticity. Valves inside veins that normally prevent blood from flowing backward sometimes weaken. If your parent has been hospitalized or immobilized for a while, blood clots can form. Diabetes damages blood vessels. Heart disease reduces the heart's ability to pump effectively. Any of these situations can lead to circulation problems.

Poor circulation in the legs is particularly common. Blood pools in the lower legs because gravity is working against it and the veins aren't pushing blood back up to the heart efficiently. When blood pools, legs swell. The skin breaks down. Sores form. In severe cases, blood clots develop. These aren't minor problems.

This is where compression comes in. External pressure on the legs helps move blood upward. It's not glamorous, but it works.

Understanding Compression Levels

Compression stockings come in different strengths, measured in millimeters of mercury, which is abbreviated mmHg. The higher the number, the more compression. Your parent's doctor will prescribe a specific compression level based on the severity of their circulation problem.

Mild compression, typically 8 to 15 mmHg, is sometimes prescribed preventively or for minor swelling. Medium compression, around 15 to 20 mmHg, is common for more significant venous insufficiency. Higher compression, 20 to 30 mmHg or even higher, is prescribed for severe problems like post-thrombotic syndrome or severe lymphedema.

There's a significant difference in how these feel. Mild compression stockings feel almost normal, just snug. Medium compression is noticeably tighter. High compression is genuinely difficult to pull on and requires real effort.

The length matters too. Knee-high stockings are most common. Thigh-high stockings work for some conditions. Full pantyhose style compression exists for others. Your parent's doctor will specify the appropriate length.

The Fitting Process

Compression stockings only work if they fit properly. Too loose and they don't provide adequate pressure. Too tight and they create pressure points that cause skin problems. Proper fitting is essential.

Your parent should be measured for compression stockings, ideally in the morning when leg swelling is minimal. Measurements include ankle circumference, calf circumference, and knee circumference for knee-high stockings. If thigh-high stockings are needed, thigh measurements matter too. Height and weight also factor in.

Once properly fitted, compression stockings should feel snug but not painful. Your parent's foot shouldn't tingle or go numb. The top of the stocking shouldn't cut into skin. If something doesn't feel right, that's information worth reporting.

Some stockings can be purchased ready-made. Others need to be custom-made for a proper fit. Compression garments are medical devices, and they're not all the same. Your parent's insurance might require a prescription and might only cover certain brands or styles.

The Daily Struggle of Getting Them On

Here's where compression stockings become real life instead of theory. They're hard to put on. Really hard.

Most people can't roll on compression stockings by sitting down, rolling them up, and standing up the way you might with regular socks. The compression is designed to resist that kind of gentle movement. Instead, your parent needs to either lie down and pull them on gradually, or use a special device designed to help.

Stocking pullers are wonderfully simple tools. They're basically plastic tubes with handles. Your parent puts the stocking into the tube, then steps into it or slides their leg in. As they pull the handles, the device expands and guides the stocking onto the leg. It eliminates the contortions usually required. These devices aren't expensive and can make the difference between your parent being able to put on their own compression stockings or needing help.

Some people use rubber gloves or plastic bags over their hands and feet to reduce friction while pulling stockings on. Sitting down makes it easier. Having someone else help works. Trial and error usually reveals what approach your parent can manage.

The real issue is that many older adults can't manage this daily. They have arthritis or back pain that makes bending difficult. They lack the hand strength required. They get frustrated and give up. This is where you might need to help, at least initially until your parent finds a system that works.

If it's physically impossible for your parent to apply compression stockings independently, that matters. Talk to their doctor about alternatives. Some people use pneumatic compression devices instead, which are machines that wrap around the leg and apply intermittent compression while your parent sits.

Daily Wearing and Skin Care

Compression stockings should typically be worn during the day when your parent is up and active, and removed at night when they're lying down. Your parent's doctor might give different instructions depending on the specific condition.

The skin underneath needs attention. Compression stockings trap moisture and heat. Fungal infections can develop. Pressure points can cause sores. Your parent should wash their legs daily and dry them thoroughly before putting stockings on. Checking skin for redness or irritation should happen regularly.

If your parent's skin is breaking down, that's information for their doctor. Sometimes padding or a different stocking brand helps. Sometimes the compression level needs adjustment. Skin problems are real and shouldn't be ignored.

When Compression Stockings Aren't Enough

Some circulation problems don't respond adequately to compression stockings alone. Your parent's doctor might prescribe medications to help with blood flow. Sequential compression devices like the pneumatic units mentioned above might be used. Elevation and movement matter too. When your parent keeps their legs elevated, gravity helps move fluid out of the legs.

Lifestyle factors make a difference. Walking is helpful because calf muscle contractions help pump blood upward. Sitting still for hours is harmful. If your parent tends to be sedentary, encouraging movement becomes important.

Your parent should avoid tight socks, pants, or anything that restricts blood flow above the compression stockings. Something as simple as tight waistbands or rolled-up pant legs above the stockings can compromise circulation.

The Bigger Picture

Compression stockings are one piece of managing venous insufficiency or other circulation problems. They're part of a system that might also include medication, elevation, movement, and regular monitoring.

Your parent might hate them. That's a reasonable response to an uncomfortable device. But understanding why their doctor prescribed them helps. Compression stockings prevent swelling that leads to skin breakdown. They prevent clots that could travel to the lungs. They give your parent's damaged circulation system a fighting chance to work adequately.

That's not glamorous. That's practical. That's the difference between independence and spending days with legs so swollen your parent can't move, or worse, developing complications that land them in the hospital.

Getting your parent to actually wear compression stockings requires some combination of education, problem-solving, and persistence. Help them find an approach to putting them on that works. Celebrate days they wear them without complaint. Acknowledge that it's uncomfortable but important. Eventually, for many people, compression stockings become part of the daily routine, like taking medications or brushing teeth.

That unglamorous routine is what keeps your parent's legs healthy and their independence intact.

Compression therapy should only be prescribed and managed by your parent's doctor. Never wrap your parent's legs tightly or apply pressure without medical guidance, as improper compression can cause harm. If your parent develops pain, numbness, tingling, or skin changes while wearing compression stockings, report these to their doctor immediately. Insurance coverage for compression stockings varies, so verify what your parent's plan covers before purchase.