Compression stockings and circulation aids — the unglamorous essentials

Reviewed by the How To Help Your Elders editorial team

Compression stockings are uncomfortable, unfashionable, and genuinely important. They keep blood flowing properly when your parent's veins can't manage it alone, preventing swelling, skin breakdown, blood clots, and hospital visits. Getting your parent to wear them consistently takes education, problem-solving, and the right tools for putting them on.

Compression Therapy Works When Circulation Doesn't

According to the CDC, chronic venous insufficiency affects an estimated 6 to 7 million Americans, with prevalence increasing sharply after age 50. As we age, veins lose elasticity. Valves inside veins that normally prevent blood from flowing backward weaken. Diabetes damages blood vessels. Heart disease reduces pumping efficiency. Any of these situations leads to circulation problems.

Poor circulation in the legs is particularly common. Blood pools in the lower legs because gravity works against it and the veins aren't pushing blood back up efficiently. When blood pools, legs swell. The skin breaks down. Sores form. In severe cases, blood clots develop that could travel to the lungs. These aren't minor problems. External pressure on the legs helps move blood upward. It's not glamorous, but it works.

Understanding Compression Levels and Fit

Compression stockings come in different strengths, measured in millimeters of mercury (mmHg). Mild compression, 8 to 15 mmHg, is sometimes prescribed preventively. Medium compression, 15 to 20 mmHg, is common for more significant venous insufficiency. Higher compression, 20 to 30 mmHg or more, is prescribed for severe problems like post-thrombotic syndrome or lymphedema. The higher the number, the tighter the stocking and the harder it is to put on.

Length matters too. Knee-high stockings are most common. Thigh-high and full pantyhose-style compression exist for other conditions. Your parent's doctor specifies the appropriate level and length.

Proper fitting is essential. Too loose and they don't provide adequate pressure. Too tight and they create pressure points. Measurements should be taken in the morning when leg swelling is minimal, including ankle, calf, and knee circumference. The stockings should feel snug but not painful. Your parent's foot shouldn't tingle or go numb. The top shouldn't cut into skin.

The Daily Struggle of Putting Them On

Compression stockings are genuinely hard to put on. The compression resists the kind of gentle rolling you'd use with regular socks.

Stocking pullers are simple, inexpensive tools that make a real difference. They're plastic tubes with handles. Your parent puts the stocking on the tube, steps into it, and pulls the handles to guide the stocking onto the leg. These devices eliminate the contortions usually required and can mean the difference between independent application and needing help every morning.

Some people use rubber gloves or plastic bags to reduce friction while pulling stockings on. Sitting down makes it easier. If it's physically impossible for your parent to apply compression stockings independently due to arthritis, back pain, or hand weakness, talk to their doctor about alternatives. Pneumatic compression devices 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 lying down. The skin underneath needs attention. Compression traps moisture and heat, and fungal infections can develop. Your parent should wash their legs daily and dry thoroughly before putting stockings on. Check skin regularly for redness or irritation. If skin is breaking down, report it to the doctor because padding, a different brand, or adjusted compression may help.

Walking helps because calf muscle contractions pump blood upward. Sitting still for hours is harmful. Your parent should avoid tight socks or clothing that restricts blood flow above the compression stockings.

The Bigger Picture

Your parent may hate compression stockings. That's a reasonable response. But understanding why they're prescribed helps with compliance. Compression stockings prevent swelling that leads to skin breakdown. They prevent clots that could travel to the lungs. They give a damaged circulation system the support it needs to work adequately. That's the difference between independence and spending days with legs so swollen your parent can't move, or developing complications that land them in the hospital.

Getting your parent to actually wear them requires education, problem-solving, and persistence. Help them find an approach to putting them on that works. Acknowledge that it's uncomfortable but important. Eventually, for many people, compression stockings become part of the daily routine.

Frequently Asked Questions

How long does my parent need to wear compression stockings each day? Typically during all waking hours, from getting up in the morning until going to bed at night. Your parent's doctor may give different instructions depending on their specific condition. Stockings should be removed at night when lying down.

Can my parent wash compression stockings in the washing machine? Most compression stockings should be hand-washed or machine-washed on a gentle cycle with mild soap and air-dried. Heat from dryers breaks down the elastic fibers and reduces compression effectiveness. Having two pairs allows daily rotation while one pair dries.

What if compression stockings cause skin problems? Redness, irritation, or rashes should be reported to the doctor. Solutions include trying a different brand, using a cotton liner underneath, adjusting the compression level, or switching to a different type of compression therapy. Skin problems should not be ignored.

Does Medicare cover compression stockings? Medicare coverage for compression stockings is limited and generally requires documentation of medical necessity. Some Medicare Advantage plans offer better coverage. Check with your parent's specific plan. Even without coverage, compression stockings are relatively affordable at $20 to $100 per pair.

My parent physically cannot put compression stockings on. What are the alternatives? Stocking donner devices help many people who can't manage by hand. If that's still not possible, pneumatic compression devices that wrap around the leg and provide intermittent pressure are an alternative. Home health aides can also assist with daily application. Talk to your parent's doctor about the best option.