services available. Options at Home,
offered by the Volunteers of America in
Northern New England (VOANNE),
provides in-home support services for
seniors, including coaching patients with
compression stockings. also be considered. Additionally, special care
must be given if a patient is not ambulatory.
Price advises a very low compression under
those circumstances. And people should
never, ever wear their compression stockings
to bed.
Modern compression stockings usually
look like socks or tights but putting them
on can be far more difficult. When putting
socks on, you gather up many layers of
fabric and stretch them over your foot. With
compression stockings, the multiple layers of
elasticized fabric require too much strength
to stretch over the foot— so patients should
pull their stockings up like trousers. Most compression garments last about six
months (with everyday use), before the ankle
compression begins to decrease and lose its
shape. Garments are best cared for when
hand- washed and air-dried, but just last
year companies began producing hosiery
that can be safely machine-washed and
dried.
Price also recommends that patients put
their stockings on dry feet, first thing in
the morning. The best technique is to
open the garment from the top and then
work on getting the heel into place before
bringing the stockings up. To remove the
stockings, patients should peel them inside
out, starting at the top, and never create a
roll like you would with a sock because, said
Price, “you’d essentially have a tourniquet.”
Different brands also tend to vary in size
and length, so in addition to trying on the
stockings, it’s important to understand the
store’s return policy.
In order to ethically provide compression
therapy garments a pedorthist must be
certified to do so. Most compression
garment manufacturers have training
courses that last between 1 and 2 days. The
certificate of completion of one of these
courses is sufficient in most States to be able
to provide these stockings. The addition of
compression hosiery to the services that you
offer allow you to further promote yourself
to clients and referral sources as their one-
stop resource for lower limb solutions.
-PFA
OTHER CONSIDERATIONS
Potential contraindications to these
garments include diabetes and congestive
heart failure, though that doesn’t mean
those that suffer with either can’t wear
compression. Arterial blood flow should
Current Pedorthics | September/October 2018
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