Compression in older people

Life expectancy is increasing but, although people are living longer, this often means that many older people are living with chronic comorbidity. Chronic leg problems such as chronic venous disease, chronic oedema and venous leg ulcers can result in many physical and psychological difficulties, and managing these conditions requires the daily and often lifetime application of compression.

Donning and doffing compression hosiery can be challenging for people of all ages, but when there are compounding factors in the older person compliance can be affected. It is important to identify these factors and have strategies in place to prevent difficulties with compliance.

The natural ageing process results in dry, fragile, and thinner skin. This is compounded by the skin changes associated with lower leg problems, eg hyperkeratosis, papillomatosis, ulceration, and eczema. Donning compression hosiery over fragile or broken skin may cause further damage or pain.

Care is required therefore to ensure hosiery is applied without affecting the integrity of the skin. Appropriate skin strategies should be introduced to improve the condition and integrity of the skin, eg washing with soap substitute to prevent further drying, moisturising to replace the lost natural emollient, and dressing any breaks or ulcerated areas to promote healing.