Compression garments are needed daily to manage Lymphedema. A common reason for edema to return is because it is too difficult to put the stockings on. We have tried a variety of devices that are available and have most available devices in the office for our clients to try so you can decide what will work for you. We can guide you in the decision based on ours and other clients experience. Our patients can take the donning devices home and try before they decide to get one.
Putting the stocking on
The first and best tool is simply a pair of gloves with rubber or latex grip. The gloves will protect the garments from fingernails and will provide good grip for rubbing the garments on. All gloves are not equal though. We have tested over a dussin gloves to find the ones that has the best grip on compression garments. Luckily it did not turn out to be the most expensive kind that worked best.
The Arion Easy Slide Caran for closed toe stockings works great combined with gloves. It can be a little confusing at first but if you take the time to learn the technique it can be a breeze. . This video shows how it works.
Open toe stockings are easier to apply because the slippie can be pulled out by the toes. There are a variety of slippie systems in different materials. Sometimes a slippie will be included with your open toe stockings. Take the time to learn how to use it. It is well worth it.
Slippie systems work great when you can reach your feet or when a caregiver assists with putting stockings on. Obviously they do not help if one can not reach the feet.
Lubricants work well together with gloves and/or a slippie system to further decrease of friction. The slippie systems only reaches the foot and ankle so the lotion is a good alternative if it is difficult to get the stocking the rest of the way up the calf, knee and thigh. It may seem expensive for such a small bottle but it only takes a few drops per application since the lotion does not absorb in the skin. I have tried ALPS fitting lotion and it works well.
For additional help with rubbing the stockings on you can put a rubber mat on the floor and rub your foot against it. Juzo has a Easy Pad for this purpose that works well but I have patients that have used bathtub mats or rubber shelve lining material.
When it is difficult to reach, or when the slippie system alone does not work, a frame may work well. There are a variety of frames in different brands. Some are wider for the calf, some are angled backwards and some have longer handles. This is sometimes the first method we try. Sometimes it is used together with some of the devices mentioned above. Here is a video that explains the use. The Jobst stocking donner is available here.
This is the newest and probably most innovative of the devices. Since it came out it has become the most popular among our patients. By eliminating friction, it allows you to roll the stockings on without much effort. It takes a couple of tries to learn how to use it but when mastered it makes putting on stockings a piece of cake. For demonstration purposes, I have put a 30-40mmHg knee high stocking on top of my shoes using the Doff 'N Donner. For videos and to order one click here. It also works great for removing stockings.
This is a tool that we found in the Netherlands and have tried. It is more costly but in our opinion the best because of its long and sturdy handle that limits the need to reach low and because it also works for removing the garments. Unfortunately the Steve donning device has only been available in Europe. After waiting a couple of years for someone to begin distributing this product in USA we have decided to import a few to make them available. We have a few and they are available to order here.
Removing the stockings
Sometimes all it takes to give the last push off the foot is a traditional dressing stick. They can be found at most medical supply stores. It has a rubber coated down turned hook that can be used to get the last of the stocking over the heel. This does require some arm and hand strength and does not always work. Another tool that works for some for the last push is the Medi Butler off.
So far the only product we have found for removing stockings by decreasing friction is the Easy Off by Arion. Same maker as the Easy Slide Caran (see above). Combined with gloves and/or a rubber pad on the floor it is an excelent way to ease the removal of stockings. Granted that the person can reach the feet.
This is a new and supprisingly simple way to remove stockings. It has become the most popular of our devices since it came out in 2012. For more information check them out at www.selfcare-solutions.com
The real challange comes when a person can not reach the feet. There are ways to put stockings on without reaching the feet, but we have not found a good tool for removing stockings without reaching and bending at the hip in the US. As mentioned above, the Steve from the Netherlands has a simple but effective way to do both. Since they are not available anywhere else in the US for retail we decided to import a few. You can find them at www.selfcare-solutions.com