A wide variety of people can benefit from compression garments and hosiery, including many people that might otherwise not be typical homecare patients. Compression clients could include geriatric patients who have been prescribed compression hosiery by their physician, as well as everyday people who are on their feet or sit at a desk all day long.
Compression can be used to treat a variety of conditions, including foot swelling, mild edema, varicose veins, thrombosis, varicosities of varying severities, and diabetes. This is where providers can help, by offering a range of compression solutions and ensuring staff can knowledgeably assist a wide range of patients.
Here are some important considerations for attracting and supporting compression patients:
Compression ranges and applications. Compression is measured in millimeters of mercury and can range from 15-50 mmHg. Higher ranges are used to treat more serious issues. Lighter compression products start out at 15-20 mmHg, and are used for tired, achy legs, mild edema, varicose veins, and foot swelling, as well as to prevent vein thrombosis. Any compression items rated at above above 15-20 mmHg are prescribed by physicians.
Higher levels of pressure such as 20-30 mmHg are intended to address severe varicosities, open face ulcers, moderate edema and post surgery treatment. This higher level of compression also helps prevent the recurrence of venous ulcers, moderate to severe varicosities during pregnancy and thrombosis. For people who have such ulcers, lymphatic edema and varicosities, they typically need 30-40 mmHg. Measurements beyond 40 mmHg are typically used in custom compression applications.
Geriatric patients. The largest challenge for anybody putting on or taking off compression garments is that those garments are nothing like regular socks or hosiery that clients have worn in the past. They are much more difficult to put on, and for geriatric patients especially the issue is even more difficult, because not only do they typically require higher compression garments, but they also often have flexibility limitations and conditions such as arthritis that make putting on and taking off compression garments that much harder. The resulting frustration can negatively impact compliance. Educate geriatric patients and other patients with flexibility and range of motion limitations on the different methods for donning and doffing compression garments.
Methods for fitting compression socks. The most common mistake patients will make is that they will put on compression hosiery as though it were a typical sock; by bunching the compression sock up on their hands at the point above its heel. Then they’ll try to pull it up over their toe area and then their heel, which is very hard to accomplish. Providers can help them by training patients on the different methods for fitting compression socks.
In the “heel pocket out” method, the patient puts his or her hand into the sock, grabs hold of the heel and turns it inside out, in order to more easily get move the sock over the more challenging portions of the patient’s foot. Then the patient slowly smoothes the sock up around his or her leg.
Also, using rubber gloves can make the process go much more smoothly, by providing traction to help grab hold of the sock. Or, a patient can use a donning and doffing device that provides a frame that holds an open toe sock in position and lets the patient step into it. If a patient uses an open toe sock, a plastic sack can be placed over the foot, the sock slipped over that, and then the sack pulled out from under the sock.
Train staff as fitters. Fitters are trained to measure and assist patients with compression garments based on the diagnosis and leg shape. They can receive training typically through seminars provided by compression product vendors. Fitters must review patients’ histories and ask a battery of questions concerning factors such as age, flexibility and overall health, in order to help the fitter determine the ideal fit. These key staff members can help teach patients how to put on and take off compression garments, as well.
Work with physicians. Ensure fitters work in concert with physicians. Physicians and fitters must work hand in hand because some doctors aren’t aware of the many different levels of compression. So, the fitter can look at the diagnosis to determine what level of pressure will work best for the patient. The doctor will provide guidelines of what he or she wants to achieve in terms of treatment, and the fitter can help accomplish that. Doctors will also be key referral partners for you, so ensure you develop a good rapport with physicians and their staff to ensure they see your business as a solution provider for their patients.
Reach out to patient groups. Likewise, ensure you position your business as an expert solution provider to various client and patient groups through marketing and education. For instance, see if local assisted living centers will let you offer an on-site seminar regarding the benefits of compression.
Points to take away:
- There are a variety of clients and patient groups that need compression, which makes it a key HME offering for savvy providers.
- Compression is measured in millimeters of mercury, with higher compressions being used to treat more severe conditions.
- Geriatric patients often need compression products, but have difficulty putting them on. Have staff show them how to do it more easily.
- Ensure you have staff attending vendor training sessions so that they can become educated as fitters.
- Your fitters will work with physicians and their staff to ensure patients get the right compression fit. This puts them in a good position to build rapport with key referral partners.
- Ensure you reach out to key patient groups to teach them the benefits of compression garments.
Visit our compendium of compression products.