How to put on TED hose over foot with toe deformities?

[Ioreth, ADN, RN]

CNAs, I need your expertise! I am a first year nursing student and I'm in the midst of my first round of clinicals in a long term care facility. I was assisting a resident this morning put on TED hose. She had some deformities in her feet due to decades of wearing tight dress shoes and rheumatoid arthritis. Some of her toes overlapped and tended to catch on the TED hose, which was very painful to this resident. The CNA assigned to her room also tried to help, but was having the same trouble I had. I really don't want to hurt this resident again, so I'm hoping to get some tips on how to handle TED hose in an elderly resident with toes like this. I was a CNA only a short time before entering nursing school, so I don't have any experience in this area. I've applied TED hose lots of times, but only to patients with the usual foot anatomy. What do you do in this situation?

[amoLucia]

Could you let the charge nurse know and maybe a Therapy consult could evaluate and recommend some type of assistive device.

Also, they do make open-toe stockings.

Could she need a podiatrist for toe nail clipping?

Best info I could add. As RN on 11-7, we were responsible for AM application of TEDS. Faced the same problems. All we could do was s t r e t c h the stocking to expand.

[LTinAK]

I'm guessing yours are the closed toe kind? If so, my post won't be very useful, but I do have a trick for the open toe kind. After you open the bag, but the bag over the patient's toes, and then the hose slides over their foot much easier. After you get the hose in place, remove the plastic bag by pulling it out the toe hole.