Managing "leaky legs" in older adults

Managing the common issue of “leaky legs” in older adults

If you have never heard of the term ‘leaky legs’ before, this commonly affects older adults, and actually describes a very uncomfortable and potentially dangerous condition. Here, we will take a closer look at what ‘leaky legs’ are, the potential causes, the symptoms that may occur, and how this condition can impact the mobility, comfort and quality of life of older adults. We will also share key information on getting a diagnosis, treatment options, lifestyle changes that could help, preventive measures older adults may wish to know in order to avoid ‘leaky legs’, and when to seek medical help if you notice symptoms. 

At Home Instead, our aim is to help people age positively and in place by bringing expert care to their home. For nearly 20 years, we have been providing the highest standard of care, and creating industry-leading training programmes for our Care Professionals that are accredited by nursing and medical professionals. Today, we are the world’s largest global domiciliary care network, supporting over 100,000 older adults with personalised, tailored care at home. So whatever questions you have about symptoms in ageing adults, we can help. 

What causes ‘leaky legs’ in older adults?

Any signs of fluid leaking that haven’t been noticed previously should be checked with a medical professional. This symptom could be the result of a number of health conditions requiring prompt diagnosis and treatment from a medical professional, and usually further care from a home carer or another type of caregiver. These conditions may include:

Lymphoedema

Lymphoedema is particularly common in older adults, and could be the cause of ‘leaky legs’. It is sometimes referred to as ‘weeping oedema’, and this happens when a case of severe lymphoedema causes blisters to form and lymph fluid to drain through the broken areas of skin. Sores can occur anywhere on the body, but ‘leaky legs’ may refer to cases where sores show up mainly on the legs. 

There are two types of lymphoedema; primary and secondary. Primary lymphoedema occurs from birth, whereas secondary lymphoedema happens as the result of an injury, obstruction or another medical condition such as an infection, breast cancer, obesity or something else. Primary lymphoedema is considered to be rare, whereas secondary lymphoedema is thought to be the most common cause of this condition. 

Lymphoedema has also been connected to liver dysfunction in some cases, since the liver is the largest lymph-producing organ in the body, generating 25-50% of the lymph fluid flowing through the body’s largest lymphatic duct, the thoracic duct. 

Research suggests up to 227,000 people in England could be living with lymphoedema, and one study involving over 7,000 patients with chronic leg oedema found 12.7% had related wounds.

Chronic Venous Insufficiency

Chronic venous insufficiency can cause swelling in the legs when blood fails to circulate properly, which can be a risk if an older person struggles with mobility and spends much of their time in one place or position. This symptom happens when blood pools in the lower legs, putting excessive pressure on the skin and causing leg ulcers to form.

Leg ulcers can lead to fluid leaking from the legs, and they may come with additional symptoms such as swollen ankles, discolouration or darkening of the surrounding skin, hardened skin around the ulcer, a heavy feeling in the legs, or aching or swelling in the legs. This can cause an older adult to experience a reduced quality of life, and research shows around 4-5% of people aged 65+ suffer from venous leg ulcers.

Studies find that venous leg ulcers are thought to be the most common form of lower extremity chronic wound, so it is important to be aware of them if they form, and take action to diagnose and treat them quickly. 

If circulatory problems are an issue for your lower limbs, you may find additional helpful information in our guide to common foot problems in older adults.

Diabetes 

‘Leaky legs’ can also occur as a complication of diabetes, which can cause swelling and water retention in certain areas of the body. An estimated 5.6 million people in the UK live with diabetes, and older adults have a higher risk of developing this condition. One severe symptom that can occur when diabetes is not well-managed is a diabetic foot ulcer, which shows the importance of quality diabetes monitoring for older adults. 

A diabetic foot ulcer is an open wound on skin that heals very slowly or does not appear to be healing – it is extremely important to consult a medical professional if you have diabetes and develop numbness in your feet or legs, or a visible ulcer starts to form. The reduced blood supply to the skin means the legs and feet have fewer cells to fight infections, meaning wounds take longer to heal and can become more easily infected. 

You can read more about this condition in our guide to diabetes in older adults.

Peripheral Artery Disease

Peripheral artery disease can lead to sores developing on skin if not treated promptly and effectively, and this is thought to happen due to reduced blood flow to the arms and legs. Symptoms that could signal the onset of ‘leaky legs’ include shiny skin or changes in skin colour on the legs. Sores on the toes, feet or legs that don’t seem to be healing quickly enough can also be a sign of peripheral artery disease. 

How can ‘leaky legs’ be managed and treated? 

Managing and treating ‘leaky legs’ depends on the underlying cause, such as venous leg ulcers or lymphoedema, and will involve a careful approach to improve the person’s circulation and support their healing. 

Compression therapy tends to be helpful for multiple conditions causing ‘leaky legs’. This involves wearing compression stockings or bandages to help improve blood circulation in the legs, reduce swelling and support efficient wound healing. These are usually stretchy but firm stockings that apply gentle pressure and help to minimise fluid buildup.

Medications may also be prescribed, such as antibiotics if an infection occurs, or pain relief to help manage any pain or discomfort. Also, in order to ensure the swift and proper healing of any open wounds, it is important for older adults or their caregivers to adhere to a strict wound care schedule to keep any sores clean and free from bacteria. This might include cleaning ulcers with appropriate solutions, applying dressings to protect them, and changing dressings regularly so they are always fresh. Caregivers should also monitor for signs of infection, such as increased redness or warmth around the sore, or discharge, and follow up with medical professionals on any signs that may indicate an infection. In some severe cases, and depending on the underlying condition, surgery may be recommended to either repair or remove a vein that is causing problems. 

If lymphoedema is diagnosed, this usually means a combination of keeping skin clean to reduce the risk of infection, using compression therapy, undergoing an exercise and movement routine as recommended by a medical professional, and using manual lymphatic drainage techniques like massage to reduce any swelling.

What lifestyle changes could help?

As with many health conditions, certain lifestyle changes could help to lessen the impact of some of the aforementioned causes of ‘leaky legs’. This will depend entirely on the diagnosis your doctor provides, however, some lifestyle modifications that may help include:

• Getting regular exercise, even if this is low-impact exercise or general movement like walking to promote blood flow and reduce swelling. You may find some useful tips for this in our guide to fitness and exercise for older adults.
• Eating a healthy diet to increase nutrients in the body and support overall health, which can aid in wound healing, as well as promote healthier skin. This could mean reducing the salt in your diet (which can elevate blood pressure), and sticking to a doctor’s recommendations for daily fluid intake to avoid under or over-hydrating. You may find further advice in our guide to what foods older adults should avoid, and why.
• Keeping legs elevated regularly to reduce swelling and encourage blood to return to the heart instead of pooling in the legs – if you spend long hours a day standing or in a seated position, create an area of your home where you can elevate your legs on a regular basis 
• Getting regular massages under medical guidance to target the lymphatic system could be effective if you suffer from lymphoedema 
• Maintain a healthy weight to reduce excess pressure on the legs and improve circulation
• Take care of skin properly by moisturising regularly to avoid dry, cracked skin that could lead to sores forming and an increased risk of infection 
• Wear appropriate footwear such as supportive shoes to reduce any strain on swollen feet and prevent injury 

Are there any preventive measures older adults should take? 

As we age, taking certain preventive measures can help to limit our risk of developing some of the common conditions older adults experience. For the aforementioned conditions that can lead to ‘leaky legs’, such as lymphoedema and chronic venous insufficiency, wearing compression garments can be both a treatment for circulation issues as well as a way to prevent symptoms from arising in the first place. 

However, it is important to consult your doctor before doing this to avoid wearing a size that is too tight or causes skin irritation, as this could eventually do more harm than good. Consulting a healthcare professional also means carers are able to put compression garments on as they can’t do this unless prescribed. Also, it is important for older adults to perform regular checks for any signs of issues on their legs and feet, and this can be done on a regular basis. You may find our guide to hand, foot and nail care for older adults helpful.

When should an older adult seek help for ‘leaky legs’?

Consider getting regular check-ups with your doctor, including examinations of your lower limbs, to check for any signs of sores, minor wounds, swelling or other issues. If you notice any signs yourself, you should always address these early. Although it may seem like a small sore on your leg is nothing to worry about, for older adults with certain health conditions this can become a much bigger health concern down the line, so treating this as early as possible is crucial.

Look out for signs of infection anywhere on the legs, such as increased redness, warmth, pus or other leaking fluids, or a high temperature or fever. If any of these are present, you should consult a doctor or another specialist as soon as you can, such as a dermatologist, vascular surgeon, or wound care nurse. Alternatively, you can tell your family caregiver or home care professional so they can organise and take you to the relevant appointment. 

If you are caring for a loved one with ‘leaky legs’, you may need to help them with certain elements of their daily routine to ensure they do not lose mobility and have their symptoms worsen as a result. You may also need to help them with tasks like applying compression socks, or managing wound care. You can read more about this in our guide to wound care management in older adults at home.

Additionally, depending on their diagnosis they may be in some pain or discomfort, so it is important to address it and provide emotional support to help them manage this. Some communities around the country offer additional resources such as local support groups, senior centres and community programs that may offer aid and education on managing some of the conditions mentioned, such as venous leg ulcers or lymphoedema. 

‘Leaky legs’ require more insight into the underlying cause, but can be effectively managed with the help of others through medical treatments, lifestyle changes and preventive measures. It is important to seek continuous support if you think you need help with ‘leaky legs’, and be proactive in caring for your leg health yourself or advising a loved one or professional carer to help you with this. 

At Home Instead, we understand there’s no place like home, so our home care offering aims to help older adults retain independence and stay in familiar surroundings. For those with ‘leaky legs’ or other needs requiring wound care and monitoring, we offer a number of bespoke services which can be tailored to your needs, and our Care Professionals are highly trained to deliver the individualised service you need. Reach out to the team at Home Instead to learn more.