More than one-third (34.9 percent) of American adults are obese, according to the 2011-2012 National Health and Nutrition Examination Survey. A person is clinically obese if their body mass index (BMI) level is 30 or more. Overweight and obesity have become pressing global health concerns. With a higher number of bariatric and aging patients comes an increased demand for skilled nursing and rehabilitation facilities that can accommodate their unique care needs. Historically, bariatric patients have faced challenges when trying to find long-term care. Skilled nursing facilities (SNFs) and assisted living facilities (ALFs) are having to innovate to accommodate these patients and provide high-quality care.
There are facilities that can accommodate obese patients and provide excellent care, but they may require a bit more effort and research to find. There are a few things to keep in mind when trying to locate skilled nursing, rehab or assisted living care for a bariatric patient.
How to Find a Long-Term Care Facility for an Obese Loved One
- Specialized Equipment. Ask if the facility has bariatric equipment. The Occupational Safety and Health Administration (OSHA) limits how much healthcare workers are allowed to lift, so if the patient needs help getting in and out of bed toileting or bathing, special equipment will be necessary. This can include larger beds (a standard hospital bed can only hold up to 350 pounds), chairs, wheelchairs and mobility aids, and shower and bath equipment, depending on you or your love one’s needs. A heavier individual may require an electric patient lift instead of manual equipment such as a classic Hoyer lift.
Because these items are extremely expensive, the number of beds available to accommodate heavier residents at any given location will be extremely limited. Waiting lists are typically quite long, since nursing facilities are not obligated to accept patients like hospitals are.
- Proper training. Patient transfers can be tricky and dangerous for individuals of an average weight, so great care must be taken when caregivers assist heavier residents. This is for the patient’s safety and that of the facility’s employees.
“The largest risk is the issue of injuring patients and caregivers from improper transfer,” says Jeff Oldroyd from Holladay Healthcare, a nursing home located in Salt Lake City, Utah. “We do give additional training in these specific transfers to our caregivers. This training is usually provided by experienced nurses and physical therapists.”
Do not be afraid to ask the facility about special training and experience requirements for any staffers who may be caring for you or your loved one. Frequent transfers and repositioning are crucial for proper hygiene and prevention of bedsores or compression ulcers.
- Adequate space in living areas. A larger room or apartment is ideal for larger patients in care facilities, but do not forget to inspect communal areas such as dining rooms and activity rooms as well. Isolation can be a real concern for these patients since their mobility is typically limited. Make sure there is enough space to maneuver a larger wheelchair in the facility so you or your loved one can interact with staff and other guests outside of their room. Creating opportunities for a patient to engage and participate in social and recreational activities will improve their quality of life and may even result in weight management or even weight loss.
- Appropriate activities. While resident involvement is important, bariatric patients have specific health and activity needs. In many cases, “regular” exercise is not possible or safe for them. Make sure to ask the facility about modified activities for patients, especially if they have recently undergone surgery. This is especially important in a rehabilitation setting where a patient is working to heal and regain or improve their functional abilities. For instance, a facility with a pool and a water therapy program can provide activity options that are more conducive than typical weight-bearing and high-impact exercise programs. An experienced physical therapist will be able to adapt a PT regimen to make sure they meet their health care goals.
- Compassionate staff. Overweight patients are likely accustomed to comments about weight and physical activity. But, beyond the equipment and therapy, it’s important to know that the staff will see a bariatric patient as more than just a number on the scale. It can be difficult for anyone to find placement in a facility, and you want to make sure any special needs will be taken care of.
- Ask your physician. Physicians often have contacts at many skilled nursing, assisted living, and rehabilitation facilities in their area. In many cases, they may be your best resource when it comes to finding a reputable facility. Communication between the facility and a physician will be key for ongoing care, so receiving a referral from your doctor will be an added bonus.
“We do have additional communication with physicians for patients with specialized needs such as obesity,” said Mark Hymas from Copper Ridge Health Care, a SNF in West Jordan, Utah. “There are specific protocols for each diagnosis, and those symptoms are monitored and shared with physicians in real time. Physicians are then able to make determinations to monitor and adjust treatments.”
Patients of any size may encounter significant obstacles and frustrations related to their healthcare. Finding a facility with the proper equipment and training, adequate space, appropriate exercise and activity programs, and compassionate staff can be difficult. However, these important tips will help you select the right care setting for yourself or your loved one.