In 2018, the percentage of people with obesity was at 42.4 percent, according to the Center for Disease Control and Prevention. The number of people with obesity continues to grow, and the specialized care that goes with the increasing rates of obesity continues to grow with it.
Patients require bariatric-specific equipment, and if you have a loved one that needs nursing home care, you want to find the right one.
Jump ahead to these sections:
- What's a Nursing Home for Bariatric Patients?
- How Do You Know If a Bariatric Patient Needs Nursing Home Care?
- What Should You Look for in a Nursing Home for Bariatric Patients?
- Are There Any Alternatives to Nursing Homes for Bariatric Patients?
- How Do You Find the Best Nursing Homes for Bariatric Patients?
Finding nursing home care even for the general population can be challenging for many reasons, such as low staffing levels, turnover, and poor infection control in some facilities.
For a bariatric patient, the search is even more difficult. We will guide you through the process to find the safest nursing home with the best care for your loved one.
What’s a Nursing Home for Bariatric Patients?
A nursing home for a bariatric patient can handle the complexities of care that the patient requires. Even though a nursing home says they will accept a bariatric patient, that doesn’t mean they are properly equipped to handle and treat this problem.
You will need to research appropriately to make sure they can care for your loved one safely and appropriately.
How Do You Know If a Bariatric Patient Needs Nursing Home Care?
Weight alone may be enough reason for someone to require nursing home care. If a person needs two people to lift, turn, or care for them, it may be unsafe for them at home or assisted living.
For example, mobility issues due to weight can make it impossible for the patient to get to the toilet or dress or bathe themselves without an extensive system to move that person from room to room.
In addition, a patient requires frequent turning to prevent bedsores. The equipment necessary for lifting is not permitted in an assisted living location. Lastly, other complicating medical problems require ongoing nursing beyond what home health can provide.
What Should You Look for in a Nursing Home for Bariatric Patients?
There are specific things you should look for and ask about in any nursing home that claims to do bariatric care. You may not get everything you want or need, but your options may also be limited since some nursing homes will refuse to accept bariatric care patients.
Equipment
The equipment required for a bariatric patient depends upon their weight. A manual Hoyer lift might work for some patients, but an electric lift might be necessary for others.
A patient may also require a larger hospital bed if they are over 350 pounds. If the nursing home doesn’t have this equipment, ask if they can get it.
Training and programming
Working with bariatric patients involves competency-based training for staff that includes the following:
- Injury prevention for both patients and staff involving ergonomic training and proper use of mechanical and electric lifts.
- One of the significant risk factors for bariatric patients is skincare. Skin breakdown or pressure ulcers can quickly devolve into emergencies requiring specialized wound care.
- Part of staff training should also be about sensitivity. Patients with weight problems should be treated with dignity and respect.
- Does the nursing home offer actual treatment for bariatric patients? If your loved one is on a special bariatric diet, can the nursing home accommodate that?
Staff to patient ratio
It takes a competent and skilled team of nurses, aides, therapists, doctors, and nutritionists to treat bariatric patients. Asking about the team and how many staff members will be available to help your loved one is reasonable.
If staffing is tight or not adequate to care for bariatric needs, you may want to move on to some other nursing home options.
Patient activities and physical therapy
Modified activities may be necessary for a bariatric patient, and you will want to know what accommodations are made for someone who might be bedridden most of the day.
Ask about the availability of physical therapy for your loved one and whether they have expertise in working with bariatric patients.
Are There Any Alternatives to Nursing Homes for Bariatric Patients?
There may be alternatives to nursing home care for bariatric patients, but it will take some planning and work. And it will probably take some financial resources as well.
Home
Depending on your loved one’s weight and other medical issues, they may be able to remain at home. A home health agency with a good physical and occupational therapist can help you determine what equipment you need to provide safe care.
One person cannot securely move or support a bariatric patient safely. Using mobility devices like Hoyer lifts will keep you both safe.
You might have to consider a hospital bed and a ceiling track system to move a loved one. You will need to call the insurance company to see which of these devices insurance covers.
If there are ongoing nursing needs, they might have to arrange those privately if home health care has expired or your loved one doesn’t qualify. You also can hire private caregivers from an agency to assist with day-to-day care needs.
In weighing the option of keeping someone at home, do a thorough assessment of their daily needs. In your desire to provide home care, you might underestimate the physical and medical care someone needs.
Your health and well-being are important too, and safety should be paramount. At least at home, you can add whatever specialized equipment is necessary to move someone safely.
Assisted living
If a bariatric patient is not too difficult to manage medically or mobility-wise, assisted living is possible.
When making that choice, a nurse will assess your loved one’s ability to care for themselves, including bathing, dressing, toileting, and getting to the dining room. Somebody will also evaluate medical issues like catheter and wound care.
If the staff at an assisted living facility cannot properly care for your loved one, they will not be admitted. The other deciding factor might be transfers. Most assisted living communities do not allow mechanical lift devices to move someone.
The basic requirement in most assisted living facilities is that one person can safely provide it if someone needs assistance. There is not enough staff to do two-person assists, and personnel safety is the primary concern.
Board and care homes
A board and care home will have the same concerns as assisted living about accepting a bariatric patient.
Since most board and care homes are in residential homes, it is unlikely but not impossible to find a place that will take your loved one, especially if you are willing to provide a Hoyer lift to assist staff.
How Do You Find the Best Nursing Homes for Bariatric Patients?
As obesity rates soar in the United States, more and more nursing homes refuse to accept bariatric patients.
There are several reasons for this: Medicaid, the primary payor source for nursing home residents, does not reimburse for the specialized equipment needed. A bariatric patient costs more to take care of.
Also, a bariatric patient requires more staff to take care of them. Understaffing in nursing homes has been a long-standing problem. Nursing homes are within their rights to refuse admission to someone.
Finding a nursing home will be a challenge, but not impossible. You will want to investigate every possibility, keeping in mind not just who will accept your loved one, but whether they have a reputation for good care.
Talk to the doctor
Talking to your loved one’s primary doctor is an excellent place to start. They have probably had this question before and might be able to guide you towards a suitable nursing home. Approach the nursing staff as well to ask for recommendations.
Outpatient bariatric clinics and surgery centers
Whether your loved one is considering bariatric surgery or not, these clinics can be a wealth of information. Following bariatric surgery, it is not unusual to have a two- to five-day stay in the hospital.
If someone is in the hospital under Medicare and has a three-night stay, they would qualify for a residential rehabilitation facility.
A good place to start is to ask to speak with the discharge planner or social worker in any specialized bariatric setting. These professionals work with nursing homes and can offer some advice about which places might accept your loved one.
Look online and for support groups
Looking online and for support groups can be a great way to get firsthand personal experience from bariatric patients.
Some information online might be outdated, so call to verify that the nursing home you have an interest in is accepting patients. Always investigate any recommendations.
Evaluating a nursing home
Since your choices might be limited, it is important not to skimp on any of the details.
You will want to come prepared with questions to ask a nursing home, and as mentioned above--whether they have the equipment or staff necessary to care for your loved one. It can be hard to find reliable information about many nursing homes.
Also, consider talking with the local Long Term Care Ombudsman program. As the program investigates nursing home complaints, they would be good to know in terms of advocating for aging adults. They are also a good resource to get information on any nursing home under consideration.
Finding a Bariatric Nursing Home
As nursing homes continue to restrict bariatric patients’ admissions, your job will be challenging. It is important to be patient and tackle the situation with resolve. With research, you will be able to find an appropriate placement for your loved one.
Sources:
- Varney, Sarah. “Rising Obesity Rates Put Strain on Nursing Homes.” Health, The New York Times, 14 December 2015, www.nytimes.com/2015/12/15/health/rising-obesity-rates-put-strain-on-nursing-homes.html
- Kirkham, Chris and Benjamin Lesser. “Special Report: Pandemic Exposes Systematic Staffing Problems at U.S. Nursing Homes.” Health News, Reuters, 10 June 2020, www.reuters.com/article/us-health-coronavirus-nursinghomes-speci/special-report-pandemic-exposes-systemic-staffing-problems-at-u-s-nursing-homes-idUSKBN23H1L9
- “Nursing Home Checklist.” Medicare.gov, www.medicare.gov/care-compare/en/assets/resources/nursing-home/NursingHomeChecklist_Oct_2019.pdf?redirect=true
- “Nursing Home Ombudsman.” Nursing Home Abuse Justice, 9 December 2020, www.nursinghomeabuse.org/nursing-home-abuse/ombudsman/
FAQs
What is bariatric nursing care? ›
A bariatric nurse provides holistic care to those patients who have a diagnosis of morbid obesity. It also includes care of patients undergoing bariatric surgeries. EDUCATIONAL REQUIREMENTS.
What weight limit is considered bariatric? ›Have a body mass index (BMI) of 35 or higher, or have a BMI between 30 and 35 and an obesity-related condition, such as heart disease, diabetes, high blood pressure or severe sleep apnea. Weigh less than 450 pounds, the maximum weight that hospital radiology equipment can accommodate.
How do you turn a bariatric patient in bed? ›To turn a bariatric client from supine to side-lying position, simply raise one bar and tighten the sheet. As the system turns the client, gently position their arms and legs as needed.
What does bariatric mean in medical terms? ›Medical Definition
bariatric. adjective. bar·iat·ric ˌbar-ē-ˈa-trik. : relating to or specializing in the treatment of obesity : involving or practicing bariatrics. Bariatric surgery is the umbrella term for all weight-loss surgeries reserved for obese patients.
Yet larger rooms are required for the care of bariatric patients. Space is needed to accommodate several large pieces of equipment, including the bed, additional healthcare workers (up to six), mechanical lift devices, wheelchairs, stretchers, commodes, and seating chairs (Muir & Archer-Heese, 2008; Muir et al., 2007).
What is considered bariatric patient? ›A person is classified as having obesity and may be referred to as a bariatric patient when they have a body mass index (BMI) that is equal to or greater than 30. BMI is used to measure weight in relation to height. Obesity classes are then determined by what range your BMI falls into.
Can I get bariatric surgery at 200 pounds? ›To be eligible for bariatric surgery, you must be between 16 and 70 years of age (with some exceptions) and morbidly obese (weighing at least 100 pounds over your ideal body weight and having a BMI of 40).
What is a bariatric restroom? ›Bariatric patients require plumbing fixtures with higher maximum weight capacities than average fixtures found in healthcare facilities. Traditional china toilets support only about 500 lbs., and are more likely to break and cause injury to patients.
What will get you denied for bariatric surgery? ›But why might a patient not qualify for bariatric surgery? BMI: First and most obviously, they simply may not have a BMI that is high enough. A BMI of 35 or more with one or more obesity related conditions or BMI of 40 or greater regardless of obesity related conditions is required to have surgery.
Which organ is impacted by bariatric surgery? ›Bariatric surgery targets a number of different organ systems including the brain, stomach, small intestine, large intestine, liver, pancreas, adipose and muscle tissue (Fig. 2).
Are you asleep during bariatric surgery? ›
Gastric bypass surgery requires a stay in the hospital. The procedure will be performed while you're asleep under general anesthesia.
How long is a bariatric hospital bed? ›A bariatric hospital bed is an extra heavy-duty and extra wide bed that is able to reach 54 inches wide, 88 inches long, with a higher weight capacity than standard models designed to safely accommodate larger individuals in hospitals, clinics, rehab centers or at home.
What are the risks of bariatric? ›As with any surgery, gastric bypass carries some risks. Complications of surgery include infection, blood clots, and internal bleeding. Another risk is an anastomosis. This is a new connection created in your intestines and stomach during the bypass surgery that will not fully heal and will leak.
Why is it called bariatric? ›Terminology. The term bariatrics was coined around 1965, from the Greek root bar- ("weight" as in barometer), suffix -iatr ("treatment," as in pediatrics), and suffix -ic ("pertaining to"). The field encompasses dieting, exercise and behavioral therapy approaches to weight loss, as well as pharmacotherapy and surgery.
What is the purpose of bariatric? ›Bariatric surgery is done to help you lose excess weight and reduce your risk of potentially life-threatening weight-related health problems, including: Heart disease and stroke. High blood pressure. Nonalcoholic fatty liver disease (NAFLD) or nonalcoholic steatohepatitis (NASH)
How do you transport a bariatric patient? ›For most obese patients, a LearJet ambulance, outfitted with a cargo door, can transport them. The LearJet has maximum bariatric patient limits of 36-inch widths and 350 pounds. The LearJet ambulance has a cargo door width of 36 inches and a standard stretcher that can accommodate 350 pounds safely.
How is life after bariatric surgery? ›You will be on a liquid or puréed foods diet for 2 or 3 weeks after surgery. You will slowly add soft foods and then regular foods to your diet. You will likely be eating regular foods by 6 weeks. At first, you will feel full very quickly, often after just a few bites of solid food.
What is the biggest impact of bariatric surgery? ›Bariatric Surgery Long-Term Risks
Dumping syndrome, a condition that can lead to symptoms like nausea and dizziness. Low blood sugar. Malnutrition. Vomiting.
You can usually start eating regular foods about three months after surgery. At each stage of the gastric bypass diet, you must be careful to: Drink 64 ounces of fluid a day, to avoid dehydration. Sip liquids between meals, not with meals.
Who is not a good candidate for bariatric surgery? ›Issues such as eating disorders, a history of blood clots, heart problems, or certain health conditions can disqualify a patient as a candidate for bariatric surgery.
What are the two types of bariatric surgery? ›
The most common types of bariatric surgery are sleeve gastrectomy, gastric bypass, and adjustable gastric banding. Lap banding is also known as laparoscopic adjustable gastric banding. During lap banding, your surgeon places an adjustable band around the top of your stomach.
What is the 30 30 rule for bariatric? ›Chew your food 30 times. Take 30 minutes to eat. No drinking 30 minutes before your meal, during your meal, or until 30 minutes after your meal. Some programs may add a fourth part - Try to complete 30 minutes of physical activity per day.
What is the best age for bariatric surgery? ›Though it largely depends on your overall health and unique needs, recent studies show weight loss surgery may be safe for those in their 60s, 70s, and even for some in their 80s. It may also significantly reduce the risk for heart disease and stroke in those who have type 2 diabetes.
Is there a drug for weight loss? ›The table below lists prescription drugs approved by the FDA for weight loss. The FDA has approved five of these drugs—orlistat (Xenical, Alli), phentermine-topiramate (Qsymia), naltrexone-bupropion (Contrave), liraglutide (Saxenda), and semaglutide (Wegovy)—for long-term use.
What are the types of bariatric procedures? ›Bariatric surgery procedures include gastric bypass, sleeve gastrectomy, gastric band and duodenal switch. These operations have proven results in treating class III obesity. They also help normalize your metabolism, including blood sugar, blood pressure and cholesterol.
What are the most common bariatric procedures? ›The most common types of bariatric surgery are sleeve gastrectomy, gastric bypass, and adjustable gastric banding. Lap banding is also known as laparoscopic adjustable gastric banding. During lap banding, your surgeon places an adjustable band around the top of your stomach.
How do bariatric patients eat? ›Eat slowly and chew small bites of food thoroughly. Avoid rice, bread, raw vegetables and fresh fruits, as well as meats that are not easily chewed, such as pork and steak. Ground meats are usually better tolerated. Do not use straws, drink carbonated beverages or chew ice.
How long is bariatric? ›Overview of Penn Medicine's Bariatric Surgery Process
Our bariatric surgery process involves multiple visits and takes most patients at least three to six months.
Phentermine-Topiramate extended release (Qsymia) is the most effective weight loss drug available to date. It combines an adrenergic agonist with a neurostabilizer. Daily doses with four strengths start at 3.75/23mg to 15mg/92mg. Adults with migraines and obesity are good candidates for this weight loss medication.
What is the most common complication of bariatric surgery? ›Leaks. An anastomotic leak is the most dreaded complication of any bariatric procedure because it increases overall morbidity to 61% and mortality to 15%.
What is the newest bariatric surgery? ›
Endoscopic sleeve gastroplasty is a newer type of minimally invasive weight-loss procedure. In endoscopic sleeve gastroplasty, a suturing device is inserted into your throat and down to your stomach. The endoscopist then places sutures in your stomach to make it smaller.
Which bariatric surgery is best long term? ›Duodenal Switch Surgery
The best long-term weight loss success rate (better than 50% excess weight loss) of 95%.
The Vertical Sleeve Gastrectomy is the most widely used, and safest, in the bariatric world. As with any major surgery, gastric bypass and other weight-loss surgeries pose potential health risks, both in the short term and long term.
What is the gold standard for bariatric surgery? ›Gastric bypass is the current gold standard for weight-loss surgery, according to the American Society for Metabolic and Bariatric Surgery and the National Institutes of Health. This procedure causes ingested food to bypass most of the stomach and the first part of the small intestine.
What is Stage 3 bariatric surgery? ›During this phase after bariatric surgery, you will transition to more solid foods. This may include soft meat, fish, chicken, cereals, cooked vegetables, and canned and fresh fruits.
What is the success rate of bariatric patients? ›The long-term success rate of bariatric surgery is between 68% and 74%, and studies have shown that the beneficial effects on weight loss are maintained for up to 20 years after gastric bypass surgery.