Few nursing homes adjust care for obese patients

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Nearly 25 percent of people entering nursing homes are moderately or severely obese, and that number is expected to grow.

Nursing home staff, who are already often overworked, are having trouble handling these patients and special needs that the facilities aren’t equipped to provide for, reports Kaiser Health News.

Even as the demand increases, the article indicates that nursing homes lose money on obese patients:

[N]ursing home administrators say they cannot afford to care for them, because Medicaid, which covers more than 60 percent of all nursing home residents, does not reimburse them for the specialized equipment required: motorized lifts; larger wheelchairs, bedside commodes and shower chairs; and longer intramuscular needles and blood pressure cuffs. The devices are expensive: $10,000 for a mechanical lift, for instance, and $5,000 for an extra-wide bed.

In addition, obese patients oftentimes can’t move themselves and require lengthier time commitments and more staff members to aid them. This not only strains those resources, but also introduces a level of difficulty for the staff who are then susceptible to injuries and could then require worker’s compensation.

KHN notes that all of this complicates care for the patients, but it also ostracizes them and can cause feelings of helplessness and isolation.

Nursing homes routinely deny obese patients because they don’t want to deal with the added costs. KHN reports that many nursing homes are unwilling to remodel door frames, toilets and beds to accommodate.

One expert told KHN that obese patients may have to go through 30 to 40 referrals before they find a home to accept them.

This is a bit of a legal gray area, as the Americans with Disabilities Act is supposed to protect patients from this type of discrimination, but the extent to which obesity is a disability is debated.

According to KHN, nursing homes are not legally required to accept patients like hospitals are.

One nursing home, Generations of Red Bay, in Red Bay, Ala., built a 10-bed obese patient wing in its facility because co-owner Andrew Fuller made it her personal mission.

Fuller told KHN that it makes little business sense and that it’s a matter of heart.

Expectedly, Generations of Red Bay frequently has a waiting list.

From KHN:

At the Generations of Red Bay facility, nurses reposition obese residents … who are unable to move on their own, every few hours to avoid dangerous pressure ulcers. Daily personal needs require monumental coordination. One nurse can help a resident of normal weight dress and sit in a chair within 15 minutes, said Kathy McCurry, head treatment nurse. “With a bariatric patient, that takes an hour with two certified nursing assistants.”

To put that time commitment in perspective, a PublicSource story previously found that the nursing staff at four Allegheny County-owned nursing homes worked 125,000 overtime hours a year.

It’s crucial to research the right nursing home for loved ones, even if they have to be located at a distance and especially if they have special needs.

Reach Stephanie Roman at sroman@publicsource.org. Follow her on Twitter @ShogunSteph.