What’s a Bariatric Nursing Home? And How Do You Find One?

Updated

Certified Care Manager, Aging Life Care Professional, and National Master Guardian Emeritus

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:

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.

ยป CAKE FOR ENTERPRISE: Leading health care organizations know the future of advance care planning is digital. Partner with Cake to create your digital solution.

 

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:

  1. 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
  2. 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
  3. “Nursing Home Checklist.” Medicare.gov, www.medicare.gov/care-compare/en/assets/resources/nursing-home/NursingHomeChecklist_Oct_2019.pdf?redirect=true
  4. “Nursing Home Ombudsman.” Nursing Home Abuse Justice, 9 December 2020, www.nursinghomeabuse.org/nursing-home-abuse/ombudsman/
Categories:

Icons sourced from FlatIcon.