Only two severely obese residents (who would be considered bariatric) have lived here. One lived in a private room for as long as possible, which allowed adequate room for her equipment and transfers. She was eventually moved to a semi-private room. Due to the space constraints, and the fact that she missed her family, she was not happy in that room. Even though this 20-plus-year-old facility's semi-private rooms are larger than those at similar facilities, they are not large enough for bariatric residents. Several staff members are needed to get a bariatric resident up, and that does not happen every day. When continent bariatric residents are up, they have to go back to bed to be toileted. That meant they spent only a few hours out of their rooms.
Both bariatric residents were aged 60 or less, bright, and informed. Though it seemed they interacted well with staff and their family and friends, I am sure they suffered from some depression because of their situation. They both spent the day in bed, one read, watched television, and talked on the phone. The other did crafts continuously to keep busy. Both of them could use their arms to assist the aides to move them in bed.
The first bariatric resident was able to go home. The second one decided that she would rather stay in bed all the time. I thought she had probably done that at home. I also knew that she felt conspicuous because of all the assistance she needed to get up and back into bed. This nursing home was not built to accommodate bariatric residents needing specialty equipment and larger spaces.
Americans are getting heavier. Sixty percent of them are overweight. Obese people in daily life suffer because of their obesity. The seats on planes are rather small if you weigh over 200 pounds. So the ‘fattening of America’ could mean many more will need a bariatric nursing home bed someday.
In order to adequately care for bariatric patients, nursing homes will have to be designed differently and older facilities will have to be adapted. The way it is now bariatric residents in semi-private rooms cannot even see some other residents because there is not enough room for them to visit. They can socialize with their roommate, the staff, and any residents able to get into their rooms.
By the time the bariatric resident gets to a facility, any type of weight loss surgery has been ruled out because of health concerns. There is a nutrition program here but bariatric residents can sabotage themselves by ordering out or having family bring food in.
If bariatric patients stay busy, their days are probably better. But that is not really enough. If we do not provide larger accommodations and specialty equipment, bariatric residents will spend their lives in bed cloistered in a semi-private nursing home room.