Growing number of care homes developing specialist bariatric rooms for obese people

An increase in the number of obese older people, has led to a growing number of care homes in the UK building specialist bariatric rooms, so they can care for severely overweight people.

Research recently revealed that nearly one in four older people are now obese, which looks set to pose a huge problem for the care sector in terms of caring for them.

The rise in obesity is thought to be due to the combination of easy access to cheap high-energy food that is aggressively marketed, plus people’s lifestyles becoming less active as they age, with more sedentary leisure activities now available such as television and the internet.

To cope with this rise in severely overweight older people, a growing number of care homes are building specialist bariatric rooms - the term ‘bariatric’ relates to people who weigh more than 25 stone. The St Monica Trust recently developed a specialist bariatric ensuite room in Sherwood nursing home for older people in the south west of England.

The suite incorporates a bespoke bedroom and en-suite wet room which have been built to a larger scale than standard. Specialist bariatric equipment has been installed throughout the suite, which includes specialist overhead tracking hoist, an ‘Arum’ bed specially designed for size and strength, a ‘Vetro’ turning mattress with built-in air flow system plus an electronically adjustable wash basin.

The decision to set up the bariatric service was triggered by a severely overweight resident as the Trust was struggling to care for her in one of its care homes.

“About three years ago, we were caring for someone with bariatric needs, which meant we were struggling to care for her in one of our care homes.

“She had respiratory problems and we did the best we could to care for her but over time we realised we had to create a care suite especially for her. But during the process she was transferred to hospital with breathing difficulties, where she passed away. She never saw the suite we had created for her.

“Our bariatric ensuite room within one of our care homes has been up and running for three years now and we have a number of people with bariatric needs who have used it successfully,” says head of care, Zara Ross.

Since the unit opened, the Trust has regularly had someone living there, which shows the demand.

After receiving more inquiries about their specialist bariatric service than it could accommodate, the Trust recently adapted some larger bedrooms in its other care homes and put special equipment in place, including a self-turning mattress (this refers to a mattress which has an automatic turning function that helps the individual to get out of bed).

Bariatric patients need emotional support as well as physical care

As well as the physical care that people need in terms of deteriorating health if they are severely obese, there are also emotional and psychological needs as people often feel very unhappy with their personal image, according to Ms Ross.

“They have to cope with the comments from people who are not obese and who can be quite intolerant and often do not understand why other people are overweight. They can also be viewed as a drain on resources such as the NHS.

“People who are severely overweight often have the same ageing problems in terms of their health as someone twenty years older.”

They are also more likely to suffer from complex conditions such as cardiac disease, hypertension, respiratory disease, diabetics, skin conditions (ulcers and dermatitis), hyperlipidaemia, osteoarthritis, depression, decreased self-esteem, certain types of cancers and gall bladder disease.

They also often require specialist management of their skin as severely obese people have an increased risk of pressure ulcers, wounds and reduced prognosis for wound healing due to their immobility. Providing care for someone with bariatric care needs impacts on the care workers as well.

Moving and handling obese people challenging for both patient and care worker

Someone who is obese may need support from more than two members of staff for personal care.

Moving and handling bariatric patients can be challenging both for the patient and the care worker and risk assessment, adequate and suitable equipment provision, and training are essential in bariatric handling. The increased strain on the patient’s joints, cardiovascular system, range of movement and posture all make it more difficult for them to move and be moved.

But it is not just about the physical handling, it is also about showing understanding and being pragmatic and helping the person make realistic plans for weight loss.

“Sometimes we find families collude and feel sorry for their relative - they smuggle in chocolate and sweets! So it is important for everyone to be part of the care plan,” says Ms Ross.

Having a larger bedroom and needing more staff inevitably adds up to higher costs and there is the whole debate around who is going to meet those costs. Ms Ross has found families can get upset about having to pay additional care costs but just kitting out a specialist bariatric room can be expensive, costing as much as £15,000-£20,000, depending on the equipment provided.

This obviously, is quite a burden on the NHS and the person with bariatric needs often carries that worry and guilt as well as the frustration and low self-esteem that comes from not being able to lose weight and being stuck in a cycle where they can’t change their habits or sometimes for clinical reasons being unable to reduce their weight.

Care homes forced to turn people away if they do not have bariatric facilities

Obesity is a particular problem in parts of Scotland and Robert Kilgour, who runs Renaissance Care, revealed last year that one of his care homes was forced to turn away a 20-stone woman as caring for her would place too much strain on the staff and resources.

He said he is considering building special bariatric rooms in his new care homes to cope with the demand.

Barchester, a leading care provider, has already installed bariatric care equipment at its Ritson Lodge care home in Hopton-on-Sea, Norfolk after being approached by a number of bariatric patients looking for care.

OpeMed (Europe) Ltd, a leader manufacturer and supplier of bariatric equipment, has also seen demand rise from care homes in recent years. Lucy Hemingway, business development and marketing manager, says: “We are seeing a growing pattern of care homes adapting rooms for obese people. We are being asked more and more to fit equipment in care homes and to give training in how to use it.

“Only recently we put specialist bariatric equipment into a care home in Bristol. We put in a ceiling hoist frame that can move across the entire room and a bariatric ceiling track and special toileting equipment. This particular care home has dedicated two of its rooms for people who are severely overweight and need specialist equipment.”

Obesity set to be major problem for care homes over next decade

Ms Ross of St Monica Trust believes that “as a population, we have to face the fact that unless there is some kind of serious health intervention, we are becoming a society where a considerable proportion is overweight”.

She says: “We have seen some tragic situations where people have been stuck in their own home for years and in some cases a bedroom wall has had to be knocked down to help them leave their home for alternative care arrangements.

“Obesity – whether associated with medical conditions, or for other reasons – is definitely a major concern for health and social care providers currently, and over the next ten years.”