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facility responsibility to the obese

Nurses   (7,182 Views | 38 Replies)

onthemark has 1+ years experience .

4,968 Profile Views; 91 Posts

In my LTC facility, there are a few woman (in their 50's and 60's) who weigh over 400 lbs. Despite their morbid obesity, they eat as much as they want including desserts, and also order take-out food! Doesn't the facility have a responsibility to monitor and curb their intake just as they do with diabetics? What do you think?

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crissrn27 has 8 years experience as a RN and specializes in nursery, L and D.

904 Posts; 10,740 Profile Views

Even with diabetics the patients have a right to eat whatever they want. All we can do is educate and give appropriate diets. If they order takeout its on them.

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iceprincess492 has 12 years experience.

85 Posts; 3,559 Profile Views

Just as with any other situation, our responsibility is to educate and educate and educate. Same thing with residents who frequently get up without assistance and repeatedly fall. We can't restrain them we can only educate and explain the consequences of non compliance. Residents have a right to refuse any treatment, medication, diet, etc.... It is our job to keep them as safe as we possibly can regardless of whether or not they are compliant.

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Dixielee has 38 years experience as a BSN, RN and specializes in ER.

1,222 Posts; 9,784 Profile Views

You are not holding them prisoner and they retain their freedom to choose to do unhealthy things. You can attempt to educate but you can't legislate or require people to take care of themselves.

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Esme12 has 40 years experience as a ASN, BSN, RN and specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

6 Followers; 4 Articles; 20,908 Posts; 148,285 Profile Views

You have the responsibility to treat them with respect and dignity just like anyother patient.

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Jolie has 34 years experience as a BSN and specializes in Maternal - Child Health.

6,375 Posts; 35,192 Profile Views

If a resident lives in a LTC facility receiving public benefits to pay for medically necessary care, is it not possible to dismiss the resident for gross failure to comply with a reasonable treatment plan?

People lose their Medicare benefits if they refuse to participate in PT, OT, ST, etc. How is this different?

Shouldn't scarce beds be used for the treatment of patients who are willing to make an effort to comply with the treatment needed to improve their health?

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VivaLasViejas has 20 years experience as a ASN, RN and specializes in LTC, assisted living, med-surg, psych.

8 Followers; 142 Articles; 9,751 Posts; 250,749 Profile Views

Medicare doesn't pay for ICF (long-term) care, which is where most of these patients eventually wind up when they don't participate in therapies. That's when private long-term care insurance or Medicaid takes over.

As much as I dislike paying taxes for these younger patients to live in a facility because they are too obese to maneuver themselves around at home, I have to wonder where else they are to go if they can't take care of themselves?

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4,266 Posts; 22,464 Profile Views

[color=rgb(46, 139, 87)]if a resident lives in a ltc facility receiving public benefits to pay for medically necessary care, is it not possible to dismiss the resident for gross failure to comply with a reasonable treatment plan?

people lose their medicare benefits if they refuse to participate in pt, ot, st, etc. how is this different?

shouldn't scarce beds be used for the treatment of patients who are willing to make an effort to comply with the treatment needed to improve their health?[/quote]

no. if they are capable of acting on their rights, it's their business. btdt with a few such cases. plus many people in ltc are paying their own way... can't discriminate.

people don't lose their medicare benefits for not doing pt/ot/st- they can be discharged from that particular rehab stay- but they still have medicare coverage for other things (outpatient therapy, hospital, md visits). and, if they're readmitted within 30 days, they can pick up the rehab again. plus, people pay into medicare- or they don't get it (aside from widows and 'orphans'). it's a tax you pay now .... you want someone to tell you that you have to do something that you feel isn't necessary- for whatever reason? my mom had some a-hole tear her rotator cuff during "rehab" after she'd repeatedly said it hurt too much. should she not have gotten some sort of help with that???

in an ideal world, maybe- but where do the others go? if they're on the streets, and end up stealing d/t hunger- then the justice system gets them, and that isn't cheap either. turning them into criminals for basic needs isn't an answer.

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Jenni811 has 3 years experience as a RN and specializes in Intermediate care.

1,032 Posts; 12,918 Profile Views

They have the right to eat what they want. A diabetic person can eat all the sugar and carbs they want, it is their right.

All you can do is educate.

You can't force someone to eat certain things or not eat certain things. If i were elderly,sick, and in a NH or Hospital i would want my life to be more about quality and if someone deprived me of my pizza, there would be hell to pay :)

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932 Posts; 9,136 Profile Views

In my LTC facility, there are a few woman (in their 50's and 60's) who weigh over 400 lbs. Despite their morbid obesity, they eat as much as they want including desserts, and also order take-out food! Doesn't the facility have a responsibility to monitor and curb their intake just as they do with diabetics? What do you think?

We educate diabetics about proper dietary/lifetyle choices, same as with any patient with any healthcare issue; however, never have I seen a situation where a facility educated and then forced a patient to comply. Patients are still able to make their own healthcare decisions.

They can refuse prescribed treatments (i.e blood transfusions, ABX, IVs, dietary restrictions, etc.) but the responsbility of the facility is clearly laid out in that we must respect the patient's right to choose, even if we don't respect the patient or the choice.

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nurse2033 is a MSN, RN and specializes in ER, ICU.

3 Articles; 2,124 Posts; 28,758 Profile Views

Patients have right to make poor decisions and it is up to us to clean up their mess. Job security!

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DixieRedHead has 20 years experience as a ASN, RN and specializes in ED/ICU/TELEMETRY/LTC.

638 Posts; 9,725 Profile Views

Residents do not lose any benefits from failure to comply with dietary recommendations because they are no considered "rehabilitation" therapy.

The do have the right to eat as they please and we do have to educate them. In my facility if they choose not to abide by the recommended dietary plan, they or their RP must sign a waiver after being advised of all ramifications.

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