Morbidly obese residents

KY2009 · May 16, 2011

Please follow proper body mechanics or ask for help when repositioning or transferring this pt. I have some bad injuries from trying to reposition an obese pt.

Trauma Columnist · May 16, 2011

Usually the facilities that take the super morbidly obese (those over 500#) are specially equipped facilities that advertise this is their specialty. It may mean the pt goes out of the immediate area.

In my area, we have an LTACH (Long-term acute care hospital) that specializes in this care -they have lifts in the ceiling rated to 1000#, all types of bariatric devices including walkers, wheelchairs, beds, scales, etc..

I would focus on the facilities in your state that cater to this specific population.

Mommy&RN, BSN, RN · May 16, 2011

Please follow proper body mechanics or ask for help when repositioning or transferring this pt. I have some bad injuries from trying to reposition an obese pt.

Thanks for your reply KY! Our floor specializes in obesity related procedures. We have many lift devices available to us. Fortunately. SW is having a hard time find ltc for her. Such a sad situation.

Mommy&RN, BSN, RN · May 16, 2011

Usually the facilities that take the super morbidly obese (those over 500#) are specially equipped facilities that advertise this is their specialty. It may mean the pt goes out of the immediate area.
In my area, we have an LTACH (Long-term acute care hospital) that specializes in this care -they have lifts in the ceiling rated to 1000#, all types of bariatric devices including walkers, wheelchairs, beds, scales, etc..
I would focus on the facilities in your state that cater to this specific population.

The second paragraph is how my unit is equipped. She really needs a different facility at the point, she needs long term care/hospice.

I did a search this morning to see if I could find a facility and had no luck. I know SW has sent her info to 6+ facilities and they have all said no. There is 1 that said they would try to see if they can accommodate her.

I just feel so bad for her. She is super nice with good family support.

CapeCodMermaid, RN · May 16, 2011

My facility accepts bariatric patients on a case by case basis. We have one woman who weighs 398 pounds but is able to transfer herself, albeit with loads of positive encouragement. We have another who weighs 455 but is an assist of 6-7. We were not given the true picture of her abilities or lack of them when we accepted her and are now suffering the consequences.

casi, ASN, RN · May 17, 2011

Most LTCs don't have bari equiptment. I've been bugging my facility to get some, but it hasn't happened.

It's really a cost issue.

gentlegiver, ASN, LPN, RN · May 21, 2011

I have worked in a couple faculities that would take morbidly-obese patients. At one place we actually had to call all the Aides (5) from another unit to help all the Aides (5) from our unit to the turn the patient to place this one person on a bed pan. This left both units with no staff covering the floors while caring for this one patient. The other patients families threatened to remove thier family member from us because it was unsafe for thier loved ones. Needless to say this patient was the last person who was morbidly-obese brought in to that faculity.

debRN0417 · May 22, 2011

Most facilities, as has already been stated, cannot afford the bariatric equipment needed for resident that is very large. Then there's the "manpower" involved and the risk of employee injuries...even if proper equipment and techniques are used. The facility usually has to dedicate a private room, which usually ends up being a semi-private room because of the all the equipment and space needed so that's one bed space lost. Unfortunately it is money. I don't know what the answer is, but more and more residents in need of nursing facility care are morbidly obese and have multiple co-morbidities to go along with it, increasing the cost and nursing care even more. And...the rate for a morbidly obese person is the same as one who is not....(reimbursement rate) There was an incident not long ago of a resident falling from a wheelchair. The CNA said that the resident was not properly positioned in the wheelchair and because the resident was so large she could not move them by herself and did not have anyone to help her. She was alone with the resident at a doctors appointment.

JerseyBSN · May 22, 2011

My facility will take morbidly obese patients, they have to order a special big bed that converts to a chair. We need 6-8 people to do care on a morbidly obese patient. Inserting a foley is a nightmare.