Obese Nursing Home Residents: A Call to Research Action

Felix, Holly C.; Bradway, Christine; Miller, Elizabeth; Heivly, Amy; Fleshner, Irene; Powell, Lawrence S.

doi:10.1111/j.1532-5415.2010.02879.x

Cited by 14 publications

(14 citation statements)

References 7 publications

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“…(13, 14) Obese residents may require more CNA time to help them with daily activities as well as pressure ulcer prevention due to their heavy body weights. (15)(16) Therefore, facilities with insufficient CNA staffing may not be able to provide sufficient care such as repositioning obese residents often, and the differences in presence of pressure ulcers between obese and non-obese residents might be exacerbated in such facilities. However, to date, most of the published studies have not examined the role of obesity when evaluating pressure ulcer rates in a NH (17–22), and none has examined whether and how CNA staffing level impact pressure ulcer rates among obese residents.…”

Section: Introductionmentioning

confidence: 99%

Obesity and Pressure Ulcers Among Nursing Home Residents

2013

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Objectives To examine the prevalence of obesity and its relationship with pressure ulcers among nursing home (NH) populations, and whether such relationship varies with certified nursing assistant (CNA) level in NHs. Data and study population The 1999–2009 nationwide Minimum Data Sets were linked with Online Survey of Certification and Reporting records. We identified newly admitted NH residents who became long-stayers and followed them up to 1 year. Analyses The outcome variable was presence of pressure ulcers during the 1-year follow-up period. Residents were categorized as normal (18.5<=BMI<30 kg/m2), mild obesity (30 <=BMI <35 kg/m2) and moderate or severe obesity (BMI>=35 kg/m2). Pooled and stratified analyses were performed to examine the relationship between obesity and pressure ulcers, and how it varied by facility CNA level. Results The prevalence of obesity increased from 16.9% to 25.8% among newly admitted NH residents over the last decade. Obesity was associated with higher risks of pressure ulcers among long-stay residents. The relationship between obesity and pressure ulcers persisted after accounting for individual health conditions at the baseline and facility-level variations. Further, the within-facility relationship between obesity and pressure ulcers varied by facility CNA levels. The odds of pressure ulcers were 18.9% higher for residents with moderate or severe obesity than for non-obese residents within NHs with low CNA levels. The percents for medium and high CNA level facilities were 14.0% and 12.8%, respectively. Conclusion To prepare for the growing obesity epidemic in NHs, policies should focus on strategies to improve care provided for obese residents.

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Section: Introductionmentioning

confidence: 99%

Obesity and Pressure Ulcers Among Nursing Home Residents

2013

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“…Even though a significant body of knowledge is available on bariatric patients, more research is needed for caring for bariatric patients in long-term care facilities. 3 Because bariatric individuals represent unique challenges, further research is also needed so that nurses and interdisciplinary teams know how to face these challenges and develop bariatric programs within their facility. Other areas that require more research include patient care, staff education programs, interdisciplinary team roles, equipment, and the role patients/families have in treatment planning.…”

Section: Resultsmentioning

confidence: 99%

Caring for Your Bariatric Patient: A Resource Guide to the Literature on Care of the Morbidly Obese

Thiele¹,

Osterreicher²

2011

Bariatric Nursing and Surgical Patient Care

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“…The provision of such care may require additional investment in equipment and staff time. 7,9,29,30 Yet, obesity status is not included in the algorithms setting prospective payment rates for SNF care, and this may create a barrier for NHs to invest in resources needed to provide high-quality care to obese residents. Unfortunately we are not able to determine the extent to which the Medicare payment rates contribute to the readmission rates among obese residents as Medicare SNF rates are set by the CMS and the case-mix adjustment algorithm is standard in the country.…”

Section: Discussionmentioning

confidence: 99%

Hospital Readmissions Among Post-acute Nursing Home Residents: Does Obesity Matter?

Cai

Wang

Mukamel

et al. 2019

Journal of the American Medical Directors Association

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Objectives: To explore profiles of obese residents who receive post-acute care in nursing homes (NHs) and to assess the relationship between obesity and hospital readmissions and how it is modified by individual comorbidities, age, and type of index hospitalizations. Design: Retrospective cohort study. Setting and participants: Medicare fee-for-service beneficiaries who were newly admitted to free-standing US NHs after an acute inpatient episode between 2011 and 2014 (N = 2,323,019). Measures: The Minimum Data Set 3.0 were linked with Medicare data. The outcome variable was 30-day hospital readmission from an NH. Residents were categorized into 3 groups based on their body mass index (BMI): nonobese, mildly obese, moderate-to-severely obese. We tested the relationship between obesity and 30-day readmissions by fixed-effects logit models and stratified analyses by the type of index hospitalization and residents' age. Results: Forty percent of the identified residents were admitted after a surgical episode, and the rest were admitted after a medical episode. The overall relationship between obesity and readmissions suggested that obesity was associated with higher risks of readmission among the oldest old (≥85 years) residents but with lower risks of readmission among the youngest group (65-74 years). After accounting for individual co-covariates, the association between obesity and readmissions among the oldest old residents became weaker; the adjusted odds ratio was 1.061 (P = .049) and 1.004 (P = .829) for moderate-to-severely obese patients with surgical and medical index hospitalizations, respectively. The protective effect of obesity among younger residents reduced after adjusting for covariates. Conclusions/Relevance: The relationship between obesity and hospital readmission among post-acute residents could be affected by comorbidities, age, and the type of index hospitalization.

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Obese Nursing Home Residents: A Call to Research Action

Cited by 14 publications

References 7 publications

Obesity and Pressure Ulcers Among Nursing Home Residents

Obesity and Pressure Ulcers Among Nursing Home Residents

Caring for Your Bariatric Patient: A Resource Guide to the Literature on Care of the Morbidly Obese

Hospital Readmissions Among Post-acute Nursing Home Residents: Does Obesity Matter?

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