Obesity and Nursing Home Care in the United States: A Systematic Review

Harris, John A.; Castle, Nicholas G.

doi:10.1093/geront/gnx128

Cited by 22 publications

(14 citation statements)

References 41 publications

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“…7 Disability requires assistance or lifestyle adaptation, whether at home, in the hospital or in a nursing home, and frequently occurs in the form one or more informal or formal caregivers. 8–10 No healthcare setting manages the challenges of disability more than nursing homes, where 80% of the 1.4 million residents in U.S. nursing homes report deficits in their ADLs. 11,12 …”

Section: Introductionmentioning

confidence: 99%

Obesity and intensive staffing needs of nursing home residents

2018

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The objective of this study is to examine how increasing body mass index (BMI) among nursing home residents affects the amount of staffing assistance needed for activities of daily living (ADL). We analyzed 1,627,141 US nursing home residents reported in the 2013 Minimum Data Set in seven BMI categories, from underweight (BMI < 18.5 kg/m2) to obesity Class IIIB (≥50 kg/m2). Logistic regression models estimated the odds of nursing home-reported need for extensive (≥2 staff member) assistance needed for ADLs. The adjusted odds increased from 1.07 (95% Confidence Interval (95%CI) 1.06–1.08) for Class I, 1.16 (95%CI 1.14–1.17) for Class II, 1.33 (95%CI 1.31–1.35) for Class IIIA, and 1.90 (95%CI 1.86–1.95) for Class IIIB obesity residents compared to residents of normal weight. As a nursing home resident’s BMI increases, especially for BMI ≥40 kg/m2, the need for extensive staffing assistance with ADLs also increases substantially.

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Section: Introductionmentioning

confidence: 99%

Obesity and intensive staffing needs of nursing home residents

2018

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“…Key areas of concern for nursing homes related to limitations in the infrastructure of current facilities, and financial barriers that specifically related to equipment procurement and safe staffing ratios. Such concerns have been well documented in the USA in relation to increasing prevalence of obesity in aged care facilities (31)(32)(33)(34). A systematic review of 28 studies examining the impact of obesity on nursing home care in the USA identified that obesity posed major issues for the provision of nursing home care, impacts the wider health care system, and provides challenges for nurses to deliver high quality care (35).…”

Section: Discussionmentioning

confidence: 99%

The care of older adults with extreme obesity in nursing homes: A collective case study

Hales

Amankwaa

Gray³

et al. 2019

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Objective: To establish the preparedness of nursing homes to deliver high quality, safe and equitable bariatric care for older adults with extreme obesity. Design and methods: A collective case study approach was used. Data collection included observational and interview data from three nursing homes, and a review of 224,200 resident admissions over a 3-year period in New Zealand. Participants: Twenty eight health care workers from three nursing homes in the North Island of New Zealand. Results: Despite a willingness by healthcare staff to care for older adults with extreme obesity, nursing homes were not well equipped to provide safe equitable care for this resident population. Key areas of concern for nursing homes related to limitations in the infrastructure, and financial barriers relating to government funded contracted care services which incorporated equipment procurement and safe staffing ratios. Conclusion: Nursing homes are unprepared to accommodate the existing and increasing number of older adults with extreme obesity who will require bariatric specific care. Government agencies and policy makers will need to consider the financial implications of the increasing need for bariatric level support within aged care, as well as the impact on individual nursing home resources and quality of care provided. Considerable sector and government attention is needed in relation to infrastructure and funding, to allow for the provision of high quality, safe and equitable care for this population group.

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“…This rise in obesity among nursing home residents poses numerous difficulties for facilities (Harris & Castle, 2017). Residents with obesity have different needs than residents of normal weight, and these different needs require unique resources to manage properly.…”

Section: Background and Objectivesmentioning

confidence: 99%

“…Specifically, they reported concerns about the availability of equipment and staff as important reasons why they may decline admission to a prospective resident with extreme obesity. In summary, the custodial and rehabilitation care for residents with obesity requires more resources in terms of staff number, staff hours, and facility equipment (Harris & Castle, 2017).…”

Section: Background and Objectivesmentioning

confidence: 99%

Organizational and Geographic Nursing Home Characteristics Associated With Increasing Prevalence of Resident Obesity in the United States

2019

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Nursing home resident obesity increases the complexity of nursing care, and nursing homes report avoiding residents with obesity when choosing which prospective residents to accept. The objective of this study was to examine the associations between nursing home obesity prevalence rate and nursing home organizational, staffing, resident, and geographic factors within a profit maximization framework. The study cohort included U.S. Centers for Medicare and Medicaid Services data from U.S. nursing homes in 2013. Study findings supported hypothesized associations between obesity prevalence rate and higher occupancy, higher bed capacity, and multi-facility affiliation, but findings did not support a relationship between obesity prevalence rate and for-profit status.

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Obesity and Nursing Home Care in the United States: A Systematic Review

Cited by 22 publications

References 41 publications

Obesity and intensive staffing needs of nursing home residents

Obesity and intensive staffing needs of nursing home residents

The care of older adults with extreme obesity in nursing homes: A collective case study

Organizational and Geographic Nursing Home Characteristics Associated With Increasing Prevalence of Resident Obesity in the United States

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