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

Abstract

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.

Healthcare Workers’ Experiences of Strategies in Caring for Patients with Obesity: A Qualitative Content Analysis

“…Most nurses ignored patients' positioning, oral care, feeding, medicine administration, and training (32) because it was difficult to position PWO, who were unable to move (33). According to McClean et al, healthcare workers were unable to position, bathe, transfer, and change the clothes and dressings of PWO, such that 46% of the nursing assistants were injured while positioning these patients, and 40% reported back pain.…”

Technology-based interventions for nursing home residents: a systematic review protocol

“…11 Nursing home residents often have limited access to microlevel social support, including support from formal (eg, doctors and nurses) or informal caregivers (eg, family, friends and acquaintances), 31 local community 32 and organisations (eg, inexperienced or inadequately trained staff). 33 Furthermore, nursing home residents often have limited macrolevel social support. This is evidenced by harmful social norms (eg, age-related discrimination) [34][35][36] and inadequate policy support that facilitates healthy ageing and quality of life (eg, insufficient regulatory oversight to ensure quality care in nursing homes).…”

“…The third set of factors that contribute to nursing home residents' vulnerability to COVID-19 centres on social support available to these adults 11. Nursing home residents often have limited access to microlevel social support, including support from formal (eg, doctors and nurses) or informal caregivers (eg, family, friends and acquaintances),31 local community32 and organisations (eg, inexperienced or inadequately trained staff) 33. Furthermore, nursing home residents often have limited macrolevel social support.…”

Technology-Based Interventions for Nursing Home Residents: Implications for Nursing Home Practice Amid and Beyond the Influence of COVID-19: A Systematic Review Protocol

“…The third set of factors that contribute to nursing home residents' vulnerability to COVID-19 centers on social support available to these adults. Nursing home residents often have limited access to micro-level social support, including support from formal (e.g., doctors and nurses) or informal caregivers (e.g., family, friends, and acquaintances) [40], local community [41], and organizations (e.g., inexperienced or inadequately trained staff) [42]. Furthermore, nursing home residents often have limited macro-level social support.…”