Nursing Homes Face More Challenges for Patients of Size

Angie Szumlinski News

By law, hospitals must treat people of all shapes and sizes when they need emergency care. However, these laws don’t apply to nursing facilities.


A recent article appearing on caringfortheages.com talks about the challenges in placing obese patients in nursing facilities. The article states that as the American population grows increasingly larger, the elder population is no exception. According to a 2016 report from the Centers for Disease Control and Prevention, the percentage of people aged 75 who are considered obese — with a body mass index (BMI) of 30 or more — shot up from 19% in 1988–1994 to 33% in 2013–2016. In the latter period, 2% had BMIs of 40 or more.


Caregivers have to anticipate that roughly 40% of their patient population may be obese, requiring extraordinary services and equipment

By law, hospitals must treat people of all shapes and sizes when they need emergency care. However, these laws don’t apply to nursing facilities. Bariatric patients may require nonstandard equipment such as beds, toilets, phlebotomy needles, examination tables, wheelchairs, walkers, Hoyer lifts, mattresses, and underwear. Other needs might include trapeze bar systems over beds and specially sized gowns, slippers, stretchers, friction-reducing sheets, bedpans, armchairs, tape measures, incontinence pads, slings, blood pressure cuffs, scales, shower chairs, commodes, and therapy tables, and it is not typical for a center to have specialty equipment on hand.

Larger patients also require more staff for bathing, moving, and repositioning. In an emergency situation, it would take two people to perform the Heimlich maneuver on a bariatric patient.


The expense and risks of serving patients of size may seem overwhelming to nursing facilities, but experts say there are ways of overcoming these obstacles. Click To Tweet Proper training is essential, research suggests that properly trained staff do not face a higher risk of injury from caring for larger patients. Staff also needs to be trained not to treat obese patients differently. For example, some have reported avoiding getting obese patients out of bed in the morning because of the amount of time it takes.

Joy Stephenson-Laws, JD, a Los Angeles–based health industry attorney, urged facilities to set appropriate prices. “Caregivers should not necessarily base their charges on a ‘normal weight’ patient with medical conditions,” she said. “They have to anticipate that roughly 40% of their patient population may be obese, requiring extraordinary services and equipment, and set their prices accordingly.”

To read the full article, please click HERE.