Tips for caring for plus size patients

According to the World Health Organisation, the figures for obesity within the world's adult population have almost doubled since 1980, with 600 million people recorded as obese in 2014.¹ As the number of overweight people continues to rise, so does the pressure on hospitals and healthcare workers to address the issue, both practically and psychologically.

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In addition to the very real need to install appropriate bariatric equipment such as bariatric hospital beds that can handle the extra patient load, there is also an essential requirement to address the psychological issues that arise for plus size patients receiving treatment within a healthcare setting.

Plus size patients may worry about whether their shape or size may inconvenience staff and other patients, or lead to delays or equipment failure. This can make a healthcare facility stay extra stressful for overweight people, unless they are given some reassurance as to how potential problems can be overcome in a dignified and respectful way.2

Potential Remedies

  • Consult with the patient about any potential problems – Increased training on more empathetic and respectful patient interaction can go a long way towards providing better levels of care and psychological support to plus size patients in a pragmatic and non-judgemental way.
  • Check with patients in advance of a hospital visit to see if they need any assistance or special equipment 
  • A hospital or clinic should be able to welcome a patient of any size, without fear of embarrassment or loss of dignity. For example, wider chairs and accessible restrooms for large patients and their family. The bariatric equipment should be readily available without “making a fuss” to find it and have enough space to work.3
  • Using unobtrusive ceiling lift equipment to avoid multiple staff gathering to manually handle the patient – overweight patients fear hurting others and being manually handled is far from dignified. Use a combination bed sheet and sling for instant access, less effort and more comfort.4
  • By providing equipment, such as bariatric hospital beds, that look as similar as possible to standard beds.5
  • Using a pressure-redistributing mattress with moisture management cover to reduce the likelihood of distressing pressure injuries and moisture lesions on the skin, which can lead to odour and embarrassment.6,7
  • Use of mobile bariatric lifting aids can help facilitate safe and more dignified patient handling.8
  • Assisted toileting and bathing can be embarrassing for any patient, but a plus size person may have additional concerns about the weight tolerance of equipment. Having bariatric bathroom equipment available ensures both comfort and patient dignity.9

     

Bushard et al10 and Butcher et al11 suggest that when organisation is developing policies and procedures to manage the plus size person, they should take a broader view in the definition rather than just focusing on body measurements, and consider several other factors that would impact on patient care and staff safety; for example the effect a person’s body shape and weight distribution will have on their functional mobility, the space required to accommodate the individual, their family, care giver(s) and equipment staffing levels to support care provision.

Arjo can provide equipment solutions and educational resources for practitioners to promote best practice, demonstrating that a plus size person can be managed effectively in a suitable environment with appropriate equipment whilst maintaining their personal dignity.

Learn more about our Clinical Consultancy Services

References
1. WorldHealth Organisation Fact Sheet 311 (2015): http://www.who.int/mediacentre/factsheets/fs311/en/ [Accessed January 2019]
2. British Psychological Society, Professional Practice Board, Obesity in the UK: A psychological perspective (2011), http://www.bps.org.uk/sites/default/files/images/pat_rep95_obesity_web.pdf  [Accessed January 2019]
3. Hignett, S and Griffiths, (2009) (Manual handling risk in the bariatric (obese) patient pathway in acute, community and ambulance care and treatment. Work, 33 (2), 175).
4. BeitzJM. Providing Quality Skin and Wound Care for the Bariatric Patient: An Overview of Clinical Challenges. Ostomy Wound Manage. 2014;60(1):12-21
5. Muir, M A and Rush, J A (2013) Moving and Handling of Plus Size People an illustrated guide, Towcester: National Back Exchange, 9
6. National Pressure Ulcer Advisory Panel, European Pressure Advisory Panel and Pan Pacific Pressure Injury Alliance (2014) Prevention and Treatment of Pressure Ulcers: Clinical Practice Guideline Emily Haesler (Ed ) Cambridge Media: Osborne Park, Western Australia; 2014
7. National Pressure Ulcer Advisory Panel, European Pressure Ulcer Advisory Panel and Pan Pacific Pressure Injury Alliance. Prevention and Treatment of Pressure Ulcers: Quick Reference Guide. http://www.internationalguideline.com/static/pdfs/NPUAP-EPUAPPPPIA-PUQuickReferenceGuide-2016update.pdf [Accessed January 2019]
8. Dutta, T., P. J. Holliday, S. M. Gorski, M. S. Baharvandy, and G. R. Fernie. “A Biomechanical Assessment of Floor and Overhead Lifts Using One or Two Caregivers for Patient Transfers.” [In eng]. Appl Ergon 43,no. 3 (May 2012): 521-31.
9. ArjoHuntleigh Guidebook for Architects and Planners, 4th edition. 2014
10. Bushard, S. (2003) ‘Trauma in Persons who are Morbidly Obese’ Cardio metabolic risk and weight management Vol. 2 (1), pp. 14-16 January 2002
11. Butcher, K., Morgan, J. & Norton, S. (2012) Inadequate Provision of Care for Morbidly Obese Patients in UK Hospitals. AnnR Coll Surg Engl (Suppl) 2012, 94 pp. 338 - 342, November 2012.