The United States is facing a demographic shift that will place a huge burden on the health care system. Over the next 20 years, approximately 10,000 baby boomers will turn 65 each day. Many of these individuals are healthy and well, and will not need medical assistance for some time. Many others, however, are not. As the rates of obesity have increased in the general public, so too have they increased among this cohort. A recent study published in Research in Gerontological Nursing found that the percentage of moderate to severely obese people (with a body mass of 35 or higher) in nursing homes increased quickly to 25% in 2010, with no signs of slowing. What does this mean for the workers who care for them?
Healthcare workers already suffer high rates of musculoskeletal injury and increasing patient weight will only exacerbate the issue. Heavier patients require more staff and specialized equipment. Nursing homes, specifically, struggle because Medicaid does not reimburse for motorized lifts, larger wheelchairs, longer needles, and other items that obese patients need. More than 60% of all nursing home residents are covered by Medicaid so this is a significant funding gap. What it means in practice is more strain on the nursing staff and most probably, more sprains, strains, and back injuries.
Many older people choose to stay in their homes and hire personal assistants. These home health aides are at greater risk for injury because they have even less official oversight. There are no on-site supervisors to monitor ergonomics and the employer/employee dynamic can get in the way of the patient/caregiver relationship.
Hospital employees will also experience the extra strain that heavier and older patients will place on the system as a whole. In general, obese patients are less healthy than normal weight patients and may require longer hospitalization and more complicated treatment protocols. The same physical stresses apply, although hospitals tend to have access to more specialized equipment and more staff.
So how can workers stay safe when working with obese patients? Proper handling and lifting techniques are crucial, as are appropriately-sized beds, wheelchairs, lifts, and bathrooms. Healthcare organizations need to provide the proper tools to their workers, so insurance companies and Medicaid need to reimburse for specialized equipment. Home health workers need a good education on ergonomics and systems of support in place. OSHA has some recommendations here.
Increasing obesity rates among the aging population is not going to go away. Healthcare workers need to be prepared for the increasing physical and emotional stress of caring for their patients.