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

ObjectiveTo establish the preparedness of nursing homes to deliver high quality, safe and equitable bariatric care for older adults with extreme obesity. Design and methodsA 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. ParticipantsTwenty eight health care workers from three nursing homes in the North Island of New Zealand. ResultsDespite 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. ConclusionNursing 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.