Long-Term Care

Providing bariatric care

LTC Nursing Assistant Trainer, October 6, 2011

Residents who are obese have highly specialized needs. Care that is routine for persons of normal size cannot be done the same for the bariatric population. This includes many ADLs, such as bathing, transfers, mobility, and transportation. Routine activities may be difficult. Things we take for granted, such as standing up, sitting down, and walking to the bathroom, can be strenuous or painful for obese residents. Certain aspects of care can be frustrating or humiliating.

Avoid assuming that bariatric residents are just larger versions of the normal adult. They experience many problems not seen in adults of normal weight, including internal fluid shifts and a change in the body’s center of gravity. Their risk of blood clots and other complications is greater due to immobility. Most have fragile skin and numerous skin-related problems. The weight of the chest makes breathing difficult, and the resident may need to use oxygen, a CPAP mask, or a BiPAP mask. Many need a fan blowing on their face and neck at all times in order to feel comfortable. Breathing is even more difficult when the person is lying down. The extra skin causes the person to feel very hot, so the resident may prefer to remain undressed and covered with a sheet or wear only lightweight clothing.

This is an excerpt from the HCPro book, The Long-Term Care Nursing Desk Reference, Second Edition, by Barbara Acello, MS, RN.

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