US Obesity putting nursing homes under strain
Growing obesity rates amongst seniors in the US are causing problems for nursing homes, who are finding that staff and facilities are poorly equipped to cope with overweight and obese patients. Frequently, new devices including stronger stairlifts and larger wheelchairs are required. The problem appears especially acute in the South, with extreme obesity rising quickly. All this means heavy seniors can be confined to hospitals instead of nursing homes, or ideally ageing in their homes; all at great expense to Medicare. 

The percentage of those entering American nursing homes who are moderate and severely obese — with a body mass index of 35 or greater — has risen sharply, to nearly 25 percent in 2010 from 14.7 percent in 2000, according to a recent study, and many signs suggest the upward trend is continuing.

But as demand from severely obese patients surges, nursing home administrators say they cannot afford to care for them, because Medicaid, which covers more than 60 percent of all nursing home residents, does not reimburse them for the specialized equipment required: motorized lifts; larger wheelchairs, bedside commodes and shower chairs; and longer intramuscular needles and blood pressure cuffs. The devices are expensive: $10,000 for a mechanical lift, for instance, and $5,000 for an extra-wide bed.

“It’s really not a moneymaker,” said Aundrea Fuller, an owner of Generations of Red Bay, the private, for-profit facility that cares for Ms. Chism in a specially outfitted wing that can accommodate 10 obese patients. Ms. Fuller’s decision to open the unit, which frequently has a waiting list, fulfills her personal mission to aid obese people, who are often ostracized and forgotten. But it makes little business sense.

“You’ve got to do it because you have a heart for it,” she said.

There is no national census of available beds in American nursing homes for those weighing more than 350 pounds, the maximum weight a standard hospital bed can handle. But industry groups and researchers say facilities rarely accept more than a few markedly obese patients.