Being a 30 year CNA, I have seen a number of changes and trends in elder care over the years.  Most of them we adapt to and the changes become part of our routine.  However, there is a current tendency that is causing me concern for the safety of both the residents and the staff.  I know it is not just in my home or even my state, it is a nationwide issue.

In my facility we are getting a lot more bariatric patients admitted and with that comes more specialized equipment that is needed to properly care for these residents.  Bariatrics is the branch of medicine that deals with the causes, treatment, and prevention of obesity.  According to Kaiser Health News, “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.”  In ten years, the number of bariatric admissions to nursing facilities nearly doubled, and has continued to do so.

Do the admitting facilities really stop and consider how hard it is to provide quality and safe care if the proper equipment is not available?  We have had several work-related injuries due to equipment that doesn’t really fit these needs. With that being said, let’s look at some of the equipment that is needed.

First, we must have an appropriate size bed and mattress, oversize wheelchair, shower chairs, and mechanical lifts and slings to transfer these residents. So, the lifts can lift up to 600 pounds which is great and in my experience, that is not an issue. What the issue is, is the base of the lift that opens to allow the chair to be put under the resident so they can be safely placed in their chair doesn’t open wide enough. The oversize wheel chairs are wider than the base of the lifts, therefor alternate provisions have to be taken to transfer the resident into the chair.

The CNAs are having to go in sideways and tilt the chair to allow these lifts to fit around the chair for proper placement of the resident. Is this safe for the resident or the CNA? Absolutely not, it puts all parties at risk for injury. The big question I have is, do the companies who make this equipment that lift up to 600 pounds not consider that the chairs are wider than a standard chair? Would it not make more sense to make a lift that accommodates these bariatric chairs?

Another interesting question is, why are the facilities who are buying these lifts not looking closer at the complete picture of what these lifts can actually do? They not only have to be able to lift these residents, but they must also be able to fit around the oversized chairs, whether it be a wheel chair or shower chair, so that the resident is able to be placed in a safe position and the CNAs should not have to compromise their safety to do so.

Before a facility admits a bariatric patient there should be an assessment of all equipment that will be required to properly and safely take care of the resident and it should be in the facility set up and ready to go when the resident arrives. This allows the resident to be comfortable and feel safe right from the start making for an easier transition. In conclusion, the answer to the question “Does one size fit all?” is no, we need equipment that fits all the needs of all our residents.