During the session, “Design for the Elder Bariatric Client,” at the 2024 EFA Conference + Expo, April 13-16 in Atlanta, speaker Meldrena Chapin, design researcher and Erickson School of Aging Studies adjunct faculty, at University of Maryland (Baltimore), discussed care challenges—and the design considerations necessary to address them—to better support older adults who are obese.
“Individuals with obesity also deal with multiple chronic health conditions and mobility challenges, which make them very likely candidates for assisted living and long-term care,” Chapin said.
Understanding mobility and other challenges
Individuals dealing with obesity are often dealing with issues pertaining to respiratory, cardiac, and circulatory systems, Chapin shared. Additionally, as body weight increases, mobility challenges become greater. These factors combined can lead to needing assistance for daily living.
Another very important consideration is the mental well-being of individuals dealing with obesity; many have experienced shame, guilt, depression, anxiety, and other mental illnesses, she said.
Research also demonstrates an increase in dementia as body weight increases, according to Chapin.
“The reality is that few residential rooms and care environments are designed or provide safe, high-quality care for these particular clients,” she said.
How body shape impacts design considerations
When designing senior living environments for obese residents, Meldrena said it’s important to consider the shape of a person’s body, particularly how and where the excess weight is focused, such as the upper or lower body or along the buttocks.
Each of these shapes has a different center of gravity and requires different supportive furnishings.
“For example, in the pear-shape individual, weight is focused on the hips and thighs, often causing the thighs and knees to open when sitting,” Chapin said. “So, a chair with a semicircular-seat shape with a wide opening or a trapezoid-shaped seat with a wider seat front is more appropriate.”
Additionally, grab bars, floor-mounted toilets, countertops, beds, and seating that can withstand 500-1,000 pounds of weight and pressure should be specified.
Resident room designs for seniors with obesity
For resident rooms, considerations can include appropriate clearances to accommodate bariatric beds, walkers, and wheelchairs, the speaker noted.
For example, rather than a traditional 3-foot clearance around the bed, a 5-foot clearance is needed for bariatric wheelchairs.
For mobile lifts, a 5-foot clearance minimum around the bed and in the bathroom is needed, while ceiling lifts should be designed with wide clearances and the appropriate steel structure for support.
In the bathroom, Chapin noted that designers should place toilets 24 to 36 inches away from side walls to accommodate lifts and staff members providing assistance.
“Specialized seating, including chairs, benches, and loveseats with steel structure, that has been designed for this population need to be provided,” Chapin said. “Space for charging and storage of mobile scooters should also be a priority in continuing self-sufficiency of elders dealing with obesity.”
Staff training
Chapin told attendees that design is not the only piece of providing quality care to seniors dealing with obesity.
Staff training and use of bariatric care protocols to avoid injury is also important.
“Care professionals should be properly trained on how to use mobile lifts, ceiling lifts, inflatable rescue lifts, and equipment to lift limbs while providing in-bed care such as dressing, wound care, and incontinence care,” she said.
During transfer and care provision, she noted that a minimum of two care providers are needed when providing transfers and care procedures using a ceiling lift.
Specialized resident programs for exercise and engagement should also be at the forefront, according to Chapin. Depending upon the individual, elders dealing with obesity may not be able to participate in normal chair exercises with typical elderly residents.
Tracey Walker is managing editor of Environments for Aging and can be reached at [email protected].
