Bariatric Patients are Nationwide
One of the benefits I get from traveling is talking to therapists in different parts of the country. Things are not the same all over the country but there are a few recurring themes. We all agree that our patients are getting bigger. I started including trunk exercises for the obese patient because I was asked that question in every seminar.
Whenever the topic of large patients comes up, it's always followed by the words "and we aren't equipped to treat them." Sometimes the problem is inadequate staffing. It takes more people to mobilize an obese patient. This is a problem when staffing is cut to the bare minimum. An even bigger problem is lack of adequate equipment. Bariatric wheelchairs, beds and walkers are a must for this population.
This morning, I had an order to find a wheelchair large enough to fit a patient so she could get out of bed for 30 minutes. She wasn't comfortable in our 30-inch chair. Plus we don't have elevating leg rests for that chair. Nor do we have a large enough cushion to accommodate her and her wound.
Equipment is another area feeling the brunt of cost-cutting. Anything bariatric is almost twice as expensive as its normal-sized counterpart. Facilities might buy some bariatric equipment. Problems develop when there are more plus-size patients than plus-size equipment. I have four decent cushions. To accommodate my large lady, I will need to take some away from other patients.
Meanwhile both the patient and her doctor will be complaining. The doctor will write orders for a bariatric cushion, wheelchair etc. Despite the obvious need, the facility will not allow me to purchase anything. Rather than spending some money to solve the problem, we'll be told to make do. We might save a little money but the stress will escalate.
I've heard similar stories many times. The research is showing early mobilization of stroke patients improves outcomes. Facilities say they want good outcomes but stop short of spending the money. I don't have any answers. There is no substitute for getting someone out of bed.