Obesity is a significant health concern in New Zealand with 1 in 3 New Zealand adults classified as obese, according to the 2020/2021 NZ Health Survey this is a 3% rise since 2019/2020 survey.
Both healthcare professionals and solution providers have had to adapt to meet the complex needs of obese individuals, resulting in greater investment in the development of specialised bariatric care techniques and equipment, designed to support rehabilitation, hygiene and provide greater independence.
In the early days of bariatric equipment, a double-width wheelchair was commonly used, resulting in poor positioning that often caused pressure ulcers and discomfort. Although a broader range of specialist bariatric solutions are available today, those prescribing equipment to support obese individuals, have more to consider.
We explore some of the key factors to consider when prescribing bariatric solutions:
Safe working load of equipment – how will your client’s weight will fluctuate over time or will additional accessories and other equipment exceed the total safe working load of the equipment.
The environment – overall accessibility, including room dimensions, width of doorways/hallways and flooring type.
Body proportions and physical dimensions – often Bariatric clients can weigh the same, but the distribution of their weight is completely different. Identify where the weight is located on the client and where the support is required.
Range of movement – identifying the individual’s extent of movement will help you achieve a balance between rehabilitation, mobility, and use of moving and handling equipment to ensure the safety of the user.
Mobility and transfers – consider strong, functional and durable aids. Adjustable equipment will allow you to cater to the individual’s unique shape. Consider features such as swing away arm rests/leg rests or arm rests that are further forward can assist with balance when standing.
Pressure care factors – bariatric clients are often higher risk of pressure injuries. Prevention, management, and treatment are similar to that of non-bariatric individuals with a few additional challenges: skin folds, difficulty moving independently and with assistance, difficulty managing own self care such as toileting, difficult to redistribute pressure and impaired sensation.
The needs of the caregiver – what support does the carer require to complete transfers and cares.
Correct positioning - unique to bariatrics is the gluteal shelf, or bulbous gluteal region. Poor posture occurs when there is not enough space for the gluteal shelf, which pushes an individual forward. This increases the risk of falls and can cause the spine to curve. Identify equipment that will support the gluteal shelf and provides overall postural alignment.
Before prescribing any solution, we encourage you to complete a thorough clinical assessment in conjunction with your multi-disciplined team of health professionals, your client, their care team and whānau.
For further support on selecting the right equipment for bariatric clients please get in touch with our team.