What Happens To Patients With Severe Obesity In Hospitals?
Wednesday, April 15, 2015
With the increasing number of Canadians living with severe obesity (BMIs 50+), it is not unexpected that more of them will be seen in healthcare settings.
However, whether or not Canadian hospitals are ready to look after these patients with in the right setting with the right equipment and whether healthcare providers are aware of and sensitive to the special needs of these patients is not clear.
This is why, Mary Forhan and her team at the University of Alberta is currently conducting a qualitative and quantitative assessment of exactly what problems patients with severe obesity face in healthcare settings.
The study, funded by Alberta Innovates Health Solution (AIHS) will look at the special challenges that these patients present in a range for settings – acute care, cancer, cardiology and rehabilitation.
A substudy will also examine the issues faced by kids and adolescent with severe obesity in healthcare settings.
Together, this project should lead to a better understanding on how healthcare systems better prepare themselves to deliver compassionate and professional care to adults and children living with severe obesity in Alberta. The learnings will likely also inform healthcare systems elsewhere.
For more on this study visit the AIHS website.
If you are someone living with severe obesity, who has experienced issues in your healthcare that could have been prevented or addressed with appropriate equipment and/or training, I’d love to hear your story.
@DrSharma
Edmonton, AB
Conflict: I am a co-investigator on this project.
Wednesday, April 15, 2015
Thank you for posting a very important concern that certainly is in the minds of providers who care for patients with obesity. I do not know if your study will discuss the medical care of patients with obesity (BMI >60) who would benefit from inpatient care potentiallly prior to weight loss surgery. We have numerous incidences with patients with severe (and extreme) obesity who require medical care (not acute care), but hospitals and medical/surgical services are unable and/or unwilling to take on these patients. As the rate of severe obesity increases, it clearly will become more of an issue. I hope your study is addressing this and would be more than glad to help in any way.
Thank you,
Scott Butsch
Wednesday, April 15, 2015
I know one of my experiences was in the original article but there has been a few other things that I’ve experienced due to the assumption that my weight seems to bring. Hurting my wrist is one. Or having chest pain and the only thing written on my chart that I was given to bring to the ultrasound was ‘morbidly obese’.
Wednesday, April 15, 2015
When I arrived at emergency they didn’t have a blood pressure cuff large enough to fit me so just shrugged their shoulders and skipped it. The chairs I had to wait in were hard (bad for arthritic hips), narrow and with arms so dug into my sides. When they wanted to draw blood I warned them it would be difficult, but they didn’t listen. After 2 failed attempts they called for another technician. Much later she showed up with a trainee in tow and told her to give it a try. Are you kidding me? When they eventually had to insert a PICC the tourniqet in the sterile pack was too short so they couldn’t use it. After spending 2 days in a painful ER bed I was finally given a room to get well enough for surgery. Turns out I had a life threatening illness. After a day I was given a state-of-the-art inflatable bariatric bed, but no one knew how to use it. I could get out of the bed, but it was painful to climb back into as it was very high and I had just had abdominal surgery. Despite repeated requests no one would find me a stool until my doctor made a scene. I didn’t discover until the last day that it could be deflated. I was fortunate enough to be in a newly opened hospital wing so had a private room with accessible toilet and shower.
Wednesday, April 15, 2015
Blood pressure cuffs! Hospital gowns! Seating in waiting rooms! Small things maybe … but they really matter!
Thursday, April 16, 2015
A lot of us health care providers are aware of and try to be sensitive to the needs of morbidly obese patients, but the equipment and other resources are just not there. And there are some morbidly obese patients who will not cooperate with our efforts. For example, I had one morbidly obese immobile man who needed to be transferred from a stretcher back to his bariatric bed when he returned from a test. Although the room was supplied with a ceiling lift more than capable of handling his weight, he vigorously objected to us using it because he “didn’t like it”. He demanded that three of us (one recovering from a recent back muscle strain) LIFT him from the stretcher to the bed. This would have required each of us to lift the equivalent of greater than 100 pounds. He only allowed us to use the sling when we politely told him that his options were to use it or remain on the stretcher all night, because we simply had no other options to move him safely. I know some people find the use of a ceiling lift or other lifting device uncomfortable or embarrassing, but it is also wrong to expect healthcare providers to risk injury and disability by refusing to let us use the little equipment we have available. I’m obese and I wouldn’t expect someone to deadlift my body weight, and I would be horrified to know that someone was injured by moving me. I will do everything in my power to assist the morbidly obese patient, but I also need that patient to work with me.