With the increase in obesity in the population, and even among the younger cohorts of residents, ACFs need to consider purchasing bariatric equipment. What is the essential equipment to provide quality care to heavier residents? Should facilities purchase bariatric equipment, or simply hire as needed?
What should they look for in construction?
Bariatric furniture needs to be able to adequately support residents of around 170kg up to 450 kg in weight and enable them to receive quality care. However, apart from beds, bariatric items are generally designed to take 350 kg.
While the choice of furniture is fairly limited at this stage, and expensive due to manufacturing costs, Independent Living Specialists’ managing director and co-owner Peter Reid says this will change with increased demand. Currently, most bariatric furniture is simply modified standard furniture, but he believes manufacturers will begin developing specific bariatric ranges, offering a wider choice of styles and products.
“We’ll start to see ‘big people’s furniture’, rather than furniture made bigger and strengthened with braces. It will be more ergonomically correct.”
Currently available for hire or purchase are beds, mattresses, shower chairs, commodes, chairs and lifting devices. The essential item is the correct bed – which should be a high-low bed with back raise, knee break and Trendelenburg, and of course it should be electronically operated to avoid the carer risking OH&S problems from adjusting the bed.
Bariatric beds generally have built-in scales for monitoring the resident’s weight, and should be fitted with a mattress replacement system to avoid pressure ulcers and maintaining skin integrity.
The mattress replacement system has a series of air pockets, which every 10 minutes have air pumped in or out to create a gentle wave of pressure rippling down the bed, taking pressure off some parts and increasing it on others, as well as generating a flow of cool air to increase the person’s circulation.
Two views of the TriFlex bariatric bed
The next most important item, Reid says, is a hoist, although some beds, like the TriFlex bed, can raise the patient to a standing position using the high-low back section. A high backed bedside chair with adjustable legs will give residents some time out of bed, and an adjustable recliner chair will raise a person from lying to sitting to standing position.
A high backed chair with adjustable legs will give residents some time out of bed
Reid says equipment like this, which takes away the effort needed to get up, enables the person to stay more mobile, as well as reducing OH&S risks to staff.
In order to carry the increased weights and sizes of obese residents, and provide safety and care for them, as well as preventing OH&S risks to staff, bariatric equipment is not simply bigger or wider than ‘normal’ furniture. All bariatric furniture is tested to meet current Australian standards. Frames need to be rigid as well as strong, castors need to reduce rolling resistance as much as possible for loads up to 350 kg, and the equipment needs to be assessed for pinch points – another OH&S problem.
As well as providing comfort and functionality for the resident, the equipment needs to be assessed for ease of management by staff. An important point to consider is will this wider equipment fit through a standard doorway? This is often an unexpected problem with bariatric furniture. Other points to consider include:
– What is the safe working load?
– How heavy is the resident?
– How wide is the resident?
– How easy is the equipment to move?
– Will it fit where it is intended to be positioned?
– Will it stay in place or need to be moved?
– How easy will it be to clean?
To buy or to hire?
Most facilities choose to own their own equipment, but some find it preferable to hire as needed. Others compromise, gradually building up a stock of bariatric equipment while in the meantime hiring what they need for short-term use.
Reid suggests that while bariatric equipment is expensive, facilities should consider owning pieces of larger furniture such as recliner chairs, bedside chairs, commodes/shower chairs. However, he says electric equipment such as hoists and beds should be hired for maintenance reasons.
“Any electric device can go wrong, and the chances are it won’t work just when you need it. If it’s hired, it can be delivered ‘tagged, tested, cleaned and sanitised’ – that is fully maintained according to Australian standards.”
Artistic Healthcare Seating’s Tony Bournon says whether bought or hired, it is important this expensive equipment is kept for the residents who gain the most benefit from it.
“Both methods work well if they are correctly managed and a strict control is maintained on the assets. One method is to colour-code the bariatric equipment so it doesn’t go into general use.”