Whether we mean it or not, when we see an overweight person walking by, we automatically start making judgements on this person’s lifestyle, perhaps that they are ‘lazy’ or ‘lack self-control’. Do we think the same of residents in aged care facilities who are overweight? How does this impact on our care and health outcomes of these residents?
It’s no secret that rates of overweight and obesity are continuing to rise in Australia. Many individuals are likely to be overweight or obese as they approach older age, around the same time as they enter aged care facilities. This poses a challenge for residential aged care facilities regarding how to best manage overweight and obese residents. Should residents who are overweight or obese be encouraged to lose weight?
Studies indicate a higher BMI is more protective of health for the elderly (compared to younger adults), as a lower mortality risk is seen in older adults in the overweight BMI range of 25-30kg/m2. Even if the BMI is over 30, weight reduction diets can be problematic if they do not provide sufficient protein and micronutrients. There is insufficient evidence to warrant the use of very low calorie diets (i.e. meal replacement shakes), anti-obesity medications or bariatric surgery as weight loss measures for the elderly.
Interventions to achieve weight loss are not recommended for residents who are unable to participate in regular strength and balance training directed by a physiotherapist, due to the adverse health outcomes associated with disproportionate muscle loss. If a weight reducing diet is not paired with weight bearing exercise, loss of lean muscle mass can occur resulting in reduced strength and function. This leaves elderly residents more reliant on assistance for activities of daily living and at a higher risk of falls.
As the aged care sector embraces consumer directed care, it is more important than ever to think carefully about how we manage residents who are overweight or obese. It must be up to the resident to determine what care they want and whether they want to lose weight. There must be a team approach with health care professionals to advise whether weight loss is recommended or will improve health and independence. It is important to consider the impact of weight loss on a resident’s quality of life.
With the knowledge that weight loss is generally not indicated for overweight residents in aged care, as workers in this industry, we need to be comfortable with providing appropriate care. We may need to set aside out own views on obesity and embrace the need for specialised equipment (such as scales, lifting machines and blood pressure cuffs), larger beds and larger chairs. Facilities will also need to provide bariatric-specific manual handling training to safely manage obese residents and protect staff members from injury. Take the time now to review how you care for obese residents in your workplace.
If you would like further information from our experienced dietitians on how to manage residents who may be overweight, please contact us on 1300 722 712.