The Big 10

Bariatrics

• By David Kopf
• Jan 01, 2012

Bariatrics has been on our Big 10 list since we started it, and it returns to 2012’s installment. There simply no denying that this is an important patient market that providers must serve. It constitutes a significant portion of the U.S. population, possesses a wide variety of needs for home medical equipment and related services, and many of those needs can be

Adults with a body-mass index of 30 or more are considered to be obese, and, as of 2010, 72 million Americans were categorized as obese by the Centers for Disease Control. Now, about one-third of the residents of nine U.S. states are obese. Also, that represents a growing segment of the U.S. population. The 2010 statistic included 2.4 million more people than in 2007. Moreover, the number of states with an obesity prevalence of 30 percent or more has tripled in two years to nine in 2009.

Of course, when it comes to bariatrics, we’re not necessarily talking about your typical American spare tire, but rather someone who has serious weight issues that put their health at serious risk. The population of bariatric patients is tougher to come by, especially for when it comes to morbidly obese Americans (those weighing 300 pounds or more; with a body mass index of 40 or more). Some studies put it as high as 9 million people. That is a significant population that needs HMEs’ help in a variety of ways.

This is why bariatrics defines so many categories, because bariatric patients have so many needs. They require special beds, special mattresses and support surfaces. They have bath safety requirements that are both shared and unique from other patient groups, and they also have home access requirements that are unique, as well. Also, because mobility is difficult for them they have unique walking aid, wheelchair and scooter requirements.

Support surfaces and wound care are a particularly critical area for bariatric patients. Bariatric patients are at greater risk for pressure sores due to their size and immobility. There is a greater skin to weight ratio in these patients, confounded, in many cases, by their inability to turn every two hours. Add increased levels of moisture due to perspiration, and the situation is ideal for pressure sores.

Also, bariatric patients typically have lower levels of oxygen in their blood due to their obesity puts a strain on their hearts and lungs. This fosters the development of wounds since nutrition and oxygen can’t get to areas trying to fight off an ulcer.

Low air loss mattresses and alternating pressure mattresses can help prevent wounds by respectively providing air fl ow to help keep skin dry, and expanding and contracting sets of air cells to continually shift pressure.

Of course with support surfaces come beds. Bariatric beds must support both their weight and size. Providers must ensure that the bed they are providing is durable and designed for a bariatric patient’s weight, as well as safe. If a bariatric patient falls out of bed, he or she can sustain significant injuries, due to his or her weight. So bariatric beds are lower to the ground to prevent injurious falls.

Also, because bariatric patients are likely to spend more time in their beds, the beds should be able to provide functionality such as being able to articulate into a sitting position so that the patient can conduct activities besides sleeping while in bed.

Bath safety is another important area of bariatric care. Bariatric patients are subject to serious injury risks in the bathroom, because the results of any slips or falls can be more devastating given their weight.

This means there are a number of bath safety product categories available to help them: Sturdy grab rails that can support the patient’s weight should be strategically throughout the bathroom.

The toilet must be a special bariatric unit that supports their weight, so some bariatric toilets can support as much as 850 pounds. Bariatric toilets are also often taller so that the bariatric patient does not have to drop down on them. Also a shower chair or bench is important. The prospect of sitting in a tub also has injury potential so bariatric patients must use a shower, but should have a chair to prevent a slip and fall.

Suffice it to say that because of the sheer statistical size of the bariatric patient population and the diverse needs of this special patient segment, bariatrics should be a consideration on every level of your business planning for 2012.

This article originally appeared in the January 2012 issue of HME Business.