In Part 1, you learned some facts about the rising incidence of obesity in the United States and how it will impact your duties as a CNA. Part 2 described some areas of patient care that require special attention. With obesity on the rise, all healthcare providers will need to learn new ways to provide the best possible care to obese, or bariatric, patients.
What are some tips that may be useful in your work with obese patients?
• Don’t use the word “obese” when speaking to the patient. He or she may be more comfortable when you say “overweight” or make no reference to the weight at all.
• Weigh patients privately and record the weight without comment.
• Encourage any type of physical activity, even something as simple as arm raises. Exercise is a proven mood-lifter.
• Observe for signs of depression: loss of energy or interest; sleep problems, crying; lack of patience; withdrawal. Report your observations to the nurse.
• Support self-acceptance and healthy choices even when the patient does not want to lose weight.
• Many ADL processes require at least two people. If a lifting device is not available, allow plenty of room for the necessary staff to position themselves.
• Encourage the patient to participate as much as possible. Even handing the patient a soapy washcloth to wash under the arms makes him or her feel less dependent.
• Allow extra time for ADL. Getting to and from the toilet or shower can take longer due to mobility issues or need for additional assistance.
• Make sure that equipment is sturdy. Toilet seats, bedside commodes, shower stools, and grab bars are examples of items that should be inspected before using.
• When possible, ask the patient to assist in positioning, standing, or ambulation. Even holding on to the bed rail can make a difference, as well as include the patient in the task.
• Using a bath blanket as a draw sheet makes moving or turning a patient easier. It’s also easier to roll the patient toward you than to try and push him away.
• When assisting with ambulation, be aware that many obese patients have severe knee and leg pain, as well as arthritis, due to their weight. Always have two people when walking with the patient, in case of sudden weakness or collapse.
If your facility accepts bariatric patients, ask for help from your supervisors to make sure that the patients get proper care and that you can perform your duties safely:
1. The facility should have a Bariatric Patient Handling Guide that outlines all the special components of caring for obese patients, including staff roles and responsibilities.
2. All staff should receive specific training on how to provide care in a safe manner, including body mechanics, patient transfer, and use of equipment.
3. Evaluation methods that ensure that all goals are being met and that staff is able to perform their duties in a safe environment.
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