Obesity and intensive staffing needs of nursing home residents.
John Alexander Harris, John Engberg, Nicholas George Castle
PMID 29884559WHAT IT FOUND
Nursing home residents with BMI 40 kg/m2 or more were more often reported as needing two or more staff for dressing, bathing, transfers, walking and toileting, but not eating.
Key findings
01After adjusting for age, gender and dementia status, higher BMI was associated with higher odds of two or more person assistance for ADLs, except eating assistance.
02Residents with Class III obesity had adjusted odds ratios from 1.23 to 2.23 for needing two or more person assistance compared with normal-weight residents, except eating assistance.
03Class IIIA obesity was associated with an adjusted odds ratio of 1.33 and Class IIIB obesity with 1.90 for receiving a two-person assist with ADLs.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
All height and weight were recorded by MDS assessors using facility-specific practices, so measurements may vary between facilities. The two-person assistance outcome reflects the assessor's perception, not necessarily observed daily assistance. The models adjusted only for age, gender and dementia status, so other unmeasured factors may contribute to the association. The analysis used one day of MDS data and did not test interventions, so it cannot establish cause or how to reduce staffing needs.
Declared interests
JAH, JE and NGC declared no conflicts of interest; the supplied publication types note NIH extramural research support.
The easy way to misread this
Do not read this as proof that obesity causes nursing home staffing shortages or that every resident with obesity needs two staff. The study reports an association in nursing home-assessed ADL assistance, and eating assistance did not show a significant increase.