Personal care assistance needs of obese elders entering nursing homes

Rates of obesity among US elders are projected to reach 34%-40% by 2010. Obesity in the growing population of elderly present challenges for the long-term care (LTC) system: studies found obesity among the elderly is associated with cognitive and functional decline, and increased rates of nursing home admission. Unfortunately, little research is investigating obesity among the elderly within nursing homes and the impact of this on the delivery of LTC services. Case studies indicate that obese elders typically require 2+ persons to assist them with personal care, yet this need has not been examined systematically. This study was undertaken to document the personal care assistance needs of obese elders (65 years+) at first nursing home admission. Descriptive and inferential statistics were used to examine the Minimum Data Set records of 47,932 unduplicated elders (≥65 years) upon first admission to a nursing home in Arkansas from 1999-2004. Obese elders (BMI≥30) had significantly (p<0.01) greater odds (1.18-1.70) of needing extensive assistance to perform activities of daily living (ADLs) compared to non-obese (BMI=16-29) elders. Excessive bodyweight of newly admitted elderly nursing home residents is associated with greater use of personal care staff to perform selected ADLs. Other research has shown that increased ADL dependency is associated with increased cost, which coupled with the current finding suggests rising rates of obesity among the elderly and those entering nursing homes may strain the LTC system in terms of staffing and cost. Interventions to address these potential impacts should therefore be developed and tested.