Providing care for older adults with extreme obesity in aged residential care facilities: An environmental scan

Abstract
Little is known about the level of service demand and preparedness of Aotearoa New Zealand’s aged residential care facilities to care for older adults with extreme obesity. The aim of this study was to assess the current state of bariatric (extreme obesity)  services within aged residential care. An environmental scan was conducted to identify bariatric resident needs and gaps in service provision to inform the development of policy and service provision. Observational and interview data from three facilities in Aotearoa New Zealand was collected along with a retrospective review of national resident admissions over a three-year period. Poor environmental design that included infrastructure deficiencies and financial barriers impacted on the ability to deliver safe and equitable care for this population. Specifically, equipment procurement and safe staffing ratios were of concern to the sector. There is an increasing need for bariatric level support within aged care, necessitating more equipment and staff, adaptation of physical care environments, and enhanced funding. Significant investment is required to address care concerns of older adults with extreme obesity at government and organisational levels.

Ngā ariā matua
Kāore i te tino nui ngā āhuatanga e mōhiotia ana mō te tiketike o ngā hiahia ratonga mō te takatū o ngā whare manaaki kaumātua o Aotearoa kia tiaki i te hanga taikaumātua tino mōmona. Ko te whāinga ia o tēnei rangahau he aromatawai i te tūnga o tēnei wā o ngā ratonga mōmonatanga nui (bariatric care) i roto i ngā whare noho mō te kaumātua. I kawea tētahi karapa taiao hei tautohu i ngā hiahia me ngā āputa o te mahi manaaki hunga noho mōmona i roto i te hora ratonga, me kore e piki ake te whakawhanake kaupapa here, me te hora ratonga anō hoki. I kohia ētahi raraunga mātaki, uiui hoki mai i ngā whare e toru i Aotearoa, i te taha o tētahi arotake tiro whakamuri ki ngā whakaurungatāngata noho i roto i te toru tau. I pā te hoahoatanga taiao hē, arā, ngā ngoikoretanga hangaroto me ngā taupā ahumoni, ki te āhei kia horaina he manaakitanga haumaru, ōrite hoki, ki tēnei wehenga taupori. Otirā, ko te hoko taputapu me ngā ōwehenga kaimahi tētahi āwangawanga nui mō te rāngai. E hiahiatia ana tētahi whakapikinga ake i te tautoko taumata manaaki hunga mōmona i roto i te ao manaaki kaumātua, e tika ai kia maha ake ngā taputapu me ngā kaimahi, te tiaro hoki i ngā horopaki kikokiko mō te manaaki, me te whakapiki tahua moni. E hiahiatia ana tētahi haumitanga nui hei whakatika i ngā āwangawanga o ngā taipakeke tino mōmona, i te taha kāwanatanga, i te taha hinonga anō hoki.

Keywords / Ngā kupu matua
aged residential care / whare noho mō te kaumātua; environmental scanning / karapa taiao; extreme obesity / tino mōmona; nursing homes / whare tapuhi kaumātua; older adults / ngā pakeke taikaumātua