Updated June 08, 2015.

Three common perspectives used in planning a hospital or assisted-living room capable of caring for the bariatric patient or resident in a dignified and safe way are:

• Plan for a certain percentage (perhaps 10%) of rooms on a floor to be equipped with bariatric furniture, equipment, and architectural elements (such as reinforced wall sinks, 42" wide commodes, and higher weight-rated handrails in the bathroom, to name a few).

• Designate a wing of a floor to be a bariatric zone.
• Equip and furnish all rooms to have the flexibility to scale up to a bariatric requirement and quickly and simply transition back to a standard requirement, as needed. This option follows the idea of planning acute-care hospital rooms to be able to scale up, or scale down, their acuity-level.

All of the above three perspectives have been chosen at different times across the country for different reasons by their respected project planning teams. As long as the thought process works within the overall planning scheme, they all can work. But regardless of "how many" rooms and their location, there are some furniture, medical equipment, and medical supply categories that need to be provided to keep bariatric patients/residents, as well as those who care for them, safe.

Furniture needs.

The type of furniture needed in the hospital patient's or assisted-living resident's room is the basic facility-provided or resident-owned furniture, albeit larger and with an increased weight capacity.

The absolute minimum space designed to meet these needs adds an additional 5 feet to the width of the standard room. Additional space may be needed depending upon the resident's personal effects and furniture.
Bariatric chairs have expanded widths, in the 36" to 42"-range, as do other pieces of bariatric furniture and equipment.

The beds available for bariatric residents range up to 54 inches wide and 88 inches long when overhead bars are included (because the bars are attached to the outside surface of the headboard).

The minimum width for doors should be 60 inches, because the doorway into the room must accommodate the bed width and the widest piece of equipment. A split door that can be expanded to that width should be considered.

Equipment needs.

Typical equipment needs for bariatric residents can include:

• Extra-capacity floor and/or ceiling lift
• Appropriately designed and sized slings (1x, 2x, 3x)
• Wheelchairs in various widths (26", 28", and larger)
• Extra-wide stretcher with 1,000 lb (455 kg) capacity
• Extra-capacity and extra-width walkers
• Armchair or stretcher-chair up to 32" (105 cm) wide
• Step stool with extra size and weight capacity
• Commode up to 42" (105 cm) wide
• Extra-wide bedpans
• Extra-capacity shower chair or shower stretcher
• Extra-capacity standing and raising aids (SARAs)
• Beds expandable up to 54" (135 cm) wide
• Bariatric-size pressure-reduction mattresses to help prevent pressure ulcers (sometimes referred to as "bed sores")
• Trapeze bar system for over the bed
• Powered "tug" for pushing bed, stretcher, or wheelchair
• Bariatric-size friction-reducing devices (air-powered or slide sheets)
• Extra-capacity clothing, slippers, and incontinence pads/briefs
• Appropriately scaled tape measures for measuring special medical supplies-e.g., longer needles, larger blood pressure cuffs, etc.

There is increasing interest in ceiling-track systems that can save space and increase safety for both bariatric residents and their caregivers. All facilities being newly constructed or with resident rooms that are being significantly renovated should seriously consider ceiling lifts, because the expense of installing tracks in the ceiling is often less during construction than when retrofitting a room after construction is complete.

Safe options for transferring bariatric residents are:

• Independent transfer with or without aids, such as a mobile walking device, cane, or other device;
• Transfer with limited assistance from one healthcare provider and a mobile walking device, cane, or other device; or
• Transfer with three or more caregivers, using a mechanical transfer device such as a standing and raising aid (SARA), a sling or ceiling lift, or a bed/stretcher that converts to a chair or repositioning aid.

Sources:

Finkelstein E.A., Trogdon J.G., Cohen J.W., Dietz W. (2009) Annual medical spending attributable to obesity: payer- and service-specific estimates. Health Affairs. 28: w822-w831.

Wang, Y., et al. (2008). Will all Americans become overweight or obese? Estimating the progression and cost of the U.S. obesity epidemic. Obesity. 16: 2323-2330.

Himes, C.L., Reynolds S.L., (2011) Effect of Obesity on Falls, Injury, and Disability Journal of The American Geriatric Society.