Obesity in the United Kingdom is a growing health concern, with health officials stating that it is now one of the leading causes of preventable deaths. Adult obesity rates have almost quadrupled in the last 25 years. ‘Bariatrics’ is a term given to a branch of medicine that deals specifically with the treatment of obesity and allied diseases.
Published statistics are concerning:
• 65% of men and 59% of woman are classed as ‘overweight or obese’ (BMI of 25 or higher).
• 24% of men and 26% of woman are classed as ‘obese’ (BMI of 30 or higher).
• 30% of children classed as ‘overweight or obese’.
• Health problems associated with being overweight or obese cost the NHS more than £6 billion every year.
A report drawn up by Foresight in 2007 concluded that 50% the UK population may be obese by 2050, at a cost of £50bn per year. It appears that the problem is continuing to get worse however, with a 2014 report by the National Obesity Forum who felt that the 2007 Foresight Report was an ‘underestimation’ of the problem.
Presented with the facts, it is clear that patient moving and handling, and the training of patient handlers, has got to evolve in order to meet the needs of a growing minority of grossly overweight patients. But how do you train your patient handlers to assist, for example, a 40 stone (250kg) person? The best way to start would be to get a better understanding of the challenges, restrictions and obstacles that such a patient would face.
A ‘bariatric suit’ provides the wearer with such an insight. It significantly restricts the movements of the person wearing it, and simulates the difficulties faced by a morbidly obese person. The financial cost is high though – a bariatric suit typically costs £1000.
The Bariatric Suit serves two distinct purposes:
It is designed to be worn by a trainee so that they themselves can endure the difficulties and mobility problems encountered during otherwise routine activity, as experienced by their grossly obese patients. The suit accurately simulates the bulk of a bariatric patient and allows a carer to experience bariatric moving and handling from the patient’s viewpoint.
Moving and handling a genuinely heavy patient brings with it the potential for serious injury to the carer. It would be unsafe, not to mention undignified, to teach patient handling techniques using a very obese person. The bariatric suit simulates the bulk and size likely to be encountered with a real patient, but without the risk associated with the excessive weight – a bariatric suit typically adds about 7kg of weight to the person demonstrating it. It’s ideal for practising procedures where lifting aids or hoists are used, as the difficulties faced in these situations are primarily those of bulk, with the hoist taking the weight.
A Daily Mail article from late December 2013 revealed the controversy and ignorance surrounding the issue of care and handling of the bariatric patient. The article focused on the slant that use of the bariatric suit in moving and handling training placed a strain on already stretched resources. However as the figures show, obesity is increasingly taking centre stage as a serious issue for society and the NHS alike. Medical staff and those caring for bariatric patients do require specialist bariatric handling skills training to keep themselves safe from injury and these types of practical training aids are proving to be invaluable as part of their ongoing practical skills education.
Ann Drinkwater has worked in Moving and Handling training for over 20 years, and now acts as both consultant and trainer. A Chartered Physiotherapist since 1977, she works the length and breadth of the UK. What does she make of the controversy over investing in bariatric suits?
‘NHS staff have a duty of care to all patients. If this experience can be safer and more comfortable for everyone involved, then this is a positive step. Health care workers undergo lots of training for any kind of medical condition. Obesity is no different in this regard. The bariatric suit is not the answer to every training situation – just a resource that might be employed, like a trainee doctor might use models to understand the human body better.’
Bariatric suits have been used in Moving and Handling training for about 18 months. Ann has been employing them in her training since the outset.
‘In my opinion,’ she explains, ‘the bariatric suit allows the handler to become familiar with the mobility difficulties the patient faces. As the NHS’s aim is to promote the patient’s activity and independence as much as possible, staff need to identify how these patients can move, and what they might need assistance with. The client can then be assisted more effectively – without compromising his or the handler’s safety – which in turn helps the client be more pro-active about his condition.’
‘Training is more effective with the suit,’ Ann concludes. ‘Otherwise, it is difficult for staff to appreciate the restrictions at work – for example, how much extra space will be needed both in and around a bed.’ Where possible and pertinent, and with the use of professional judgement, the bariatric suit should be appreciated as a serious training tool, enabling a holistic view of the challenges of this modern epidemic.