Environments for Aging - Winter 2017 - 15

INTERIORS

Creating supportive bariatric
environments
As obesity rates among seniors increase, communities need to consider the appropriate furnishings,
equipment, and space planning to benefit residents and staff By Meldrena Chapin and Kathryn Rutledge

KATHRYN RUTLEDGE

besity is a growing problem in the
U.S., and one that's affecting seniors
more and more. The 2015 GallupHealthways State of American Well-Being
Index reported that more than 30 percent of
elders ages 65-74 and more than 20 percent
of those 75 and older reported incidences of
obesity. The World Health Organization defines
obesity as people having a body mass index
(BMI) greater than 30, with those having a BMI
greater than 40 considered severely or morbidly obese. "Bariatric" is the term often used
to refer to those who are obese, and "morbidly
obese" defines those overweight by more
than 100-200 pounds or having a body weight
greater than 300 pounds.
As the number of overweight adults
increases, senior living communities need to
be prepared to care for bariatric residents.
Seniors who are dealing with obesity report
difficulty with depression, functional mobility,
and multiple activities of daily living (ADLs),
particularly dressing, bathing, walking, and
transferring from a seated position to standing. Chronic illnesses, including heart disease,
stroke, diabetes, incontinence, osteoarthritis,
and certain cancers, are more prevalent
among this population. Challenges with
mobility also increase with age for those with
obesity, with the majority needing assistive
devices or wheelchairs. To better support
these residents, senior living communities
must address a current lack of appropriate
care programs, furnishings, and equipment.
The following four approaches can help guide
designers, architects, and operators to create
the right care environment for these individuals and their families.
1. Space planning considerations
Guidelines for facility design and space planning for bariatric residents are available from
the American Institute of Architects (AIA), the
Veterans Administration (VA), Facility Guide-

Benches and chairs that curve around the body can provide additional comfort to bariatric residents during dining.
lines Institute, and Bariatric Room Design
Advisory Board.
Recommendations include that public
spaces, dining areas, and resident activity
rooms should be designed to allow access for
all residents, with corridors at a minimum of
48 inches wide and interior doors at least
42 inches wide. Passageways between furnishings should also be enlarged from a standard
36 inches to 42 inches, to allow adequate
space for residents and equipment to pass.
Resident room door openings should be at
least 60 inches wide to transport a bariatric
bed or stretcher, which can be accomplished
by using a bi-fold door, a 45-inch door with a
15-inch second "leaf" opening, a pocket door,
or a sliding barn door.
Bariatric guidelines from several organizations recommend a minimum 5 feet of clearance around three sides of a bariatric bed for
caregivers to provide adequate care and safe
handling. Each resident room should also
provide a 72-inch turning radius for a bariatric
wheelchair.

Bariatric toilet rooms, provided in resident
rooms, dining areas, and resident activity zones, should be outfitted with bariatric
toilets that are floor mounted, located 24 to
36 inches from the side wall to accommodate a caregiver on each side, and capable
of withstanding 700-1,000 pounds. Shower
spaces require grab bars with structural steel
supports capable of withstanding 500-1,000
pounds of pressure, a hand-held shower
nozzle mounted on a side wall, and additional
space for caregivers. For bariatric residents
with no mobility, a shower area with an extended hand-held shower nozzle and sized to
accommodate a bariatric stretcher and two to
three caregivers is recommended.
2. Choosing the right furnishings
When choosing bariatric furnishings, designers should look for chairs, benches, and sofas
that are similar in style, color, and upholstery
to complement other furnishings in a room and
not stand out. Steel structures (which can hold
700-1,000 pounds) are essential to providing
Winter 2017 * EFAmagazine.com

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Environments for Aging - Winter 2017

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