Term Paper on "Obesity in Elderly"

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Obesity is prevalent among all groups of white, white, black and Hispanics. In a study conducted by Bermudez and Tucker (2001) on the prevalence of obesity among elderly Hispanics, it was concluded that, "Obesity (BMI > 30 kg/m2) was prevalent among all ethnic groups, ranging from 17% to 29% for Dominican and Puerto Rican men, respectively, and from 29% to 40% for non-Hispanic white and Dominican women, respectively." This study goes to show that the differences based on gender and ethnicity is not very substantial and it is a common problem that is likely to complicate in the future. In fact, this trend exists not only in the U.S. across all sections of people, but also around the world.

Medical problems

With obesity, comes a whole lot of medical problems for the elderly. It drastically reduces their quality of life, making them less mobile and more disease-prone. According to Kimmon (2004, p.1), "Obesity in the elderly is clearly associated with an increased risk of diabetes, cardiovascular disease, hypertension, stroke, lipid abnormalities, osteoarthritis and some cancers."

Obesity can also have a profound impact on the mental health of patients. It can lead to the loss of self-confidence and over a period of time, it increase the possibility of depression in elderly people who are obese. In a study conducted by Seale, Seale & Zhang (2008), they found many verbal and non-verbal cues among obese elders that pointed towards a lack of self-confidence and enthusiasm. "Verbal cues of emotional distress included expressions such as "I'm such a basket case," "what else is there to live for?" Non-verbal cues of emotional distress include depressed face, downward gaze, self-touching, drooping posture, and slowed speech (suggesting depression) or fidgety hands, darting eyes, and a still upper body (suggesting anxiety) (American Psychiatric Association 1994)." (Seale, Seale & Zhang 2008, p.424). Latest studies have also linked obesity with other mental illness like Alzheimer, Schizophrenia and other retardation diseases.

It also severely affects the mobility of individuals. In a study conducted by Sharkey, Ory & Branch (2006), the Lower Extremity Physical Performance (LEP) was measured among individuals who had a BMI of more than 30kg.m2. The LEP were timed tests that assess the balance, gait and strength of individuals. Morbidly obese individuals fared poorly in these tests and it was concluded that obesity had a profound impact on their mobility. "Considering the predictive ability of LEP for subsequent falls, increased disability, repeated hospitalizations, nursing home placement, and mortality, the findings of this study offer one explanation for reports that indicate that the burden of healthcare cost of obesity grows disproportionately with individuals who are most obese." (Sharkey, Ory & Branch. 2006, p.1412). This study reveals the seriousness of the issue and the need to do something about it. Unfortunately, the present healthcare system is not geared to take these challenges.

Healthcare System

The elderly already account for more than one-third of the total healthcare costs in the United States and this is only going to increase with this rate of growing obesity. This is a serious problem for the healthcare system of the country because the Social Security Administration estimates that the number of elderly population is likely to double by the year 2030.

Another major implication of obesity in the elderly is the increased need for assistance and long-term care. Kimmon (2004, p.1) rightly points out, "Studies have shown associations between obesity and poorer health-related quality of life in the elderly, including worse physical functioning. Since physical function is closely linked to the need for more intensive assistance, a greater proportion of elderly Americans in the year 2010 may require long-term care, home health assistance and personal equipment such as lifts and scooters."

The nursing homes that care for the elderly are already filled and with the infusion of more people, it can only put more strain on the system and this in turn will lead to the inevitable decline in the quality of service. According to DiResta, Fleshner & Polomano (2008), more than 30% of people admitted in the nursing care facilities are obese. This requires a lot more nurses and increased costs to meet their needs. The current nursing homes are not equipped to handle this increased level of care for obese patients. One of the main reasons is that the rate of obesity has been so rapid that nursing homes did not have the required time and resources to adapt to this growing problem. In a study conducted by 1625 nursing homes in Kansas, Maine, Mississippi, New York and South Dakota for a period of 10 years, from 1992-2002, it was found that the rate of obese patients increased from 15% in 1992 to 25% in 2002. (Lapane & Resnik, 2005).

Besides increased staffing needs, there are other problems faced by the nursing homes. They include room size and the need for specialized equipment like wheel chairs and scooters. The study conducted by Dutton, Engelke, McAuliffe & Rose (2005) conclude that obese patients require specialized equipment, more staff and specialized techniques and learning to meet their caring needs. This can be a major problem for nursing homes because the nurses have to provide more care and attention to obese patients and this can put the non-obese patients at a higher risk. To recruit more staff, the facility may need a lot more money and this may prove to be a huge stumbling block.

Even home health workers encounter problems in taking care of obese people. A study by Dulon, Kromark & Nienhaus (2009) concluded that home healthcare workers faced more back problems because of the non-availability of proper devices to care for them. This is a serious concern because these lumbar problems can reduce the number of home healthcare workers who are willing to take care of the obese people. In cases where the home healthcare workers assist the elderly, expensive equipment may be needed to reduce the work load for the workers. Alternatively, this can also increase the need for assisted living homes drastically, thereby putting more and more pressure on the already strained system.

The next problem related to healthcare for obese elderly people is the availability of geriatrics specialists. Geriatrics is the branch of medicine that deals with old age and the problems that come with it. The number of doctors specializing in geriatrics is very low today. According to Thompson (2009), there are currently only 7,128 certified geriatrics physicians against the expected need of 36,000 doctors. This huge short fall can have a profound impact in the field of geriatrics and it can put more pressure on the healthcare system on the whole.

Caregivers have a greater role to play in the coming years. They must take the initiative to help elderly people to come out of their problems. Weight counseling for the elderly will be one of the most important tasks of geriatrics caregivers. The study conducted by Seale, Seale & Zhang (2008) conclude that physicians spent very little time with their patients who are obese. "In general, it appears that elders receive very little counseling time about weight loss; further, the time decreases with age. It is very doubtful that the minute and a half or less spent discussing… READ MORE