James M. Berklan

There is something oddly juxtaposed about so many Americans cheerfully reacting to a jolly, obese man in a red suit at this time of year. Good thing he isn’t ill or disabled and in need of skilled nursing care.

While it is nothing new to long-term care providers, the New York Times this week blew out a story about how obese individuals are putting a “strain” on nursing homes. The sad fact is that not enough supports and funding are in place to take care of individuals who can’t take care of themselves — including the often forgotten dangerously overweight people who require institutional care.

Their risks are perhaps greater than many others’ — joints and bones become more fragile, internal systems give way to diabetes and heart disease quicker, and so on.

In just 10 years, the rates of obesity overall rose dramatically (from 14.7% in 2000 to 25% in 2010). And it only figures to get more ominous as the you-know-who generation ages.

As big as they might be, these folks are at great risk of being ostracized or forgotten, or somehow both at the same time, as weird as that sounds.

The Times article noted that trailblazer Genesis HealthCare recently discontinued a special bariatrics program due to the strain it put on workforces and budgets. The long-term care community has often followed the Genesis lead on caregiving initiatives, which is not a happy fact in this case.

There also have been cases of skilled nursing facilities turning down referrals of vastly overweight people. With so much concern about readmissions and value-based payments pushing to the fore, this might become a growing trend.

Some feel the situation is nearing crisis proportions, and that is worrisome because of the growing challenges that could be ahead. If regulators and the caregiving community can’t handle the load now, what will happen in the future? Medical experts rightly point out that expecting obese individuals to just lose weight is neither realistic, nor in many cases, safe.

Policy and regulatory experts need to get their heads together with provider leaders to find more workable solutions. It’s a present that needs to be given, for the benefit of many who know what it’s like to be Santa, and then some.

James M. Berklan is McKnight’s Editor. Follow him @JimBerklan.