To mark National Obesity Awareness Week (Jan 11-17), QCS Customer and Policy Lead, Leah Cooke (pictured), discusses the myriad of challenges faced by care providers in managing obesity in care homes.
It is hardly surprising that some studies released at the peak of the pandemic escaped the attention of care workers and their managers. At Quality Compliance Systems, a leading provider of guidance, best practice content and technology to the care sector, it’s our job to read every report and feed in the key ideas and findings in to our policies and procedures, which are read by more than 100,000 care workers in 5,000 care services.
In August, a report published by the Local Government Association (LGA) caught my attention. The study, entitled, ‘Social Care and Obesity’ resonated with me because it shines a powerful spotlight on the rise of obesity in care homes – an area, in a resource-stricken sector that is often overlooked.
The study says “social care services should address both prevention of obesity and care of people with obesity in order to reduce this burden on individuals and society”.
Compassion and dignity
Having worked in the care sector as a qualified registered general nurse for the last twenty years, I’m a keen advocate of person-centred care and strongly believe that those service users carrying excess weight should never be regarded as a financial burden and always be treated with compassion and dignity.
However, with the LGA forecasting that “up to a third of adults are predicted to be obese by 2024”, I share its view that the care sector faces a monumental challenge to prevent a potential obesity epidemic. The big question challenge for the care sector, which promotes compassionate care over anything else, is to come up with a solution that ensures that all service users, enjoy the same level of access to services, regardless of their weight. That must be the foundation on which any solution is built, and it starts with care workers.
Care workers are so well trained in spotting the signs of malnutrition and dehydration, but tackling obesity requires a radically different approach. Often staff don’t have the training or resources to develop effective obesity awareness strategies. I think, therefore, the sector needs to invest in care staff so that they feel empowered and are able to raise the delicate subject of obesity with service users in a compassionate and dignified way. That is by no means easy. It doesn’t just require great tact and sensitivity on the part of the care worker, obesity awareness programmes also need to be woven deep into the culture of a care home. When it is deeply ingrained within a service, care workers can start can start to ask honest questions, such as ‘Are you happy with your weight?’ and ‘Is a weight programme something that you need support with?’.
The importance of education and policies and procedures
Education needs to be at the heart of any obesity awareness initiative, as do policies and procedures. As a society, we perhaps don’t place enough emphasis on the fact that obesity is not a condition, but a disease, which, if left untreated, can lead to Type-2 diabetes, high blood pressure, heart disease, strokes and cancer. At QCS, our over-arching nutrition and hydration policy, which also covers obesity, not only provides best practice advice as to what a healthy, balanced diet should look like, but reveals the underlying psychological causes that influence eating behaviours.
But an obesity programme will only work if it equips care workers to explore and identify the causes. While a lack of exercise and eating the wrong foods over a number of years is a common cause of obesity, care workers must also take into account that the triggers that lead to obesity are often complex and nuanced. While it’s not the job of a care worker to analyse the psychological factors that might lead a person to comfort or binge eating, they can monitor and observe the correlation between a person’s eating habits and their mental health. After building up a picture of their habits, and speaking to them, with consent, care workers could arrange an appointment with a GP, who could then refer them to a dietician or a psychologist.
At the same time, while care workers have a duty of care to protect and support service users, they must also respect a person’s freedom to choose how they live their life. If, for example, an eighty-year old resident chooses not to lose weight, then their decision must be respected nor should they be pressured into making lifestyle changes if they don’t wish to. Anyone wishing to find out more can access QCS’s polices on procedures relating to human rights and also to consent and capacity.
Obesity programmes should promote enablement
However, for those who actively wish to lose weight, there are many options. While the COVID-19 crisis has opened a door to virtual exercise sessions, which can often be tailored to meet a range of needs and abilities, fundamentally, mobility programmes should be closely aligned to helping a person maintain independence, an idea which QCS has explored in a series of standard operating procedures.
So, how exactly do these standard operating procedures translate to the real world? Instead of introducing an elderly resident to chair-based exercises straight away, care workers should focus on what service users can and cannot do. So can they brush their hair and their teeth? Can they get put their shoes on? Coaxing residents into demonstrating simple tasks like these and building on them every day, serves as a highly effective outcome-based goal setting programme. It also champions enablement, while at the same time promoting wellbeing, which is the cornerstone of any obesity awareness programme, and activities of daily living are a good first step in combatting obesity.
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