| A conflict and challenge exists between the quality of care and life experienced by the obese elderly patient who remains in the acute care hospital waiting for admission to a nursing home and the nursing home leader's and organization's best interests. Obese elderly patients who remain in an acute care hospital waiting for admission to a nursing home often have their urgent medical needs addressed, but fail to receive care that improves their quality of life (Healthcare Association of Hawaii, 2008, 2009). The purpose of the qualitative, phenomenological study was to explore if and how nursing home leaders' lived experiences regarding obese elderly patients influenced their attitudes and behaviors and to explore if any connection existed between the nursing home leaders' attitudes and behaviors and their admission decisions. According to nursing home leaders, accommodation of the obese elderly patient's needs is priority when making admission decisions. Accessibility and availability of size appropriate equipment and supplies, adequate staffing ratios and obesity-related staff training, and reimbursements that cover the cost of care are among the barriers to admitting obese elderly patients to nursing homes. Strategies to overcoming these barriers will require health-care stakeholders, including long term and acute care leaders, lawmakers, vendors, and public and private insurance providers, to work together to find solutions. Eliminating the barriers to admission should increase the number of obese elderly patients admitted to nursing homes, lower health care costs, and improve the obese elderly patient's quality of life. |
