Nursing homes ill-equiped for obese patients

EDINBURG - Guadalupe Ruel is a big man with nowhere to go.

At 64, he weighs 500 pounds and has been on disability for nearly 25 years. After being evicted from his nursing home in Rio Grande City, he said he is finding it difficult to find a new place because of his size.

According to national healthcare studies, his is a small but growing problem. Caring for the seriously obese requires more staff and special equipment that can put a dent in nursing homes' bottom lines, so only a very few accept such residents.

Many area facilities don't have the resources to take on morbidly obese patients and others just don't want to, said Ted Disque, nursing director at Doctors Hospital at Renaissance in Edinburg.

"These patients aren't worth the money," Disque said. "They don't generate any money for the nursing home."

Because Doctors Hospital treats patients seeking weight-loss surgery, the facility has specialized equipment to deal with large patients, from wider beds and wheelchairs to special slings for weighing the bedridden. But case managers have a hard time finding follow-up care for large patients after gastric bypass surgeries and other weight-loss procedures, since many patients are too heavy to care for themselves.

Ruel said he inherited a wide bed at Retama Manor in Rio Grande City from another obese patient, but clashes with staff led to his eviction just before Christmas.

Retama administrators declined to comment on Ruel's case.

He said they had him placed in a psychiatric facility, after a hospitalization for chest pain, to silence his frequent complaints about mistreatment and improper behavior by employees at the facility.

Now, he is waiting at Doctors Hospital's Behavioral Center while case managers try to find him long-term care.

"There's discrimination against people who weigh (more than) 350 pounds," he said. "We're the last segment of society that doesn't have any protection, because of our weight."

But Hari Namboodiri, an administrator at Las Palmas Health Care Center in McAllen, said the decision to reject an obese patient is usually based on whether a facility can provide adequate care without taking resources away from other patients.

"You need three, four people for assistance (with obese residents)," he said. Lifts that help staff move patients are often incapable of handling patients weighing more than 300 pounds, and employees can be hurt trying to lift or turn such residents.

In addition, these patients often have more complex healthcare needs and are higher risk, Namboodiri said. Obesity can worsen the illnesses usually associated with aging, particularly heart problems and diabetes.

Laura Albrecht, a spokeswoman for the Texas Department of Aging and Disability Services, said there is no law that says long-term care facilities like nursing homes have to be "everything to everyone."

"If they're unable to take a patient, then they are unable to," she said. Her agency does not track whether special-needs patients have difficulty accessing care.

Eventually, Doctors Hospital administrators expect to be able to find a facility for Ruel, who has worked with case managers at the Valley Association for Independent Living and Texas' Adult Protective Services.

"They never stay here forever," Disque said.