Few challenges presented to healthcare providers are quite as vexing as treating obesity. The problems extend far beyond being overweight. Obesity makes patients more likely to suffer from a long list of physical and psychological diseases and disorders.
Nurses must deal with these patient issues daily, in virtually all settings. The challenges can be particularly acute for home care nurses, who regularly travel to those who may not be able to travel themselves.
Ana Nunez, BSN, RN, CCM, COS-C, an interdisciplinary care team manager with Visiting Nurse Services of New York, and Carolyn McCrea, BA, RN, a field nurse who works with Nunez at VNSNY, have experienced these issues firsthand and offer some tips for nurses to help their patients who struggle with obesity.
Those who suffer from obesity likely have developed habits that may be difficult to break. Nurses should work with patients to help them make the connection themselves between their physical condition and those diet and fitness habits.
“I believe incremental changes do work,” Nunez said. “I advise clinicians to set realistic goals along with the patient, and provide feedback on progress.”
McCrea said home health nurses must come to terms with the understanding they cannot “independently alleviate the health challenges presented” by obesity and poor diet.
“If the patient does not participate, then the patient will not change their behavior,” McCrea said.
To secure that participation, nurses should expect to educate their patients, while modeling the desired traits themselves.
“Most importantly, the patient has to be engaged in change, and the clinician can assist in keeping the patient motivated by pointing out the health benefits of improved diet, exercise and fitness,” Nunez said.
For instance, nurses can, while out in the community, introduce patients to resources for better nutrition that are “realistically in the patient’s neighborhood and within reach,” Nunez said. She also suggested nurses can “paint a picture of health and mobility that the patients can use to set their own individualized goals,” through such small activities as traveling with a backpack and walking shoes.
Nunez and McCrea suggested nurses start with small changes, enlisting the help of community resources, caregivers and friends. Begin fitness regimens using home exercises to gradually increase comfort levels, and collaborate with rehabilitation services and social workers to establish programs for patients in the home and in the community.
Nunez said nurses always should be aware underlying mental and emotional health issues could impede any treatment plan.
“Personally, I have learned no one gains a large amount of weight overnight,” Nunez said. “Therefore, we cannot expect them to lose the weight overnight.”