Is bariatric DME becoming the new normal?

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Friday, February 24, 2017

There is no consensus among manufacturers about whether bariatrics should continue to be its own category or whether it should be incorporated into other HME segments. While some are including bariatric versions of mobility, bath safety, support surfaces and aids to daily living within those product portfolios, others continue to position bariatric models in their own category.

Whether bariatrics becomes more mainstream remains to be seen, though it appears that sales of bariatric versions are modestly on the rise across the product spectrum.

For instance, Geneva, Ill.-based Comfort Company has seen sales of bariatric cushions 24 inches wide and above grow 27% from 2012 to 2016. Even so, that figure represents only 5% of overall cushion sales, said Stacey Mullis, director of clinical education.

“I would conclude from our limited data that although there is a steady increase in demand for bariatric products, the overall percentage of sales for wheelchair bariatric seating continues to justify its own separate product category rather than being considered mainstream,” she said.

Jay Doherty, senior clinical education manager-East Coast, for Exeter, Pa.-based Quantum Rehab, explains that bariatrics may remain a separate category based on funding criteria.

“Manufacturers are integrating applicable technologies into bariatric products, such as advanced electronics, that are also used in standard-weight products,” he said. “In this way, we’re seeing more consolidated product lines that include bariatric models as an extension rather than a separate line.”

Because the Centers for Disease Control and Prevention has identified 65% of Americans as overweight or obese, “bariatric DME is the new normal,” contends Karen Lerner, RN, regional vice president of pressure prevention for Somerset, Pa.-based Drive DeVilbiss Healthcare.

“Many product categories will feature bariatric options, marketed in a thoughtful way as to not alienate this group,” she said.

To be sure, bariatric products are becoming more commonplace, agreed Jim Ernst, vice president of product development for Kansas City, Kan.-based Leisure-Lift.

“While the sale of bariatric units might appear more mainstream, it is only because some have entered the market with a ‘one-size-fits-all’ approach,” Ernst said. “This is not a good thing. It’s unfair to bariatric end users to combine the categories of wheelchairs and bariatric wheelchairs.”

Assessing patients, products

Obesity takes a toll on the body and it is important for HME providers to assess their capabilities when considering which product might be right.

Jeremy Eng, general manager for Orange, Calif.-based Eagle Health Supplies, explains: “Equipment not only needs to structurally support the weight of patients, but it needs to make them feel safe and sturdy when using the equipment. Bariatric patients often have difficulty standing in the shower or bathtub, or climbing over the bathtub wall.”

For those patients, a swivel sliding transfer bench not only makes it easier to get into the bathtub or shower, but gives those patients  the independence and dignity that come with bathing on their own, he said.

Sleep problems are a common co-morbidity of obesity, Lerner said. Patients who have trouble turning and repositioning during sleep may be at risk for skin breakdown; in their case, slide transfers may not be the best option due to potential shear and friction wounds, she said.

“If patient lifts are used, proper sling selection, placement and removal are crucial,” Lerner said.

Skin issues are aanother consideration for mobility products, Doherty added.

“Some of the challenges are adequate foot support, as well as foot support that can be moved out of the way for transfers,” he said. “Some of these individuals are still performing pivot transfers, where they cannot ambulate but can transfer with their feet on the floor.This transfer allows them to remain independently at home so the challenge can be to have proper foot support while they are seated in the wheelchair, but then able to move that foot support out of the way for the transfer to occur.”

Ernst points out that bariatric patients should not just be defined by their overall dimensions or weight, but by body type and how it affects their seating.

“No two morbidly obese patients are the same,” Ernst said. “Factors such as redundant tissue, edema in the legs and height-to-weight ratio require a very specialized product in most cases.”