People who remain obese throughout their lives create particularly difficult end-of-life challenges for their doctors, including shorter life spans, a higher likelihood of hospitalization and the need for more intensive care services, a recent study published in the Annals of Internal Medicine reports.
Health care providers also often struggle with conducting physical assessments of their obese clients, providing mobility assistance, performing necessary procedures and identifying problems such as malnutrition and frailty.
The study's lead author, Dr. John Harris, said this area of care for the obese has been largely overlooked.
"We know about obesity and serious illness; we know about obesity and disability; but there has basically been no research about obesity at the very end of life," Harris said.
In their research, Harris and his team discovered a link between patients who register as "obese" on the body mass index (BMI) scale and higher-than-average Medicare costs in the last months of life, shorter hospice enrollments and hospice services, and fewer incidents of in-home deaths.
"The goals of care at the end of life (are to) transition to more symptom management and less curative management," Harris said. "The management of symptoms at the end of life is closely related to better care and satisfaction for patients, as well as an increase in satisfaction for caregivers and family members.”
The researchers made their determinations after collecting and examining 14 years' worth of survey results and Medicare claims from the National Institute on Aging's Health and Retirement Study.
