Fact Sheet 2
Designing a safe environment for the obese and bariatric
client in aged care
When considering effective management solutions for bariatric clients, it is essential to have
a well-designed facility or care environment.
(Diagram 1: Courtesy of David Borys, University of Ballarat)
The design, layout, space requirements, floor coverings, furniture and fittings of facilities and
care environments all potentially impact on the ability to manage bariatric clients, and/or
impact on the way in which care is delivered.
The bariatric client will require more space for safe manoeuvrability, safe manual
handling, equipment storage and dignified care.
When designing new, or renovating existing, facilities, the following features should be
considered1:
• Providing specialised bariatric equipment that accommodates a client’s weight, size
and shape
• Larger doorways that permit entry and exit of bariatric equipment (wheelchairs,
hoists, etc)
• Handrails and grab rails with expanded weight capacities
• Elevators able to hold larger bariatric beds and equipment (if necessary)
• Corridors wide enough to turn and manipulate bariatric equipment
1
The Facility Guidelines Institute 2010
Recommended Room Dimensions (Refer Diagrams 2 & 3)2
The size of a room for a bariatric client must accommodate:
• Bed
• Larger equipment, including commode, walking frame, chair
• Ceiling lifter, with sufficient loading capacity, on “J” or “H” track
• Capacity for multiple health care workers at the same time
• Large visitor furniture
• Room and access to safely perform transfers and use equipment
Diagram 2
Area
Room size
Door width
Room around bed for lifters,
bari equipment
Room lifter
Bathroom size
Bathroom door width
Grab rails
Percentage of Bari rooms
(RACF)
2
3
Villeneuve, J. et al. 2007
AS/NZS 1428.1 & .2
Diagram 3
Recommended
(Villeneuve et al. 2007)
23m²
Min 1.5m (Recommend split door
1.2m & 300mm)
Min 1.8m on 3 sides of the bed
Ceiling lifter
7.8m²
1.2m
Stronger than AS/NZS1428
1 in 32
Current guidelines3
15 m²
Min 1.2m
Min 1.1m for lifter
access
5m²
Min 900mm
AS/NZS 1428
Design of facilities should also consider that clients need access to:
• Dining areas
• Social activities areas
• Outside areas
• Transport for outings
• Storage of equipment
• Ambulance and funeral services
References
1. Hignett, S., Chipchase, S., Tetley, A. & Griffiths, P. (2007). Risk Assessment and Process
Planning for the Bariatric Patient Handling Pathways. Health & Safety Executive. Loughborough:
Loughborough University. http://www.hse.gov.uk/research/rrpdf/rr573.pdf
2. Villeneuve, J., Morissette, L., Gambin, C., Poulin, P., Renaud, H., Bertrand, G. (2007). Work injury
prevention when working with Bariatric clients. Objectif Prevention.
3. Government of SA. (2008). Guidelines to the safe design of Aged Care Facilities.
http://www.safework.sa.gov.au/contentPages/docs/ac_sd.pdf
4. Government of Victoria. (1999). Designing workplaces for the safer handling of patients/residents.
http://www.safework.sa.gov.au/contentPages/docs/agedHandlingPatients.pdf
5. Creating and Maintaining a Safe Lifting Environment for Patients of Extreme Size. (2010).
http://www.safeliftingportal.com/hottopics/bariatrics.html
6. AS/NZ 1428.1-2009 and AS/NZ 1428.2-1992. Design for access and mobility.
7. Australasian Health Infrastructure Alliance. (2010). Australasian Health Facility Guidelines.
Revision v4. Part C. Design for access, mobility, OHS and security.
www.healthfacilityguidelines.com.au
8. The Facility Guidelines Institute. (2010). Patient Handling and Movement Assessments: A White
Paper (Cohen et al. - USA)
www.fgiguidelines.org
9. Wignall, D. (2008). Design as a Critical Tool in Bariatric Patient Care. Journal of Diabetes Science
and Technology, 2(2), 263-267
10. Kim, H. (2009). Universal Design: Meeting the needs of the Bariatric Population. Cornell
University.
11. Lipperman, G. & Preira, G. (2002). Accommodating the bariatric resident. Nursing Home Long
Term Care Management, 51(10), 82
12. Harrell, J.W. & Miller, B. (2004). Big Challenge. Designing for the needs of bariatric patients.
Health Facilities Management, 17(3), 34–38
13. Wilson, K. (2006). Commentary: Ergonomics and the bariatric patient. Bariatric Nursing and
Surgical Patient Care, 1(3), 173-177
The information contained in these Fact Sheets has been compiled by a Working Party, comprising:
• Jo Bills (Project Consultant)
• Hal Robertson (Member, SA Aged Care Industry OHSW Consultative Committee)
• Ingrid Ormay (Member, SA Aged Care Industry OHSW Consultative Committee)
• Chris Racar (Member, SA Aged Care Industry OHSW Consultative Committee)
The Fact Sheets are part of a larger project on "Management of bariatric (severely obese)
residents/clients in the aged care sector”, generously funded by Employers Mutual, as part of their
Member Benefits Program, and initiated by Elanora SYP Homes Inc.
It is intended for broad distribution and dissemination, in order to assist the Aged Care Industry to
manage the burgeoning issue of the management of Bariatric clients in Aged Care. We trust you find it
a useful reference.
Supported by