In a quiet Australian nursing home, Mary*, a 72-year-old resident with a body mass index (BMI) of 45, faces daily struggles that many of us might overlook. Transferring from her bed to a wheelchair requires two staff members and a specialised hoist — equipment her facility only recently acquired after years of underfunding.
For Mary, the lack of tailored bariatric care means longer wait times for assistance, increased discomfort, and a sense of being a burden. Her story reflects a broader challenge: Australian nursing homes are grappling with rising obesity rates among residents, and many are unprepared to meet the complex needs of bariatric care.
Obesity is a major public health issue in Australia, with around 62% of adults classified as overweight or obese. Alarmingly, this trend continues into older age:
A 2013 US study, applicable to Australia’s context, found that obese nursing home residents need significantly more staff time — up to 60 extra minutes for tasks like bathing, compared to those of average weight. With Australia’s aged care sector already facing critical workforce shortages, the increasing demand for bariatric care further strains limited resources.
The AIHW notes that aged care residents are increasingly frail, with just 15% considered independently mobile. For bariatric residents, this frailty is compounded by obesity-related conditions such as diabetes, heart disease, and reduced mobility. This results in a need for custom equipment, skilled staff, and often double the handling requirements per task.
Outside of aged care facilities, the challenge extends to family carers and community-based care workers. Many older Australians living at home with obesity rely on support for personal hygiene and mobility.
Carers often face unsafe conditions when attempting to assist with showers, transfers, or toileting due to limited access to hoists, bariatric equipment, or wider spaces in traditional homes. This not only increases the risk of injury for carers, but also compromises the dignity and safety of the person receiving care.
With more people opting to stay in their homes for longer, bariatric planning and training in home care packages is becoming just as critical as it is in residential settings.
The Royal Commission into Aged Care Quality and Safety (2018–2021) exposed systemic failings across the sector — from staffing and training gaps to lack of infrastructure.
Nearly 60% of nursing homes operate below international benchmarks for safe staffing. Bariatric care requires two or more carers for most tasks, but current staffing ratios rarely allow for this without sacrificing care elsewhere.
Manual handling risks are also severe. Bariatric residents increase the physical strain on carers by up to 30%, making injuries more likely. Yet many facilities still lack proper hoists, slide sheets, or bariatric beds, forcing staff to improvise in ways that are unsafe for both parties.
Training is also lacking. A 2025 study found that one-third of bariatric nurses in Australia had not attended relevant CPD in the past year. Key topics needed include safe positioning, equipment use, and obesity-related health management.
A major, often overlooked challenge is that many aged care homes were not designed for larger-bodied residents.
As obesity in older Australians rises, there is growing pressure on aged care providers to retrofit old facilities or build new ones with bariatric care in mind, with wider doors, larger bathrooms, reinforced flooring, and ceiling hoist tracks as standard.
Yet this raises an important funding question: Will the Australian Government provide subsidies or capital support for existing providers who need to renovate or rebuild to accommodate bariatric residents?
Currently, no specific capital grants or funding streams are earmarked for this purpose, leaving older facilities at risk of falling behind, or excluding obese residents altogether.
Addressing these challenges will require action on several fronts:
As projections indicate a growing number of older Australians living with obesity, the demand for bariatric care will accelerate. Without planning, Australia risks a future where vulnerable residents like Mary are left behind, or unable to access aged care at all due to limitations in infrastructure, equipment, or staff.
The question is no longer whether bariatric care should be a focus, but whether our system can adapt fast enough.
Mary’s story is a call to action. With the right investment in equipment, staffing, design, and policy, Australia can provide aged care that is both inclusive and dignified. But to do that, we must move from awareness to action now.
