The Power to Heal

Manufacturers of beds and support surfaces are seeing their market expand, and they think HME providers who sell their equipment will, too — especially if that equipment is going to bariatric patients. The beds and support surfaces market — growing by leaps and bounds, according to industry leaders — is only going to get stronger, and product makers attribute much of this strength to the obesity epidemic in the United States.

“There’s been a marked increase in bariatric patients,” says Leigh Smith, director of marketing for Mellen Air. “Where before the bariatric bed frame was a peripheral item, now it is a necessity in the marketplace because of the change in the medical profile of our country.”

In fact, U.S. Surgeon General Dr. Richard Carmona made the headlines earlier this year when he said that obesity was more of a risk to Americans than any chemical or biological weapon Saddam Hussein might be hiding. In response, citing statistics that show 61 percent of U.S. adults and 13 percent of children are overweight, U.S. Senators Bill Frist, R-Tenn., Jeff Bingaman, D-N.M., and Christopher Dodd, D-Conn., introduced legislation this summer aimed at reducing obesity.

Along with recognition of the obesity problem in the general population, there has been a shift in how obese patients are viewed, from individuals who are at fault for their condition to individuals with genuine problems and needs that can be met with beds and support surfaces equipment. “More and more organizations are popping up, demanding care for these people,” says Len Feldman, owner of Big Boyz. “They’re no longer being treated as gluttons, but people with real problems,” he says.

Obesity used to be a shameful or embarrassing condition, experts say. “In the past, [obesity] was kind of tucked away,” says Duwayne Kramer, president of Leisure-Lift. “Today, more people are out there trying to get something done about it.”

More Equipment, More Often

One market factor recognized by both manufacturers and dealers is the sheer volume of equipment that bariatric patients require, and this doesn’t mean just the size of beds and support surfaces products. While these patients do need larger devices, explains Mani Cohen, president of Unicare, which recently began manufacturing bariatric mattresses, the nature of obesity means bariatric patients also require more equipment, more often.

“The services provided for a bariatric patient are considerably greater than those for a respiratory patient, for example,” Feldman points out. “This is really a field every dealer should become involved with. For any dealer who is lucky enough to get a bariatric patient, that patient will definitely need far more durable medical equipment than any other individual patient.”

Experts say caregivers need all the help they can get in caring for a bariatric patient, because what is required of that caregiver is often beyond the means of one individual. “It’s extremely difficult — even in the hospital with a lot of extra hands — to take care of a bariatric patient,” Kramer says. “In the home, you need as much equipment there as you can have because the caregiver is essentially on his or her own.

“We’re designing [bariatric products] as much for care of that person as for the person who cares for them, to make their life easier in that isolated area,” he continues. Such reasoning has led Leisure-Lift and other manufacturers to develop new devices, like a trapeze system for bariatric beds that uses gravity and mechanics to assist the caregiver in turning a bariatric patient.

Other beds and support surfaces manufacturers are mindful of caregivers, as well. “We continue to improve the product to make it easy for busy caretakers,” Feldman says.

Bigger is … Pricier

Challenges within the bariatric market niche abound, however, and manufacturers say meeting them isn’t always easy. “[Bariatric] products cost more because there’s so much more to them,” Feldman says. “The surfaces have to be different because of the weight of movement, for example. These are the problems bariatric manufacturers have to solve.”

Manufacturers of beds and support surfaces products must anticipate not only how the product may be used to help a patient or caregiver but also how the product may unintentionally injure or limit a bariatric patient. The federal government has stepped up regulation of the bariatric home care market, establishing rules for bariatric bed manufacturers to prevent confinement of a patient, for instance.

“Side rails are a big issue in beds” because of the notion that they serve as restraints on a bariatric patient, Kramer explains.

As new standards for side rails and other regulations continue to evolve, manufacturers in the segment say they are working to respond with equipment that addresses these issues. “It’s a challenge to meet the rules of the federal government; to satisfy all of the rules out there in this litigious society,” Feldman says. “Rules and regulations save lives, but it’s almost impossible to anticipate all the possibilities. What happens in the field can never be duplicated.”

Quality Heals All Wounds?

Beyond the focus on new standards, product development in the beds and support surfaces market is centered on wound care, according to market experts.

“Improving wound healing, that’s the future,” says Mark Ludwig, senior vice president for Sunrise Medical. “More focus is needed on this.”

According to Ludwig, the National Pressure Ulcer Advisory Panel (NPUAP) is continuing to work on an initiative to improve support surfaces standardization in the industry. The NPUAP’s goals are to educate people about terms and definitions, to evaluate the lifespan of products and to introduce a uniform testing approach for tissue integrity. Ludwig suggests clinical trials are needed to validate wound-healing rate assumptions. “These are clearly the key, and published work may be even more effective,” he says, “but progress is slow.”

Low-quality products on the market are blocking the way for progress in industry standards, manufacturers say. Newer materials, which are not necessarily cost-effective, lead to escalated prices and low-cost competition from overseas — what those at Leisure-Lift call “me, too” manufacturers. “They’re a challenge,” confirms Steve Allee, director of marketing for Leisure-Lift. “They come into the business without a lot of experience and offer a lower-quality product.”

Manufacturers point out that patients who purchase a lower-quality bed, especially obese patients who may buy a model unsuited for bariatric use, quickly learn their mistake. “You can add a couple of pieces of sheet metal [to a standard home care bed] and call it a bariatric bed, but it still might be too narrow. Unfortunately, in this case it’s an extremely expensive first venture when someone buys the wrong bariatric product,” Allee notes.

Manufacturers of beds and support surfaces are confident, however, that these low-cost players won’t last. “Eventually there will be a shakedown as people find out they bought the wrong product — that it’s not wide enough or there’s not enough support,” Allee says. “When something goes wrong with the bed, there’s nowhere to put the patient, and the dealer is on the hook when the end-user calls [him] in the middle of the night,” Allee says. “A bariatric bed is a 24-7 operation.”

A Place for Home Care Beds

The use of home care beds in nursing homes is a recent concern for manufacturers in the beds and support surfaces market. “Home care beds are not designed for nursing home use,” states Duwayne Kramer of Leisure-Lift. “They’re not designed to the same standards.”

Agrees Mark Ludwig of Sunrise Medical, “Clearly a home care bed wasn’t designed to meet the needs of a nursing home patient. Nursing homes look at home care beds as an alternative because of cost pressures, but the nursing home bed industry needs to take notice and improve their cost base.”

A home care bed is intended for just that — use in the home, these experts say, and dealers should be wary of selling such beds to nursing homes. “A dealer who does that puts [himself] in a dangerous position. It’s not an appropriate situation,” Kramer says.

Experts Interviewed:

Steve Allee, director of marketing, Leisure-Lift, Kansas City, Kan.; Mani Cohen, president, Unicare, Toronto, Ontario, Canada; Len Feldman, owner, Big Boyz, Ivyland, Pa.; Ingrid James, executive vice president, James Consolidated, Walnut Creek, Calif.; Duwayne Kramer, president, Leisure-Lift, Kansas City, Kan.; Mark Ludwig, senior vice president, Sunrise Medical, Longmont, Colo.; and Leigh Smith, director of marketing, Mellen Air, Long Beach, Calif.

Meeting Therapists’ Demands

Complementary products are gaining importance in the beds and support surfaces market, according to leading manufacturers. It’s not just bed frames and mattresses any longer, they say: Today’s market demands more, especially when it comes to a patient getting in and out of a home care bed.

Turning devices and transfer-assist products are increasingly popular, for example. Turning devices are essential for preventing skin breakdown or pulmonary complications, according to Ingrid James of James Consolidated. “Billions could be saved if people paid attention to prevention,” she says.

Mani Cohen of Unicare says transfer-assist products work to ensure that “patients are more secure and safe getting on and off beds.” He credits therapists for recognizing this need. “The pressure of therapists’ demands is driving changes in products,” he says.

As an alternative to a more obtrusive lift that reqires someone to operate the controls, transfer-assist products allow more flexibility of movement and more independence for the patient, Cohen says. “Patients are far better off,” he says.