Finding into death of Colleen Mary Chapman

Contributing factors

• WHO Class IV obesity
• Moderate narrowing of all three major coronary arteries
• Absence of weight management plan
• Frequent provision of unhealthy foods despite morbid obesity
• Lack of dietitian involvement

Coroner's recommendations

1. Ensure Specific Health Management Plans are updated on a yearly basis or as care needs change
2. Advocacy for NDIS plans to fund required disability specific allied health supports including meal management plan reviews and updates
3. Implementation of weight management plans for obese residents with referral to dietitian and/or nutritionist
4. Development and implementation of nutritional diets to support weight loss
5. Engagement of customers in menu planning with embedded focus on healthy eating choices
6. Implementation of Weight Management Charts to monitor weight fluctuation with regular review
7. Referral of customers with mobility concerns to physiotherapist or occupational therapist for exercise programs
8. Expansion of clinical practice team capacity for allied health support and case conferences
9. Development of evidence-based resources to support customers' health and wellbeing including Scope's Supporting Healthy Eating Guide and Supporting Physical Activity Guide
10. Promotion of Heart Foundation Action Plans
11. Ensure all customers have up-to-date annual health assessments