1. Oral Health Program
for
Long Term Care Residents
Presentation to Saskatchewan Oral Health Coalition
November 4th, 2013
Audrey Harder, Speech Language Pathologist
Ashley White, Dental Health Educator
Healthy people. Healthy communities.
2. The Importance of Daily Oral Care
• The purpose of oral hygiene is to prevent the buildup of
plaque, the sticky film of bacteria and food that forms on
the teeth.
• The mouth is an important part of your body that enables
you to eat, talk and breathe. Cleaning your mouth daily
improves oral health and overall health.
Healthy people. Healthy communities.
3. • Access to proper oral health care is more
profound for seniors residing within a long-term
care facility.
• According to the Surgeon General’s report,
“nursing homes and other long-term care
facilities have limited capacity to deliver needed
oral health services to their residents, most of
who are at increased risk for oral diseases.”
Healthy people. Healthy communities.
4. Survey in LTC facilities - 2009
• Done to identify the current state of oral care
across 13 long term care facilities
– 71.2% of residents were dependent for oral care
across the facilities
– 13.2% required set-up help only
– No facility indicated that regular dental checkups and
cleanings were done
– 4 different policies were identified regionally, none
had been recently updated
Healthy people. Healthy communities.
5. Results:
1. Those with natural teeth: 94.4% of facilities fell in
the fair oral care category, 5.6% in the incomplete
oral care category.
2. Dentures: 88.9% of facilities fell in the incomplete
oral care category, 11.1% in the fair oral care
category. Typically, individuals with dentures did not
have their mouths cleaned, only their dentures.
3. No teeth (edentulous): 100% of facilities fell in the
incomplete oral care category.
Healthy people. Healthy communities.
6. What is a caregiver?
• What constitutes as a caregiver?
• Is it the person who provides direct patient
care?
• Is it the person who supervises those who
are providing direct care?
• Is the decision makers?
• Facility manager? VP’s? CEO? Board
members?
Healthy people. Healthy communities.
7. Goal of the Program:
• Improved oral health for residents of the long
term care facilities across the health region
consisting of oral assessments, individualized
daily oral care plans, regular dental check ups
and cleaning, and referral if necessary.
• A regional or PROVINCIAL standardized
program and policy.
Healthy people. Healthy communities.
8. Current status of project:
•
•
•
•
•
•
•
Cut Knife, Edam and St. Walburg
– initial assessment and first 6 month follow-up screening completed,
they are continuing to screen each resident every 6 months
Dr. Cooke – initial staff training was completed
Jubilee Home – questionnaire phase
Simplified staff education component by putting training module on
line, along with all staff quizzes on survey monkey.
Presented status of LTC project to PNHR Board Members. Made
recommendations, none of which were followed up with.
Met with our managers to discuss frustration, program at stand still.
Discussed RPIW at our championship site in Cut Knife. This did
not occur.
Healthy people. Healthy communities.
9. Current status of project:
•
Developed several policies for use in LTC. These were not
approved at the manager level.
• Met with rural clinical nurse educator for ideas/suggestions on how
to move forward. Developed 5 oral care audit questions for her to
use in facilities to evaluate how oral care is being delivered to
residents by staff – specifically SCA’s. These have yet been put into
use.
• Contacted SHR for permission to use their LTC program model.
• Meet with Cut Knife facility manager to discuss implementation of
new program next week.
Healthy people. Healthy communities.
10. Project Barriers:
•
•
•
•
•
•
•
Staff turnover
Scheduling conflicts
Staff buy-in
Oral care not a priority
Lack of oral care equipment
Transportation to dental offices for follow up care
No outside contract dental services or space available to
provide dental care in the facilities
• No PNHR ltc facilities have built in dental suites
• Finding a dental office that treats residents with
dementia or residents in wheelchairs
Healthy people. Healthy communities.
11. Conclusion
• Our goal has been to provide quality individualized
geriatric oral care to all LTC residents.
• Where do we go from here? How can we improve
access to oral care? What can we do better?
• How can we improve the current oral care regime in
facilities?
• How can we get LTC staff and facilities to recognize the
importance of oral health in relation to overall well-being.
Healthy people. Healthy communities.
