Caregivers’ perceived comfort regarding oral care delivery in group homes: A pilot study

Abstract

The purpose of this study was to investigate the perceived comfort, behaviors, and barriers reported by group home caregivers while providing oral health care to individuals with special healthcare needs (SHCN). A 23-item survey was sent to 428 caregivers in two group homes in Iowa. Bivariate and logistic regression models were used to analyze data (p ≤ 0.05). The overall response rate was 32%. An analysis of the bivariate and multivariate logistic regression indicated that caregivers who felt more comfortable providing care for individuals who verbally and physically resisted oral health care had worked more than 2 years at their current location (p = 0.0323), felt "neutral to very comfortable" brushing (p = 0.0020) and flossing (p< 0.0001) the teeth of individuals with SHCN, and reported "sometimes to always" experiencing these individuals not opening their mouths (p = 0.0127). Comfort in providing oral care to individuals with SHCN appears to be linked to experience and length of time working with this population.

At-home oral care for adults with developmental disabilities

“…Both paid and family caregivers reported that the greatest barrier to at-home oral care routines was the behavioral problems of adults with DDs, followed by lack of time and not enough help; these findings are consistent with those of previous reports from paid caregivers. 15,18,20 …”

“…Caregivers described flossing as the oral health activity most likely never performed in residences 20 ; Seirawan and colleagues 11 reported that only 11.8 percent of adults with DDs flossed at least once per day. Caregivers cited substantial behavioral and physical difficulties, 18 as well as lack of cooperation, 15,20 as major impediments to providing adequate at-home oral care. Other impediments included lack of time and staff shortages.…”

“…15,18 The percentage of caregivers who reported receiving instruction regarding the oral health care needs of people with DDs ranged from 27 percent 7 to 80 percent. 20 In contrast to the information available about paid caregivers, information about the oral health care role of family caregivers is almost nonexistent. According to the results of a study conducted by Pradhan and colleagues 12 in Australia, adults with physical and intellectual disabilities (PIDs) who lived with their families were less likely to receive assistance with oral health care than were adults with PIDs who lived in community residences or institutions.…”

Group home caregivers' comfort levels regarding physical resistance during oral hygiene care

“…7 Many of these barriers have also been reported in the SHCN population. Jobman et al 21 identified difficult behaviors in individuals with SHCN living in group homes, which included moving their heads uncontrollably, not opening their mouths, biting, spitting, and hitting the caregiver. It is reasonable to conclude…”

“…These results affirm that experience dealing with physical resistance can It is worth noting that an analysis of the bivariate results showed that the caregivers who were comfortable providing oral hygiene to consumers who physically resisted the care provided weekly direct care to a greater number of consumers; while spending more hours per week providing direct care for consumers approached a marginally significant level (p = 0.0545). In a pilot study of comfort levels of caregivers in group homes, Jobman et al 21 reported that caregivers who had worked more than two years at their current location felt "more comfortable" brushing, as well as flossing, the teeth of consumers with SHCN who verbally and physically resisted the oral care. These findings are important and suggest that comfort in providing oral hygiene care to this population may be linked to experience providing care for consumers with SHCN.…”