Caregivers’ perceptions towards oral healthcare services for elders living in Malaysian nursing homes—A qualitative study

Abstract

Objective: To assess the perceptions of caregivers towards oral healthcare services received by elders in Malaysian nursing homes and to identify challenges and suggestions for improvement. Background: Caregivers play an important role in the oral health care of elders in nursing homes. Methods: This study employed a qualitative approach using the nominal group technique (NGT) to obtain caregivers' feedback in nursing homes in Malaysia. Data were manually transcribed, summarised into keywords/key phrases, and ranked using weighted scores. Results: In total, 36 caregivers (21 from government and 15 from private nursing homes) participated in the NGT sessions. Overall, caregivers were satisfied with the low treatment cost, the quality of treatment, and the availability of dental visits to nursing homes. Caregivers were dissatisfied with the frequency of dental visits, long waiting times at government dental clinics, and inadequate denture hygiene education for elders in nursing homes. The challenges faced by caregivers were elders' poor oral health knowledge and attitude and lack of elders' trust of caregivers to look after their oral health. Suggestions for improvement were to increase the frequency of dental visits to nursing homes, provide oral health education to elders and caregivers, and give treatment priority to elders at dental clinics. Conclusion: Despite being satisfied with the basic oral healthcare services received by elders in Malaysian nursing homes, caregivers raised some issues that required further attention. Suggestions for improvement include policy changes in nursing home dental visits and treatment priority for elders at government dental clinics.

Comparison of facilitators and barriers to providing oral hygiene measures in dependent older people and young children: A systematic review

“…Lack/different levels of knowledge How to perform OH among staff/ caregivers and patients/ elders/ residents 45‐50 Possibilities of dental professionals (e.g. dental hygienists) helping with OH 45 …”

“…No/ inadequate training of Hygiene education to elders 47 and staff 46,47 Oral health 59 Formalized training programs 47 …”

“…Oral health/ oral care Knowledge 49 Education and practical training (to staff and to the elders) 46,47,48 Training aids 49 …”

“…Communication Communication from dentist to staff or to elders 46 Poor attitudes among individuals' externals (dental care providers and families) 47 Poor interprofessional communication and referral to practices 45 Language barriers between staff and elders 46 …”

“…This ensured that every statement had been reproduced once. Our aim was to include young children that depend on help for maintaining adequate oral hygiene, and studies in children (and in dependent older people) were included regardless • Oral health 59 • Formalized training programs 47 Lack of skills • Among professionals and patients 48,49 Holistic view to care (oral care as part of basic care) 50 Oral health/ oral care • Knowledge 49 • Education and practical training (to staff and to the elders) 46,47,48 • Training aids 49 Professional experience 45 Lack of knowledge • How and why preventing oral disease due to language deficits 51 • About health possibilities 52 • Benefits of tooth brushing 52,53 • Of oral health (parents and children) status associated with higher level of dental knowledge 58 Lack of skills • Among parents 52 • Technically difficult 53,54 Oral health/ oral hygiene knowledge • Of parents 53- • Material and human resources 45,59 • Access to practical information 45 • Interprofessional training 45 • Financial incentives for collaborative or active and networking 45 • Knowledge regarding interaction OH-GH 50 • Prioritization 47,48 • Staff consistency 47 • Suitable electronic patient record system 49 • Too tired 59 • Care for oral hygiene is delegated to the patient or companion and (nurses) do not supervise 59 • Oral hygiene only performed for mobile patients 59 • Unclear responsibilities 50 • Hierarchical relations 50 Personal environment • Family engagement 47 Political level • Political attention 50 • Poor embedding of OHC in care policies, procedures, instruments and medical guidelines 45,47 • Integrative policies 45,…”