Nursing home executive directors' perception of oral care in long-term care facilities.

Abstract

Oral health in long-term care (LTC) facilities has been repeatedly documented as less than ideal. The complex nature of this environment has made it difficult to understand and improve the oral health status of residents through education and training. The purpose of the study was to investigate how the executive directors (EDs) of LTC facilities value oral health and to determine facility variables, which may influence how oral care is delivered. A mail survey of the EDs of all LTC facilities in Ohio (n = 1018) was conducted with 338 responses received after secondary follow-up (33.2% response rate). The 30-item survey included information concerning the nursing facility, the EDs, the EDs' perception of the level of oral health care, and value statements rated on a Likert-like scale. The results of the survey showed that more than two-thirds of the EDs were female and that most facilities were proprietary (70.3%). ED gender was not statistically associated with any of the oral health variables. Fifty-three percent of the EDs rated their residents' oral health as fair or poor but were still satisfied with the oral care provided at their facilities. The apparent discontinuity between perceived levels of oral health and satisfaction with oral care suggests that EDs are distanced from the oral care of their residents or they do not acknowledge oral health care needs. While the survey results revealed important facility characteristics and administrators' perceptions about oral health, the most important aspect of this project was the low response rate despite secondary follow-up. That, coupled with the negativity expressed upon follow-up, suggests a larger issue that may affect oral health in nursing facilities: oral health continues to have a low priority in this setting. Continuing efforts to improve oral health and educate LTC professionals about oral health's influence on general health is critical for managing the oral health of future generations of aging adults.

Oral Health Services in Long-term Care Facilities Between 1989 and 2003—Has Germany Seen any Progress?

“…Johnson and Lange 37 reported that 40% of home directors questioned were satisfied with the dental care provided. Pyle et al 38 reported that 63.4% of home directors were satisfied with the dental care in their facilities, although 49% of home directors rated the oral health of their residents as moderate to poor. These studies highlight the lack of awareness of dental problems amongst home directors.…”

Oral care measures for preventing nursing home-acquired pneumonia

“…In some guidelines, such as British Thoracic Society guidance on the prevention of CAP, oral hygiene is not mentioned (Lim 2009 ). Moreover, nurses have limited knowledge regarding provision of mouth care in general (Frenkel 2000;Jablonski 2005;Pyle 2005). Chiba 2009 reported that 32.4% of caregivers hesitated to provide oral care measures, which indicated their lack of knowledge about oral hygiene but bespoke oral health education has been shown to have a positive effect on caregivers' knowledge and attitudes (Charteris 2001;Frenkel 2001;.…”

Revising the Resistiveness to Care Scale

“…In earlier research, behavior meeting this definition was usually labeled as “uncooperative behavior” (Adams, 1996; Kambhu & Levy, 1993; Pyle, Jasinevicius, Sawyer, & Madsen, 2005), “disruptive behavior” (Algase et al, 1996; Kolanowski & Whall, 2000; Whall, 2002), or as “agitation” (Volicer, Bass, & Luther, 2007). Investigators in the past decade have made important distinctions between the latter construct and resistiveness to care.…”