Oral health assessment in domiciliary care service planning of older people

Abstract

Objectives:The aim was to examine importance and consideration of oral healthrelated issues (OHRIs) during service planning by the case managers (CMs). Methods and results:The study was conducted in a major Finnish city. All 25 CMs, supervising over 450 domiciliary care employees who are caring for 4600 domiciliary care clients, received a multiple-choice questionnaire with additional open-ended questions. CMs were dichotomized by age and educational background. Differences were compared with the chi-square test and Fisher´s exact test. Response rate was 88%. All CMs considered OHRIs important. However, OHRIs were not routinely considered during service planning, especially by the CMs with a social service than health background (0% vs 30%, P < 0, 0.056). OHRIs were considered never or seldom by 73% of the CMs. OHRIs were mostly considered after evaluating the overall need for domiciliary care. A lack of guidelines was reported by 45% of the CMs. Of the CMs, 41% could use their knowledge for paying attention to OHRIs. All CMs wished for better routines for paying attention to OHRIs. Conclusion:OHRIs are not routinely considered in service planning. This study indicated a need for structured guidelines and further education for assess the need for oral home care assistance. K E Y W O R D S domiciliary care, older people, oral health assessment Spec Care Dentist. 2019;39:485-490. wileyonlinelibrary.com/journal/scd 485

Perceived oral health and oral health behaviours among home‐dwelling older people with and without domiciliary care

“…However, the support needed is often not regularly carried out by those providing domiciliary care. 10,41 This study highlights the importance of constructing guidelines on how oral hygiene measures should be recognised in daily domiciliary care.…”

“…Oral health is not routinely assessed during domiciliary care planning, 10 and domiciliary care clients with functional limitations have poorer oral health 30 . Previous studies have focused on the clinical aspect regarding the oral health of home‐dwelling older people, with fewer studies examining the perceived or oral health behaviour of domiciliary care clients 30‐32 .…”

“…Yet, oral health is frequently neglected in caring and nursing, including domiciliary care. [8][9][10] Support for maintaining good oral health (cleaning teeth, mouth, dentures and regular use of oral healthcare services) is required among older people, as the need for aid increases when functional capacity decreases. 11,12 Older people are increasingly retaining more of their own teeth, 13 increasing the risk of oral diseases 14 and bringing new challenges in maintaining oral health with or without assistance.…”

“…24,25 Oral health-related quality of life (OHRQoL) also decreases along with non-regular oral health service use, 26 poor oral health and tooth loss. 23,25,[27][28][29] Oral health is not routinely assessed during domiciliary care planning, 10 and domiciliary care clients with functional limitations have poorer oral health. 30 Previous studies have focused on the clinical aspect regarding the oral health of home-dwelling older people, with fewer studies examining the perceived or oral health behaviour of domiciliary care clients.…”

The association of frailty with oral cleaning habits and oral hygiene among elderly home care clients

“…Especially among older people with cognitive impairment and compromised functional capacity, obtaining good standards of oral hygiene is difficult and such people are often dependent on support from relatives or caregivers. It has been suggested that home care services should also include determination of oral health-related issues and assessment of the need for oral health services (12).…”