Oral health care in residential aged care services: barriers to engaging health-care providers

Abstract

The oral health of older people living in residential aged care facilities has been widely recognised as inadequate. The aim of this paper is to identify barriers to effective engagement of health-care providers in oral care in residential aged care facilities. A literature review was conducted using MEDline, CINAHL, Web of Science, Academic Search Complete and PsychInfo between 2000 and 2013, with a grey literature search of government and non-government organisation policy papers, conference proceedings and theses. Keywords included: dental/oral care, residential aged care, health-care providers, barriers, constraints, and limitations. A thematic framework was used to synthesise the literature according to a series of oral health-care provision barriers, health-care provider barriers, and cross-sector collaborative barriers. A range of system, service and practitioner level barriers were identified that could impede effective communication/collaboration between different health-care providers, residents and carers regarding oral care, and these were further impeded by internal barriers at each level. Findings indicated several areas for investigation and consideration regarding policy and practice improvements. While further research is required, some key areas should be addressed if oral health care in residential aged care services is to be improved.

Oral Health and Its Associated Factors Among Older Institutionalized Residents—A Systematic Review

“…Effective oral care to control plaque and promote oral healthcare includes proper tooth brushing and cleaning [37,38,41,98] and annual dental check-ups [42,75,76]. Primary care to promote oral health is crucial to help the institutionalized elderly population meet an acceptable level of oral health [37] and increase their awareness of oral healthcare [90,108]. To improve the motivation to regularly visit the dentist, an educational program should be developed for both institutionalized residents and caregivers.…”

An integrated oral health program for rural residential aged care facilities: a mixed methods comparative study

“…These problems are further exacerbated by residents’ physical and cognitive impairments, medical complications, and dependence on others to maintain their oral hygiene [ 14 – 16 ]. Several barriers to accessing oral health services have been suggested and include: accessibility of Dentists for RACF residents (particularly in rural areas); limited or non-existent referral pathways to access dental treatment; high costs of transporting residents to a Dentist; and significant issues with moving residents from familiar surroundings to be seen at an oral health clinic (particularly residents with dementia) [ 17 – 22 ]. Evidence also suggests that RACF staff often lack knowledge of the specific oral hygiene requirements of older people, have limited time for adequate oral care and may also have poor attitude and awareness towards oral health [ 23 – 26 ].…”

Geriatric dentistry, teaching and future directions

“…Qualitative research has indicated that older individuals perceive that some clinicians and services lack an understanding of the context in which their older patients live . Additionally, the context of aged care itself is changing, with an increasingly multidisciplinary approach to care and increasing care in the home …”