Community oral healthhealth promotion & disease prevention healthy communities Seniors’ oral health: planning for the future Author: Jackie Smorang, BA,

community oral healthhealth promotion & disease prevention

healthy communities

Seniors’ oral health: planning for the

futureAuthor: Jackie Smorang, BA, Dip DH,

MSEdPresented by Dr. Luke ShwartManager, Community Oral Health Services

www.calgaryhealthregion.ca/hecomm/oral/oral.htm

APHA Conference • 2003 Nov 17

2Seniors’ oral health: planning for the future • APHA Conference 2003 November 17

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Overview

A. What is oral healthB. Seniors demographicsC. Best practices reviewD. Status quo in CalgaryE. Recommendations/Action

Plan


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Persons age 65+ y Calgary Health Region

89,200

154,700127,300

0

50,000

100,000

150,000

200,000

2002 2012 2016


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Seniors: a continuum

independent ------ need help ------ dependent


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Independent-living adults: % edentulous (1991 Ontario)

16.8%

30.2%

40.8%

05

101520

253035

4045

50-64 65-74 75+

Age (y)

% e

dent

ulou

s


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Edentulism: age or cohort?Older adults:• inferior access to care over lifetime• less sophisticated dental treatment• determinants of health

– disadvantaged– low income– uninsured– less educated


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Service usage by nursing home residents (2000 US)

17%25%

64%69%

88%

0102030405060708090100

medical nutritional social physicaltherapy

dental

Services

%


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Seniors’ self assessment vs. professional assessment (1995 Winnipeg)

Professional assessment: need care

100%89%

0%

20%

40%

60%

80%

100%

dentate edentulous

Self-rated oral health:good or average

94%

0%

20%

40%

60%

80%

100%


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Barriers to Dental Care

• lack of perceived need • financial constraints • transportation and

access difficulties• poor health


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Best practices

• Literature review• Working examples • Evaluation • Educational

institutions


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Problem: lack of evaluation• Measurement of changes

in oral health status of elderly is complex

• No universally accepted index

• More research needed


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Integrated Oral Health Care Model

Resident & Family

Care staff Community professionals

Dental hygienist as coordinator

1999 B.C. Karen Moore


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Recommendations Summary• Education and information (oral health

linkage to general health) needed for seniors, health professionals, caregivers and policy-makers.

• Include oral health in Seniors’ Programs assessments.

• Oral care standards for residents in regional care facilities.

• Targeted dental treatment program for at-risk low-income seniors.


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Action Plan — 5 parts

1. Initiate accord across all Regional programs

2. Use health promotion strategies to generate awareness and action

3. Identify gaps and priorities

4. Generate innovative strategies5. Advocate for change


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1. Initiate accord across all Regional programs

a. Oral care is an essential element of primary care and integral to the general health and well-being of older adults

b. Include oral health in seniors’ general health assessments

c. Collect oral health information.


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2. Use health promotion strategies to generate awareness and actiona. Raise awareness among

seniors, professionals, policy-makers, health care personnel, the public

b. Improve knowledge among Regional health care providers

c. Develop partnerships in the seniors’ community to generate and leverage oral health promotion


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3. Identify gaps and priorities

a. Review current Regional programsb. Review knowledge, attitudes and practices by

care facility staffc. Develop standards/outcomes for care facilitiesd. Develop a continuing education plan for

Regional dental staff re: oral care needs of the elderly

e. Identify seniors’ oral health needs and priorities– seniors’ focus groups– dental health professionals

f. Report (for future program planning)


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4. Generate innovative strategies

a. Develop innovative pilot project(s)

b. Improve communication and cooperation between individuals and agencies (re: seniors’ oral health)

c. Evaluate projects and initiatives– impact on seniors’ oral health– assist in resource allocation

d. Share information about ways to improve seniors’ oral health care


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5. Advocate for changea. Advocate for

provincial standards for care facilities

b. Advocate revised provincial regulations for Dental Hygienists

c. Advocate that all students in health professions learn oral health needs of seniors


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Vision

General awareness of importance and implications of seniors’ oral health Oral health services to seniors in various

living situations Oral care programs sensitive to concerns

of the elderly and reflect the diversity of their financial, physical and mental conditions

No financial and physical barriers to care


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Creating the Future

No single, simple, strategy

It requires effort, perseverance, resources and changes in attitude

Documents

Community oral healthhealth promotion & disease prevention healthy communities Seniors’ oral health: planning for the future Author: Jackie Smorang, BA,