Healthy Lifesmiles

Development of an Oral Health Promotion training programme for nurses and carers of older people in

Co. Meath

Mary O’Farrell, Carmel Parnell, HSE Dublin North East

Background

Increasing aging dentate population

Numbers aged 65+

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Numbers aged 65+ and 80+

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Age 80+ as a proportion of age 65+

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% dentate aged 65+

Whelton et al., 2007

BackgroundOral health of older people in residential care is poorTraining of carers essentialNorth East Healthy Aging (2002) recognised need for oral health care for older people in residential care

Background

St Joseph’s Hospital, Trim, Co. MeathResidential and Day Care UnitPilot oral health needs assessment, 2004

Pilot study

254 older people examined o 104 residents, 150 Day Care users

Poorer oral health status among residentso Fewer teeth but more decayo No dentures

High need for denture treatment for both groups

Pilot study

Questionnaire to staff (n=54: 66% response rate)o Most were involved in oral health careo 1 in 5 had received training in oral health careo 98% interested in receiving training in oral health

care for older peopleo Low staff turnover

Development of Programme

2007: Pilot oral health programme developed in partnership with:o HSE Meath Dental

Serviceso HSE Meath Oral Health

Promotero HSE Managemento St Joseph’s Director of

Nursing, senior nursing and health promotion staff

Aim

Improve the skills of hospital staff in providing oral health care for residents

Objectives

Develop Model of Good Practiceo Establish ethos and standards for oral health

Develop structured training programme for nurses and carerso OHP resource packo OH aids

Provide denture markingEvaluate training programme

Model of Good Practice“These Oral Health Standards are

driven by a respect for the rights of older people and the principle that

older people in residential care settings should be able to lead full lives that reflect, as far as possible, the lives they led prior to admission into what will be their home - the

residential care setting. Consequently, the standards

promote a person-centred ethos and culture that should govern the

provision of residential care for older people.”

Summary of Standards

1. Oral health assessment on admission2. Denture labelling with the owner’s consent3. Suitable facilities for on-site dental treatment 4. Arrangements for emergency and routine dental care

for residents5. Suitable environment in which residents are able to

maintain their oral health6. Structured Training for Nursing and Care staff in oral

health care for residents7. Introduction of a healthy eating policy8. Regular ongoing oral care from nursing, care and

public dental service staff for residents with dementia

Training Programme

90 nurses and carers

Interactive workshops

Healthy Lifesmiles

Resource pack for staffo Information packo Tutor’s guideo 12 Information cardso Guide to oral hygiene aidso CD

Oral Health packs

Evaluation

Pre and post training questionnaires to workshop participantso Highlighted low awareness of oral health care

prior to trainingStaff very positive about training programme

Evaluation

“We are very tuned in now to what food we are giving the patients and tuned in to why patients may be having problems. We are bringing them regularly to the dentist and we are carrying out all the oral assessments”

Evaluation

Appreciation of oral health in context of general health“…the dietician visits the wards every week, so I don’t see it any different that the dentist should visit the ward, and that would help the transition from education for us”

“ So, it (poor oral health) really does impact on them. And the pork chop is gone, and the dinner is gone to custard, you know.”

Ways forward

New oral health policy for older peopleDisseminationOngoing evaluation

Acknowledgements

The Team:Mary CarrDorothy HalpinRosarii Mc CaffertyMairin Mc InerneyLiz O’ReillyRita O’TooleDeclan QuinnStaff and clients of St Joseph’s hospital, Trim