Seniors

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Seniors oral health planning for the
futureAuthor Jackie Smorang, BA, Dip DH,
MSEd
Presented by Dr. Luke ShwartManager, Community
Oral Health Serviceswww.calgaryhealthregion.ca/h
ecomm/oral/oral.htm APHA Conference
2003 Nov 17
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Overview

• A. What is oral health
• B. Seniors demographics
• C. Best practices review
• D. Status quo in Calgary
• E. Recommendations/Action Plan

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Persons age 65 y Calgary Health Region
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Seniors a continuum

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

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Independent-living adults edentulous (1991
Ontario)
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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)
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Seniors self assessment vs. professional
assessment (1995 Winnipeg)
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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
1999 B.C. Karen Moore
Resident Family
Community professionals
Care staff
Dental hygienist as coordinator
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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 strategies
• 5. 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 action

• a. 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 programs
• b. Review knowledge, attitudes and practices by
  care facility staff
• c. Develop standards/outcomes for care facilities
• d. 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 change

• a. 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