Oral health care for institutionalised elders : caregivers' perspectives and outreach service

Abstract

Background and objectives: Population is ageing in many countries/regions. Hong Kong is facing the same challenge. Institutionalised elders are vulnerable to oral diseases. Caregivers in residential care homes play an important role in maintaining oral health of institutionalised elders. This project aimed (i) to understand the awareness and practices of caregivers regarding oral health care of elders and the obstacles caregivers faced, and (ii) to provide oral health education and service to caregivers, elders, and their families. Methods: 18 residential care homes for the elderly (RCHEs) in Hong Kong were recruited. Questionnaires were distributed to all 183 caregivers in these RCHEs to collect information on their demographic background, training experience, awareness and practice on oral care for elders, and barriers/difficulties they encountered. Oral health talks were given to caregivers, elders, and their families in 3 RCHEs. Dental checkups and fluoride treatment were provided to elders of these 3 RCHEs. Results: 110 (60.1%) caregivers responded to the questionnaire. The mean knowledge score in denture use and care was 2.8+/-0.9 (out of a highest possible score of 4). The mean scores in oral hygiene practices were 1.2+/-1.1 and 1.4+/-1.2 (out of a highest possible score of 4) for dependent and independent/partially dependent elders, respectively. The mean score of caregivers’ reaction to elders’ dental complaints and oral abnormalities was 7.1+/-1.4 (out of a highest possible score of 8). Caregivers who had attended formal training courses scored significantly higher in knowledge (p=0.006) and practice (p<0.001) as compared with their counterpart. Obstacles faced by caregivers were poor awareness/cooperation of elders, lack of families’ understanding and institutional support, heavy workload, and resource constraints. Oral health talks were given to 120 caregivers, elders, and their families; 38 elders received the dental service. Conclusions: The findings identified some areas for improvement, pointed to the necessity of providing professional training to caregivers, and highlighted the importance of engaging all stakeholders for better oral health care for institutionalised elders.