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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
healthy communities
Overview
A. What is oral healthB. Seniors demographicsC. Best practices reviewD. Status quo in CalgaryE. Recommendations/Action
Plan
3Seniors’ oral health: planning for the future • APHA Conference 2003 November 17
healthy communities
Persons age 65+ y Calgary Health Region
89,200
154,700127,300
0
50,000
100,000
150,000
200,000
2002 2012 2016
4Seniors’ oral health: planning for the future • APHA Conference 2003 November 17
healthy communities
Seniors: a continuum
independent ------ need help ------ dependent
5Seniors’ oral health: planning for the future • APHA Conference 2003 November 17
healthy communities
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
6Seniors’ oral health: planning for the future • APHA Conference 2003 November 17
healthy communities
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
7Seniors’ oral health: planning for the future • APHA Conference 2003 November 17
healthy communities
Service usage by nursing home residents (2000 US)
17%25%
64%69%
88%
0102030405060708090100
medical nutritional social physicaltherapy
dental
Services
%
8Seniors’ oral health: planning for the future • APHA Conference 2003 November 17
healthy communities
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%
9Seniors’ oral health: planning for the future • APHA Conference 2003 November 17
healthy communities
Barriers to Dental Care
• lack of perceived need • financial constraints • transportation and
access difficulties• poor health
10Seniors’ oral health: planning for the future • APHA Conference 2003 November 17
healthy communities
Best practices
• Literature review• Working examples • Evaluation • Educational
institutions
11Seniors’ oral health: planning for the future • APHA Conference 2003 November 17
healthy communities
Problem: lack of evaluation• Measurement of changes
in oral health status of elderly is complex
• No universally accepted index
• More research needed
12Seniors’ oral health: planning for the future • APHA Conference 2003 November 17
healthy communities
Integrated Oral Health Care Model
Resident & Family
Care staff Community professionals
Dental hygienist as coordinator
1999 B.C. Karen Moore
13Seniors’ oral health: planning for the future • APHA Conference 2003 November 17
healthy communities
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.
14Seniors’ oral health: planning for the future • APHA Conference 2003 November 17
healthy communities
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
15Seniors’ oral health: planning for the future • APHA Conference 2003 November 17
healthy communities
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.
16Seniors’ oral health: planning for the future • APHA Conference 2003 November 17
healthy communities
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
17Seniors’ oral health: planning for the future • APHA Conference 2003 November 17
healthy communities
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)
18Seniors’ oral health: planning for the future • APHA Conference 2003 November 17
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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
19Seniors’ oral health: planning for the future • APHA Conference 2003 November 17
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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
20Seniors’ oral health: planning for the future • APHA Conference 2003 November 17
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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
21Seniors’ oral health: planning for the future • APHA Conference 2003 November 17
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Creating the Future
No single, simple, strategy
It requires effort, perseverance, resources and changes in attitude