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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+
www.cso.ie
Numbers aged 65+ and 80+
www.cso.ie
Age 80+ as a proportion of age 65+
www.cso.ie
% 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